1. What is it?
An abdominal muscle strain is an excessive stretching or tearing of one or more of the four abdominal muscles. These muscles are the rectus abdominus (the “six pack” muscle in the front of the abdomen), internal oblique, external oblique and transverses abdominus muscles.
2. What are the causes/predisposing factors of injury?
Causes of injury vary. Too many crunches done too aggressively or with poor technique can strain the muscle, as can overstretching the area by a twisting movement or a backward bending movement. A sudden cough or sneeze may also cause injury.
Predisposing factors include poor conditioning of the muscles and lack of an appropriate warm up prior to activity.
3. What are the symptoms?
As with all muscle strains this injury is graded from a 1 to a 3 based on severity. A “1” is overstretching of the muscle fibers with no tearing, while a “3” is a complete rupture. A grade 1 injury may not present as pain initially, but may be felt later as localized soreness over the injury site. Grade 2 and grade 3 injuries are usually felt immediately and may present as spasm, swelling and later bruising over the site. A grade 3 injury may additionally present as a hernia or defect in the involved muscle.
Generally, abdominal strains will make it painful to do a sit up, bend backwards, and sometimes twist from side to side depending upon the specific muscle involved.
4. What can be done to prevent or treat this injury?
Treatment can be challenging since you cannot splint the area and it is nearly impossible to rest the abdominal muscles. Avoiding activities that aggravate the injury is essential. Icing and use of anti-inflammatories can be of benefit as is gentle pain free stretching. In cases of a complete rupture, surgical repair may ultimately be necessary.
Prevention is simple. Make these muscles stronger and perform appropriate warm up procedures prior to activity. There are numerous abdominal strengthening exercises in the form of crunches and core stabilization programs. These are important for proper posture as well as reducing the likelihood of low back pain. All runners should be doing some type of these exercises to reduce the chance of injury not only in the abdominal area but in the low back as well.