Movements involving the torso/ upper body require the participation of the abdominal muscles and hence an amount of tension is placed in them.
When this tension becomes excessive as a result of too much repetition or high force, the abdominal muscles become stretched or torn. This is known as a Side Strain.
Your abdominal or stomach muscles are constantly working to enhance your performance in everyday activities. When these muscles are injured, you are likely to face difficulties in your daily activities.
Some abdominal muscles are seen superficially such as ‘the 6-packs’, while the others are located beneath the superficial ones and cannot be easily observed.
These muscles enable you to hold your stomach contents in place and assist in coughing, laughing, and sneezing. They also assist you to rotate your torso and move sideways.
Abdominal muscle strains usually occur in individuals who are engaged in sports for eg. tennis players or athletes. If you are a tennis player, the tennis serve is one of the movements which involve the highest risk of sustaining an abdominal muscle strain and caution needs to be taken in order to avoid any injury.
What are the Signs and symptoms?
Individuals diagnosed with Side Strain, in general experience a sudden, sharp pain in the side of the chest or abdomen after the movement is performed.
Pain may occur suddenly or gradually over a period of time. Some individuals are able to continue activities but realise that they experience a lot of pain after the activity.
However, in more severe instances, the individual may be unable to continue the activity and may need to put a stop to active participation in sports for a while.
Pain may also increase with activities that place strain on the abdominal muscles such as throwing, twisting, turning or side bending movements.
Pain is usually felt with shoulder activities and some individuals may also experience pain or stiffness after these activities with rest, particularly upon waking up in the morning.
Individuals with this condition may also notice swelling around the abdomen, muscle spasm and weakness in the stomach area. In severe instances, the individual has difficulty in deep breathing, laughing, coughing or sneezing.
The most frequent causes of abdominal strains are sudden and swift twisting movements as well as sudden and extreme backward bending movements- eg gymnastics movements or tennis serve movements.
When the force of the movement is too much for the abdominal muscles, the muscles become overstretched.
If the magnitude of the force is not reduced but continues, then the muscles may become slightly torn or a complete tear may also result.
What are the levels of severity of Abdominal Muscle Strain?
A muscle strain varies in severity from a mild stretch to a complete tear. A mild stretch in the abdominal muscle is diagnosed as a first degree abdominal strain and can cause pain around the abdomen, mild swelling, and pain when coughing, laughing and sneezing.
A moderate strain in the abdominal muscle involves a partial tear and is known as a second degree strain. The individual may experience sudden abdominal pain and swelling. The individual has considerable restrictions in his/her movements due to the pain he/she experiences.
A third degree muscle strain is the most severe injury and is diagnosed as a complete abdominal muscle tear. The individual with this type of strain is unable to continue any activity and needs to be treated immediately.
How is an abdominal muscle strain diagnosed?
The individual undergoes a thorough assessment which involves the activities he/she is engaged in, the movements which can be performed, abdominal muscle tests and other tests. The examinations provide enough information to determine the severity of the muscle injury and also ascertain the specific muscles injured.
Further investigations, for example, an MRI or ultrasound, are occasionally conducted to confirm diagnosis and also determine the severity of injury.
The writer is a Senior Physiotherapist at the 37 Military Hosdpital