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5 Things You Need to Know About Abdominal Strain

by
author image Dr. Tina M. St. John
Tina M. St. John runs a health communications and consulting firm. She is also an author and editor, and was formerly a senior medical officer with the U.S. Centers for Disease Control and Prevention. St. John holds an M.D. from Emory University School of Medicine.

Whether you're an elite athlete, a weekend warrior or simply enjoy an active lifestyle, an abdominal strain can leave you on the sidelines. Also known as a pulled abdominal muscle, this injury involves overstretching muscle or tendon fibers that results in a mild to severe tear. An abdominal muscle strain often occurs suddenly, but it can develop more gradually due to overuse. Learning a few facts about abdominal strains can help you identify this injury and point you in the right direction on the road to recovery should you develop this ailment.

How an Abdominal Strain Occurs

As many athletes and fitness buffs know, there are 3 types of muscle contractions: isometric, concentric and eccentric. Eccentric contractions occur when a muscle is lengthening against a load, such as when you're lowering your torso to the floor while doing sit-ups. Given this, you might have already guessed that abdominal strain injuries occur when your ab muscles are engaged in eccentric contraction and stretched to their maximum capacity. While abdominal strains occur less frequently than those of the legs or back, they are relatively common injuries. Most abdominal strains involve microscopic or partial tears. A complete abdominal muscle rupture is rare.

Activities Associated With an Abdominal Strain

An abdominal strain usually occurs while participating in a sport or physical activity that involves frequent, forceful stretching and twisting of your abdominal muscles. Common examples include:
-- Tennis, handball and squash.
-- Volleyball, basketball and hockey.
-- Lacrosse and baseball, especially batting and pitching.
-- Golf, rowing, swimming and diving.
-- Pole vaulting, hurdling and high jumping.
-- Weightlifting and workouts targeting the abs.

A high-force blow to your abdomen can also cause an abdominal strain. This mechanism of injury might occur with a motor vehicle or cycling accident, or while participating in a contact sport, such as football, boxing or mixed martial arts.

Signs and Symptoms

Abdominal strains hurt. With an acute tear, meaning one that happens suddenly, you'll likely experience intense, sharp pain at the site of the injury. Strains due to ongoing overuse cause similar but milder pain, which builds in intensity over time with continued use of the injured muscle. With a strain in one of your obliques, the pain typically occurs on the side of your abdomen -- usually along the lower border of your rib cage or, less commonly, along the front of your hipbone. Rectus abdominis muscle strains usually cause lower abdominal pain, originating about 2 inches below your navel and commonly extending into your groin. Less frequently, the pain occurs higher in your abdomen, near the midline extending from the lower border of your breastbone to your pubic bone.

The site of an abdominal muscle tear is typically tender, and you might notice swelling in the area. The affected muscle might also cramp. Movements and activities that engage the injured muscle, including coughing, sneezing, deep breathing and lifting, aggravate abdominal strain pain.

Getting Back Into the Game

If you sustain an acute abdominal strain, stop your current activity. Applying ice or a cold pack to the area for 15 to 20 minutes several times daily for the first 24 to 48 hours can help limit pain and swelling. After the first few days, taking an over-the-counter pain reliever -- such as aspirin, ibuprofen (Advil, Motrin) or naproxen (Aleve) -- might help control your pain. Your doctor might recommend a steroid injection at the site of the tear if your injury is caused by overuse.

Whether your abdominal strain occurs acutely or results from protracted overuse, resting the injured muscle is key to your recovery. In other words, don't try to power through the injury. Doing so can lead to a more severe tear and will prolong your recovery. For a mild strain, expect to be sidelined for roughly 2 to 10 days. Recovery time for a moderate strain is usually 2 to 6 weeks. A severe strain might require surgical repair and up to 10 weeks of recovery time. Once your pain is gone, your doctor may recommend physical therapy to aid with your recovery, address any core muscle imbalance and get you back to your regular activities.

When to Seek Medical Care and Warning Signs

A minor abdominal strain might not require medical care -- if your only symptom is mild, localized pain that goes away with a few days of rest. However, it's important to see your doctor as soon as possible if your pain persists or worsens. Seek immediate medical care if you sustained a blow to your abdomen or if your abdominal pain is moderate to severe or is accompanied by any warning signs or symptoms, including:
-- Painful abdominal wall bulge.
-- Abdominal wall bruising.
-- Nausea or vomiting.
-- Bloody or black stool.
-- Dizziness, lightheadedness or loss of consciousness.
-- Fever or chills.
-- Paleness or clammy skin.
-- Rapid heart or breathing rate, or both.
-- Shortness of breath or other breathing difficulty.

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