The oblique muscles make up 2 of the 4 abdominal muscle groups in the body and are separated into internal and external segments. These core muscles play an important role in many common activities, including sitting, standing and walking. A strain injury to one or both of the abdominal obliques -- which occurs when the muscle is overstretched or partially torn -- can be both painful and debilitating.
An oblique strain is usually characterized initially by sudden, sharp pain in or around the rib cage. The area is often tender to touch, and a bruise may develop, depending on the severity of the injury. Twisting and bending motions are typically painful. The oblique muscles are more active while sitting up than while lying down. As a result, even sitting or standing may be painful following an oblique strain. Deep breathing, sneezing or coughing also commonly elicits pain.
The oblique muscles are active during forward bending, side bending and twisting movements. Therefore, a strain is usually preceded by one of these motions. These types of injuries are frequently associated with sports such as baseball, golf or tennis. Higher-intensity exercises targeting the abdominal muscles, such as sit-ups or crunches, can also be responsible. However, even something as simple as chronic coughing or sneezing can cause an oblique strain.
Oblique strains can take up to 10 weeks to resolve. Treatment for an oblique strain typically includes icing the affected area, avoiding aggravating activities and taking antiinflammatory medication -- such as ibuprofen (Advil, Motrin) or naproxen (Aleve) -- if advised by your doctor. As the pain subsides, stretching and core-strengthening exercises may be gradually reintroduced as you're able to tolerate them without pain.
Warnings and Precautions
The occurrence of an oblique strain is often obvious when symptoms occur in close chronological proximity to specific types of activity. When the pain is delayed, however, the cause may not be as certain. Other medical conditions can also cause pain in the side area where the obliques reside, including rib fractures, pleurisy and other lung conditions, and diseases of the heart, stomach, liver and gallbladder, among others. See your doctor for any unexplained, persistent, worsening or severe chest or abdominal pain in the area of the obliques, especially if accompanied by other symptoms. Seek emergency medical care if you experience difficulty breathing, shortness of breath, or dizziness or fainting.
Reviewed by: Tina M. St. John, M.D.
- American Journal of Sports Medicine: Abdominal Muscle Strains in Professional Baseball 1991-2010
- Physical Therapy: Differential Diagnosis and Treatment in a Patient With Posterior Upper Thoracic Pain
- British Journal of Sports Medicine: Uncommon Abdominal Muscle Injury in a Tennis Player: Internal Oblique Strain