Orthopedics Sprains & Strains Pulled Abdominal Muscle Symptoms and Treatment By Jonathan Cluett, MD Jonathan Cluett, MD LinkedIn Twitter Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Updated on August 08, 2022 Medically reviewed by Stuart Hershman, MD Medically reviewed by Stuart Hershman, MD LinkedIn Stuart Hershman, MD, is a board-certified spine surgeon. He specializes in spinal deformity and complex spinal reconstruction. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Severity When to See a Doctor Treatment How to Prevent Reinjury Frequently Asked Questions An abdominal muscle strain, also called a pulled abdominal muscle, is an injury to one of the muscles of the abdominal wall. A muscle strain occurs when the muscle is stretched too far. When this occurs, the muscle fibers are torn. Most commonly, a strain causes microscopic, or tiny, tears within the muscle. Occasionally, in severe injuries, the muscle can rupture or break from its attachment. Here's a closer look at the symptoms of an abdominal muscle strain, along with tips for preventing and treating this type of injury. The Abdominal Wall The abdominal wall is made up of several muscles, including:Rectus abdominis: The muscle over the front of the belly that gives you a "six-pack" appearance when it's well developedInternal and external obliques: Wrap around the sides of the body and help you bend Symptoms Verywell / Emily Roberts Symptoms of abdominal muscle strains include: Immediate pain in the area of the injured muscleDifficulty flexing the muscle because of this painMuscle spasm of the injured muscleSwelling and bruising An abdominal strain is sometimes confused with an epigastric hernia. This condition is when tissues in the abdomen push through the abdominal muscles. While the symptoms are similar, a hernia will often cause a bulge on the surface of the belly. Severity Abdominal muscle strains are graded according to the severity of the injury: Grade I (mild): Mild discomfort, which usually does not limit activityGrade II (moderate): Moderate discomfort, which may limit the ability to perform activities such as bending or twisting movementsGrade III (severe): Severe injury that can cause pain with normal activities, often with muscle spasm and bruising When to See a Doctor 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 strainYour injury is interfering with daily activities like walking, sitting, or sleepingYou are not sure if you have an abdominal strain or another conditionYour symptoms do not get better quickly Treatment Treatment of an abdominal muscle injury is difficult. There's no way to splint the abdomen and it's nearly impossible to fully rest these muscles. That said, the most important step after you sustain an abdominal muscle strain is to allow the muscle to relax so that the inflammation can subside. The following can help: Avoid exercise to allow the injured muscle to heal.Avoid activities that cause pain or spasm of the abdominal muscles.Practice gentle stretching. It should not be painful or excessive, as this may slow the healing process.Apply ice to the injured area in the acute phase, or during the first 48 hours after injury. It's also helpful to apply ice after activities.Apply heat before activities to loosen the muscle. Is Ice or Heat Better for Treating an Injury? How to Prevent Reinjury One the injury is fully healed, you can avoid another strain by practicing some common-sense preventive tips. Never overexert yourself while exercising. Avoid exercises with explosive, "jerking" movements. Focus on isometric resistance exercises, which strengthen your core muscles with steady and controlled movements. Avoid hyperextending your back (bending too far backwards) when lifting weights. Tighten your core muscles if you have to cough or sneeze. Summary An abdominal muscle strain, or pulled abdominal muscle, can cause pain that ranges from mild discomfort to muscle spasms and bruising. Since you can't splint the muscles, the best treatment is rest, gentle stretching, icing after activities, and heating prior to activities. In addition, using some common-sense strategies during exercising can help prevent the abdominal strain in the first place. A Word From Verywell Recovering from an abdominal muscle strain may take time but it is possible. Some people find treatments such as ultrasound, therapeutic massage, and specific exercises particularly helpful. You should see your physician to determine if these would be appropriate for your condition. Frequently Asked Questions What causes abdominal muscle spasms? Abdominal muscle spasms and cramps can be caused by muscle overuse and injury, low levels of calcium and potassium, dehydration, alcoholism, hypothyroidism (underactive thyroid), certain medication, pregnancy, menstruation, and kidney failure. Applying heat to the muscle for 15 minute intervals, properly stretching, drinking plenty of fluids, and getting enough potassium and calcium in your diet may help prevent worse muscle spasms in the future. Where is the rectus abdominis located? The rectus abdominis is located on the front of the belly. When this muscle is strong and well-developed, it is responsible for the "six pack" appearance. It is also referred to as the "abs." What causes oblique muscle strain? Oblique muscle strain, sometimes called "side" strain, is often caused by sudden, powerful twisting motions like those seen by a baseball pitcher or a javelin thrower. The strain results in acute pain and tenderness of the oblique muscles as well as the lower back. The oblique muscles are located on the left and right sides of the rectus abdominis. 3 Physical Therapy Abdominal Exercises 4 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. American Academy of Orthopaedic Surgeons. Diseases and conditions: Muscle contusion (bruise). Lang B, Lau H, Lee F. Epigastric hernia and its etiology. Hernia. 2002;6(3):148-50. doi:10.1007/s10029-002-0074-0 MedlinePlus. Muscle Cramps. Kato, Kinshi et al. “Abdominal oblique muscle injury at its junction with the thoracolumbar fascia in a high school baseball player presenting with unilateral low back pain.” Fukushima journal of medical science vol. 2020;67(1):49-52. doi:10.5387/fms.2020-27 Additional Reading Dines JS, Bedi A, Williams PN, et al. Tennis injuries: epidemiology, pathophysiology, and treatment. Journal of the American Academy of Orthopaedic Surgeons. 2015;23(3):181-189. doi:10.5435/JAAOS-D-13-00148 By Jonathan Cluett, MD Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit