Abdominal Strain

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An abdominal strain is the result of overstretching or tearing of one or more of the abdominal muscle fibres. It usually causes abdominal pain and swelling together with additional symptoms depending on the severity of the injury.

Another name for this injury when it involves only overstretching of muscles is a pulled abdominal muscle.

Typically, it involves a lower abdominal muscle fibre at or below the belly button.  The three groups of muscles that can be affected are the transverse abdominis, internal and external obliques and the rectus abdominis.

This type of sprain is fairly commonplace among athletes who train or compete intensively in a sport. The core muscles play a key role in performing many sports or exercises. Injuries to these muscles are therefore relatively frequent.

Like most other muscle strains, an abdominal strain is typically treated at home using rest, icing, compression and elevation.


Abdominal muscle strains are sometimes confused with hernias, and the two injuries sometimes have similar symptoms. However, they are in fact quite different.

An abdominal hernia is caused when an internal organ  starts to protrude through the abdominal wall of tissue. We will briefly summarize hernia symptoms below.

Causes of Abdominal Strains

Most abdominal muscle strains are the result of one of the following:

  • Activity for which the muscle is not prepared through prior exercise;
  • Excessive exercise, i.e. an overuse injury;
  • Playing a sport with incorrect technique;
  • Lifting heavy objects. Again, lifting with an improper technique is behind many of these injuries;
  • Sharply twisting the body, a movement that happens frequently in many sports.
  • Sharp and uncontrolled expiration such as that caused by coughing, laughing or sneezing.

Risk Factors

Your risk of experiencing a stomach muscle strain is greater if you had previously experienced one.

In addition to this factor, your risk of this type of strain increases if:

  • Your muscles are fatigued;
  • Your muscles are tight, probably due to inadequate warming up or stretching before commencing activity.

Grades of Abdominal Strain & Their Symptoms

Abdominal strains can be divided into three categories or grades depending on the severity of the injury. The symptoms of a strain depend on the grade of the injury experienced.

Grade 1

This is a strain caused by mild stretching of one or more of the abdominal muscle fibres, but without any tearing. You may experience abdominal pain at the site of the injury and mild swelling. Your transverse abdominis muscles may be the ones injured. If so, you may also experience increased pain at the injury site when you laugh, cough or sneeze.

Grade 2

This usually involves partial tearing of one or more muscle fibers, but not a complete rupture.  Pain and swelling are generally more severe than with a Grade I strain. Additionally, you will likely experience localized bruising and skin discoloring.

Your abdomen will probably feel “tender to the touch” at the site of the injury.

You will find it difficult to move without experiencing pain – possibly severe.

You may also experience occasional muscle spasms.

If you think you may have experienced a grade II strain, you should contact a healthcare professional for medical advice.

Grade 3

Victims of a grade 3 sprain have experienced a complete rupture of one or more abdominal muscles. In addition to the Grade 2 symptoms described above, you may experience nausea, vomiting and difficulty breathing. Your heart beat may also become shallow and/or rapid.

If you think you have experienced a Grade III injury, you should have someone call for emergency care. While waiting for care to arrive, try to keep as still as possible. If possible, have someone apply an ice pack to the injury site and monitor your vital signs (heartbeat, breathing) carefully.

Hernia Symptoms

People who experience a hernia may have signs and symptoms similar to those of a grade III abdominal strain. However, with a hernia, you may notice a bulge in the abdominal area. You may also experience constipation, nausea and vomiting.


This injury is usually a result of sports activity. Hence, you should have your diagnosis done by a sports medicine specialist if possible.

To perform the diagnosis, the doctor will probably ask you to describe your symptoms in detail. He or she may also ask for additional information about how the injury happened. For example, you may be asked what you were doing at the time of the injury. The doctor may also ask about abdominal muscle injuries that you may have suffered.previously.

Having reviewed your symptoms and medical history, your doctor will likely move to a physical examination. He or she will likely palpate (examine by touch or feel) the site of the injury. The goal will be to ascertain its exact location. He may also perform tests of your abdominal muscle strength.

It is unlikely that either imaging studies or blood tests will be needed.


Your treatment plan for an abdominal strain will likley include most of the following.


Your doctor will recommend that you abstain from vigorous physical activity for a while. Ditto for anything that may stress the abdominal muscles. The idea is to allow the injured muscles a chance to rest and recover naturally.


Apply an ice pack or cold compress to your injury every 2-3 hours for periods of about 20 minutes. The idea is to reduce blood flow through the injury site and, with it, pain and swelling. Do this for 2-3 days or until the pain and swelling have receded significantly.

Pain Relief Medication

If the pain & inflammation are severe, you can try an over the counter inflammation fighting drug (NSAID). Good options to try include  aspirin, Ibuprofen or Naproxen. If the pain is your main concern, a simple pain killer like Tylenol may be adequate.


Once your pain and swelling have largely gone away, you can start to apply compression to your injury. Compression will improve blood flow through the area and bring nutrient rich blood to aid healing. A tensor bandage or compression garment like the EmbioZ Waist Support Compression Top can help achieve this.


Try to keep the site of the injury above heart level as much as possible, e.g. when lying down.

Physical Therapy

Consult with a physical therapist for an exercise program to stretch and strengthen your core muscles. It will help to reduce your chances of experiencing another abdominal strain after your return to regular activities.

In the vast majority of cases, the above treatments will be adequate to treat an abdominal strain. Unless there has been complete and/or significant muscle fiber tearing, surgery is not needed.

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