Considering that the rectus muscle is structured in such a way that its fibers form the coveted “cubes,” most often pain in the abdominal muscles occurs precisely in it.

It is believed that the prelum abdominale – abdominal muscles – are 4 types of muscles:

  • Transversus abdominis is a transverse muscle that is responsible for the clear location and support of the abdominal organs.
  • Musculus obliquus internus abdominis is the internal oblique abdominal muscle responsible for twisting, circular movements.
  • Musculus obliquus externus abdominis – external, external oblique abdominal muscle, one of the widest abdominal muscles, responsible for turning and tilting the body to the sides.
  • Musculus rectus abdominis is the rectus muscle, which actually forms the abs; in addition, it is involved in stabilization and support of the spinal column, and is responsible for oblique movements.

    • In general, the abdominal muscles, together with the diaphragm, control the process of intra-abdominal pressure and participate in reflex acts – coughing, defecation. If the abdominal muscles are weakened, their atony provokes displacement of internal organs (prolapse, ptosis), gastrocardial syndrome. Abnormal contraction, hypertonicity or muscle injury is accompanied by pain and can lead to pressure on organs and their dysfunction.

    Causes of pain in the abdominal muscles

    The most common causes of pain in the abdominal muscles:

    • Physiological – during pregnancy, pain in the abdominal muscles often occurs in older people due to atony of muscle fibers.
    • Functional – pain after training. Microtraumas of muscles, sometimes their ruptures, can lead to hemorrhage (bleeding) in the posterior zones of the rectus muscle or to a hernia of tendon bridges, diastasis, or a hernia of the “white line”.
    • Combined syndromes, which can be both functional and pathological – ARS syndrome (dysfunction of the pelvic semiring in combination with asymmetric shortening of the thigh muscles, oblique and rectus abdominal muscles and damage to the symphysis tendons).
    • Compression – rectus abdominis syndrome, developing as a reflex protective spasm during protrusion, herniation of intervertebral discs in the lumbosacral region or lower thoracic region.
    • Inflammatory – myositis, vaginal phlegmon (vagina musculi recti abdominis) of the rectus muscle, which developed as a result of a hematoma.
    • Myofascial syndrome is a complex complex of non-inflammatory symptoms, which in turn has many causes, both functional and pathological.

    About 75% of cases of abdominalgia in the rectus muscle area are associated with functional factors, thus, the causes of pain in the abdominal muscles are most often provoked by sports injuries, sprains, and excessive stress on muscle tissue.

    How does pain in the abdominal muscles manifest?

    Considering that the main complaints about pain in the abdominal muscles are those who engage in strength training, bodybuilding, sports and other types of physical activity, myogenic symptoms are most often delayed, the so-called post-workout pain. The pain is aching, nagging in nature, this is caused by microtraumas, minor injuries, and ruptures of muscle fibers. As a rule, the symptoms subside after 2-3 days, the pain decreases as the muscles recover and crepitus.

    Other symptoms of pain in the abdominal muscles:

  • Diastasis of the rectus muscle without hernial formations is characterized by a peculiar protrusion of the edges of the divergence of the aponeuroses in the upper part of the linea alba. The pain is felt in the navel area, but can also be diffuse, accompanied by constipation, dyspepsia, flatulence, and a feeling of heaviness in the abdominal area. In addition, men often experience pain in the groin; muscle pain is localized in the lower abdomen. The pain may intensify with reflex movements – coughing, sneezing, sudden movements.
  • Hematoma, hemorrhage in the sheath of the rectus abdominis muscle is considered a pseudotumor and is accompanied by clearly localized pain at the site of hemorrhage. If the hematoma is in an advanced state, ischemia and necrosis of the surrounding muscle tissue may develop; the clinical picture of this condition resembles the symptoms of inflammation of the appendix and other diseases of the digestive system.
  • ARS syndrome is a complex symptom complex that develops not only in the abdominal muscles, but also in the semicircle of the pelvis, in the ligaments of the pubic symphysis (symphysis). The subjective description of sensations can be varied, but complaints of pain in the lower abdomen, radiating to the groin, possibly to the upper thigh along the muscle fibers, are quite typical. The syndrome significantly limits motor activity; in addition, inflammation of the tendons can cause an increase in body temperature.
  • Hernia of the tendon ligaments (bridges) of the rectus abdominis muscle, Hernia lineae albae – hernia of the white line. Symptoms of pain in the abdominal muscles develop as a hernia forms – the formation of a lipoma, protrusion of the abdominal cavity, the formation of a hernial sac. Often, hernias develop asymptomatically and appear only when they are strangulated, which causes acute muscle pain at the slightest tension in the abdomen, nausea, dyspepsia and other symptoms that may be similar to the clinical picture of many diseases of the abdominal organs.

    • Symptoms and signs of pain in the abdominal muscles with myofacial syndrome depend on which muscle tissue is damaged:

    • Upper area of ​​the rectus abdominis muscle. The pain manifests itself both in the muscle itself and can be reflected in the middle of the back. A trigger point of tension in the lower part of the rectus muscle provokes pain in the lower back, as well as in the lower abdomen. The pain is often accompanied by heartburn, flatulence, and spasms in the groin area. The menstrual cycle in women diagnosed with MFPS (myofascial pain syndrome) is much more painful, with severe tension and pain in the rectus muscle.
    • Trigger points in the oblique abdominal muscles cause bladder spasms, disturbances in the urination process, pain in the groin, in men – pain in the testicles, in women – in the ovaries.
    • Myofascial stress points in all four types of abdominal muscles provoke noticeable dysfunction of the digestive tract, as well as pain in the genitourinary system in both women and men.

    Obviously, the simplest in terms of clinical recognition are the symptoms of abdominal muscle tension caused by extra-abdominal functional factors. Other signs and clinical manifestations of damage to the abdominal muscles require careful, comprehensive diagnosis.

    Diagnosis of pain in the abdominal muscles

    According to statistics provided by the World Organization of Endoscopists and Gastroenterologists, the accuracy of identifying the causes and diagnosing pain in the abdominal area is only 50%. This figure is especially alarming in terms of diagnosing myogenic manifestations in the abdomen. This is due to the nonspecificity of the symptoms, as well as insufficient knowledge of myalgia as a phenomenon in principle.

    The main method used by doctors to determine the causes of muscle pain, including in the abdomen, is the palpation method. However, in finding trigger points of tension in the abdominal muscles, difficulties may arise, since it is very difficult to differentiate the oblique muscles, and the straight muscle also in a number of such cases:

    • Reflex protective tension of all abdominal muscles, reminiscent of the clinical picture of an “acute abdomen”.
    • Significant fat layer if the patient is overweight. An asthenic physique can also complicate diagnosis, especially in patients with anorexia.
    • Pain in the abdominal area is combined with previous surgical interventions in the epigastric region (cesarean section, cyst removal, etc.).
    • The patient’s anxious state, psycho-emotional tension, which does not allow relaxation of the abdominal muscles.

    Diagnosis of pain in the abdominal muscles should exclude serious pathologies of internal organs and acute conditions requiring emergency care. The doctor should be alert to the following accompanying symptoms:

    • Weakness, dizziness, lack of appetite.
    • Hypotension.
    • Increased heart rate, tachycardia.
    • The patient’s feverish state, hyperthermia.
    • Indomitable vomiting.
    • Absence of characteristic peristaltic noises.
    • Ascites.
    • Significant tension in the abdominal muscles (plank symptom).
    • Presence of Shchetkin-Blumberg symptom.
    • Defecation or urination with blood.

    Differentiated diagnosis of myogenic pain in the abdominal area generally consists of the following stages:

  • Interview and examination of the patient.
  • Palpation of the abdominal muscles, starting with the most painful areas in a horizontal position and maximum muscle relaxation.
  • Percussion of the abdominal area.
  • Auscultation of the abdomen to determine peristaltic sounds.
  • Electromyography.
  • If there are alarming symptoms, rectal or vaginal examinations may be prescribed.
  • Contrast radiography according to indications.
  • Ultrasound of the abdominal organs according to indications

    • Methods such as gastroscopy, colonoscopy, and angiography can also be used, but these are exceptions rather than the rule in diagnosing abdominal muscle pain.

    Treatment of pain in the abdominal muscles

    If the pain symptom is caused by sports overload, treatment for pain in the abdominal muscles consists of eliminating the load on the damaged area, rest, but not strict bed rest, which not only does not give results, but can aggravate the pain.

    As a rule, no other methods of therapy are required; simple microtraumas of muscle tissue self-heal within 2-3 days. Many fitness and bodybuilding experts recommend continuing exercise without paying attention to pain. Perhaps such advice is useful, but only if you are sure that the symptom is caused by poor muscle warming up before training and minor stretching. If the pain does not subside after a few days, a muscle rupture may have occurred, in which case immobilization of the lumbar region, tightening of the abdominal area with an elastic bandage, bandage and complete rest are required. During the first day you can neither warm nor cool the muscle; on the second or third day, depending on the nature of the pain, thermal or cooling procedures are indicated. Gentle rubbing with ointments containing anti-inflammatory components (Voltaren, Diclofenac) is also effective.

    Hernia of the white line of the abdomen, ARS syndrome and other more serious diseases require medical attention. Most often, treatment for muscle pain is carried out on an outpatient basis with timely access to a medical facility.

    Threatening symptoms, severe pain, fever, drop in blood pressure are a reason to call emergency medical care.

    How to prevent abdominal pain

    Preventive measures to prevent pain in the press are typical advice from coaches, bodybuilding and fitness instructors:

    • Before training, you must warm up and warm up your muscles.
    • The training load should be compiled with the help of a specialist who will analyze the physical condition, muscle tone, and the body’s readiness to achieve the desired results. Only the trainer should draw up a training program.
    • In sports, the golden rule is regularity and gradualness. Jerks, excessive loads, long workouts are a sure way for pain in the abdominal muscles to accompany the entire process of improving the body.
    • Pregnant women and those who have recently undergone abdominal surgery, including caesarean section, should not engage in strength sports.
    • During training, you need to take breaks and rest your muscles.
    • During classes you should drink the right amount of liquid, usually 100-150 milliliters of water during a break.

    Prevention of pain in the abdominal muscles, which concerns other more serious pathologies, involves regular visits to the doctor for medical examinations, adherence to the basic rules of a healthy lifestyle, including a balanced diet.

    Pain in the abdominal muscles indicates, first of all, that the entire muscular system is not sufficiently trained, therefore, it needs to be strengthened both to form a beautiful abdomen and to maintain normal digestive organs.

    In the process of restoring muscle tone and strength, you need to observe moderation and remember that the treasured “abs” will appear sooner or later, the main thing is not to overdo it in this endeavor.

    Leave a Reply