How to Treat a Pulled Abdominal Muscle (2024)

A pulled abdominal muscle is an overuse injury that often happens in sports or when lifting something heavy. The muscle is stretched too far, causing tiny, microscopic tears. It's also known as an abdominal muscle strain or pulled stomach muscle.

Symptoms include abdominal pain, muscle spasms, and weakness. The initial treatment includes rest and ice, followed by gentle exercise. In some cases, physical therapy may be needed.

Symptoms

The main symptom of a pulled ab muscle is pain in the area of the muscle strain. Depending on the affected muscle, the pain may be in the upper, middle, lower, or right or left side of your abdomen.

You have four groups of abdominal muscles:

• Rectus abdominis: The long, flat muscle that runs along the center from the bottom of your rib cage to the pubic bone and makes up the "six-pack" abs.
• External obliques: The side muscles run diagonally from the center of your ribs to the top of your hip bones.
• Internal obliques: Deeper side muscles rundiagonally from the front of the hip bone to the lower ribs.
• Transversus abdominis: The deepest layer of your abs is a horizontal band of muscle that wraps around the torso from the ribs to the pelvis, like a corset.

These muscles stabilize the core, rotate the torso, and flex the spine. A strain in these muscles can cause pain when you move in various directions.

Pain may be felt in the immediate area of the injury, cover a wider area, or extend to your back, hip, or groin. Other symptoms of a pulled abdominal muscle include:

• Difficulty engaging your core muscles
• Muscle cramps
• Muscle spasms
• Muscle tenderness
• Muscle weakness
  
• Swelling and inflammation
  

Causes

Abdominal muscle strains can be caused by muscle overuse, injury, or poor conditioning. Among athletes, pulled abs are a common sports injury in baseball, hockey, and soccer.

Any activity that engages the muscles with excessive force can lead to an abdominal muscle stain, including:

• Excessive or very intenseexercise
• Lifting heavy objects, especially with improper lifting technique
• Sudden twisting of the torso
• Vigorouscoughing, sneezing, or laughing

A strain in the internal or external obliques is often caused by sudden, powerful twisting motions like those seen by a baseball pitcher or a javelin thrower.

Poor conditioning or an imbalance in core-muscle strength can make you more vulnerable to abdominal muscle strain. Research shows a size difference between the right and left rectus abdominis increases the strain risk.

Diagnosis

Your healthcare provider can diagnose a pulled abdominal muscle based on your symptoms and after ruling out other causes of pain. They'll order an X-ray if they suspect that you have any broken bones in your rib cage.

Abdominal muscle strains are graded according to the severity of the injury:

• Grade I (mild): Mild discomfort, which usually does not limit activity
• Grade II (moderate): Moderate discomfort, which may limit the ability to perform activities such as bending or twisting movements
• Grade III (severe): Severe injury that can cause pain with normal activities, often with muscle spasms and bruising

Pulled Muscle vs. Appendicitis

A pulled stomach muscle on the right side can be mistaken for appendicitis. They both cause abdominal pain on the right side that worsens when you cough, sneeze, or move around.

Appendicitis pain, however, starts suddenly without an apparent cause and worsens in hours. Appendicitis also has additional symptoms like:

• Fever
• Loss of appetite
• Nausea
• Vomiting

Pulled Muscle vs. Hernia

A strain in the lower abdominal muscles is sometimes referred to as a sports hernia, a soft-tissue injury in the lower abdomen or groin.

A sports hernia is different than an inguinal hernia, which occurs when tissues in the abdomen push through a hole in the abdominal muscles.

While the symptoms are similar, an inguinal hernia will often cause a bulge on the belly's surface. However, a pulled ab muscle or sports hernia can lead to an inguinal hernia.

Treatment

Treatment for a pulled muscle typically involves rest, ice, compression, and elevation.

However, treating an ab muscle strain is a little trickier. There's no way to splint it, and it's nearly impossible to rest your abs fully.

Initial treatment for an abdominal muscle strain includes the following:

• Try to find a comfortable position that allows the muscle to relax.
• Apply ice to the injury for 10 to 15 minutes every hour for the first day, then every two to three hours until you are feeling better.
• Avoid exercise and activities that cause pain or spasm in the abdominal muscles.

After the first three days, you can apply ice or moist heat (eg, a hot water bottle or a steam towel). Try gently stretching the muscles and gradually increasing your normal activities. Listen to your body's cues; avoid movements that cause pain, and don't overdo it.

Once the pain has resolved, you can slowly return to exercise. It may help to apply moist heat before exercising to loosen the muscle. Apply ice after exercise to reduce inflammation and ease post-exercise soreness.

Sometimes, a pulled abdominal muscle requires physical therapy or surgery to heal fully.

When to See a Healthcare Provider

Physicians and physical therapists can recommend treatments that may speed your recovery. You should be evaluated by a doctor if:

• You have symptoms of a severe abdominal strain.
• Your injury is interfering with daily activities like walking, sitting, or sleeping.
• You are not sure if you have an abdominal strain or another condition.
• Your symptoms are not improving after a week.
  

How to Prevent Reinjury

Once the injury is fully healed, you can avoid another strain by practicing some preventive tips:

• Never overexert yourself while exercising.
• Avoid exercises with explosive, "jerking" movements.
• Focus on isometric resistance exercises to strengthen your core muscles with steady and controlled movements.
• Avoid hyperextending your back (bending too far backward) when lifting weights.
• Tighten your core muscles if you have to cough or sneeze.
  

Summary

A pulled abdominal muscle can cause pain that ranges from mild discomfort to severe pain that makes everyday activities difficult. It's often caused by a sports injury, overuse, or poor muscle conditioning. Abdominal muscle strains usually resolve with at-home care.

A mild strain should heal in a week or two, but more severe strains can take several months. If the pain is severe, impacts your ability to function, or does not show signs of improving after a week, see your healthcare provider. Physical therapy or surgery may sometimes be needed.