How to Treat a Pulled Abdominal Muscle

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An abdominal muscle strain is an injury to one of the muscles of the abdominal wall. It can be caused by a sports injury, overuse, or poor muscle conditioning.

Also called a pulled muscle, a muscle strain occurs when the muscle is stretched too far. This causes tiny, microscopic tears within the muscle.

Symptoms of a pulled abdominal muscle include abdominal pain, muscle spasms, and weakness. The symptoms can be felt in the upper, middle, or lower abdomen, on your left or right side, and can extend to your back, hip, or groin.

A strained abdominal muscle can be tricky to treat. The initial treatment includes rest and ice, followed by gentle exercise. In some cases, physical therapy may be needed.

This article discusses pulled abdominal muscles. It explains the symptoms and treatment for abdominal muscle strains and how to prevent future injuries.

Symptoms of a Pulled Abdominal Muscle
 Verywell / Emily Roberts

What Are the Symptoms of a Pulled Abdominal Muscle?

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 run diagonally 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

Can a Pulled Abdominal Muscle Feel Like 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


Severity

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

What Causes a Pulled Abdominal Muscle?

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 intense exercise
  • Lifting heavy objects, especially with improper lifting technique
  • Sudden twisting of the torso
  • Vigorous coughing, 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.

Pulled Muscle Strain 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.

How Is a Pulled Ab Muscle Treated?

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.

How Long Does It Take for a Pulled Ab Muscle to Heal?

A pulled abdominal muscle can take a few weeks to a few months to fully heal, depending on the extent of the injury. A mild abdominal muscle strain can take a week or two weeks to heal, but more severe strains can take six weeks or longer.

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. A muscle strain is a tear in the muscle fibers caused by a sports injury, overuse, or poor muscle conditioning.

Abdominal muscle strains usually resolve with at-home care. Initial treatment includes rest and ice. After three days, you can add in gentle stretching. As you start to feel better, you can gradually increase your activity.

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 to treat a pulled ab muscle.

The amount of time it takes to recover from a pulled abdominal muscle depends on the degree of injury. A mild strain should heal in a week or two, but more severe strains can take several months.

12 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.
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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.