The obliques consist of two separate muscles, the external oblique and the internal oblique, located on the sides and front of the abdomen. People often refer to them as the waist muscles.
The obliques are involved in bending, twisting, and stabilizing the body's core. Even slight movements in the core of the body can produce pain.
Where Are The Oblique Muscles?
The obliques connect the ribs, top of the hip (iliac crest), to the fascia of the abdominals and lower back. Fascia is a strong connective tissue shown as the shaded gray sheets in the images above.
The muscles form a crisscross pattern that strengthens abdominal strength and flexibility.
For detailed anatomy information, see the Oblique Muscle Anatomy Page.
The Movements (Functions) Of The Oblique Muscles
- Bends the body side to side ie. side bends (lateral flexion)
- Aids with twisting the body side to side (rotation)
- Aids with bending the body forward (flexion).
- Assists with forced exhalation (forcing air out when breathing)
- Compresses the abdominal wall (keeps internal organs in place)
Oblique Muscle Pain And Symptoms
The symptoms:
- Pain and stiffness in the abs, waist, and sometimes the lower back
- Finger-like projections of pain through the abdomen
- Pain in the groin area
- Movements such as bending over or twisting to the side may cause pain
- Laughing, coughing, and sneezing may be painful
- A band of pain across the upper back below the shoulder blades
- A band of pain across the lower back just above the hips
- Heartburn and indigestion
- Pain in the upper/middle back when inhaling deeply
- Your abdominal muscles may feel weak
- If you strain (pull) the muscle, there may be redness, bruising, and swelling in the area of the muscle strain.
The Causes Of Oblique Muscles Pain
- Sitting for long periods
- Slouching posture
- Weak abdominal and lower back muscles
- Overexertion during exercise (bending forward, twisting, and side-bending exercises)
- Lifting a heavy item and twisting at the waist throws the body off balance, especially if you are using tools such as a shovel or pitchfork
- A direct blow to the muscle
- Chronic coughing and sneezing can strain the obliques.
- Abdominal scars from surgery and the resulting scar tissue may limit the mobility of the muscles
- Constipation
Sports and activities that affect the oblique muscles:
The oblique muscles are heavily involved in twisting, rotating, and bending the upper body and are frequently injured in sporting activities.
- Golfers, tennis players, and batters in baseball can strain the obliques when swinging with arms extended and twisting at the waist.
- Baseball pitchers, shot putters, javelin throwers, and bowlers strain their muscles when twisting, pushing off, and extending their arms while throwing.
- Kayakers and rowers often have problems with the obliques due to the back-and-forth motion, twisting, and the strain of pulling through water.
- Sit-ups and crunches affect all abdominal muscles due to the up-and-down pull of the exercise
- Household and gardening chores such as vacuuming, sweeping, mopping, pulling weeds, and raking leaves can stress the obliques
Trigger Points In The Oblique Muscles
Trigger points are sensitive spots in the muscle that feel like a pea-sized knot. They develop in the muscle fibers when the muscle becomes stressed or injured. The area around the trigger point is tender, and pressing on it causes pain. When applying pressure to the knot, you may experience pain or tingling in other areas of the body. This is referred pain.
Trigger points in the oblique muscles can contribute to pain throughout the rib cage, abdominal area, pelvis, and groin. The muscles can also contribute to bands of pain across the upper and lower back. They may also contribute to heartburn and urinary discomfort.
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Oblique Muscles Treatment Suggestions
Oblique Muscle Strain
Cold Therapy: Apply ice packs for 20-30 minutes per treatment during the first 24-48 hours to reduce inflammation. Cold treatments can be repeated once per hour or as needed.
Alternating Cold/Warm Therapy: Once the swelling subsides, alternate cold and warm therapy. Use cold packs first for 20-30 minutes. Wait until the skin returns to normal temperature, and then apply a warm pack. This cycle can be repeated throughout the day as needed.
Chronic Pain Around The Oblique Muscles: Heat treatments are usually more effective for chronic pain in the oblique muscles. Treatments should last 20 minutes and can be repeated throughout the day.
Braces and Wraps
Providing support and compression to painful oblique muscles can help relieve pain and speed up the healing process. A Velcro low-back brace works well to support the oblique muscles. For lower oblique strains, look for a wideband brace that will provide support from the bottom of the ribs to the hip bone.
If the strain is high around the sternum and ribcage, a rib brace provides the best support. There are different styles for Men and Women.
Trigger Point Treatment:
Trigger points in the oblique muscles can be challenging to find for someone new to trigger point therapy. The best course of action is to find a massage therapist or physical therapist trained to treat trigger points. With the guidance of a therapist, you will learn where to search for oblique trigger points and the technique to self-treat.
Once you understand how to search, find, and treat oblique trigger points, The Trigger Point Therapy Workbook is an excellent book to learn how to treat other trigger points throughout the body.
Trigger points in the oblique and other abdominal muscles can mimic other medical conditions. A physician should always examine persistent abdominal pain.
Preventing Oblique Muscles Pain
- Sitting for hours a day, especially if you are slouching, can cause the obliques to shorten and become tight. It is important to take breaks to stand up, walk around, and stretch to help maintain muscle health. If you work at a desk, a standing desk will make it easier to alternate between sitting and standing. If you tend to slouch while sitting, consider using lumbar support to help maintain proper spine alignment, which will ease the stress on the oblique muscles.
- Be sure to warm up before starting exercises targeting the abs and obliques. Stop when muscle fatigue begins.
- When lifting items, do not twist your body. Bend at the knees and use your legs to lift the object. Secure the item before moving, then turn your body and step forward. DO NOT twist at the waist to step off.
- If you are sneezing and coughing due to allergies or illness, your chest and abdominal muscles may become sore. Talk to your doctor about medications that suppress chronic coughing and sneezing.
- Constipation affects the oblique muscles and all muscles in the abdomen, lower back, and pelvic region. If you tend to have frequent constipation, talk to your doctor about dietary changes and other methods to help relieve it.
Interesting Facts About The Oblique Muscles:
- The oblique muscles form part of the abdominal wall protecting internal organs from external blows and impacts.
- They help the body to adapt to changes in position and movement allowing the body to maintain balance and posture.
- The external oblique fibers run diagonally downward and forward, while the internal oblique fibers run diagonally upward and forward. This creates a crisscross pattern that enhances strength and flexibility in the abdominals.
- The oblique muscles can contribute to burning and discomfort in the urinary tract, bladder, and possibly incontinence. If you are suffering from these symptoms, you should check for oblique trigger points.
- When taking a deep breath, back pain can signal trigger points in the obliques and/or the rectus abdominis muscles.
Areas of Pain
Abdominal Pain | Ankle Pain | Arm (Low) Pain | Arm (Upper) Pain | Back (Low) Pain | Back (Upper) Pain | Chest Pain | Elbow Pain | Foot Pain | Groin Pain | Hand Pain | Head Pain | Hip Pain | Knee Pain | Leg (Low) Pain | Leg (Upper) Pain | Neck Pain | Pelvic Pain | Shoulder Pain | Wrist Pain
Muscle Groups
Abdominal, Low Back | Arm | Chest, Shoulder, Upper Back | Face, Head, Neck | Foot | Hand | Hip, Pelvis | Leg (Lower) | Leg (Upper) | Spine
References:
Clay, J. H., Allen, L., Pounds, D. (2015). Clay & Pounds' Basic Clinical Massage Therapy: Integrating Anatomy and Treatment (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins
Davies, C,. Davies, A., (2013). The Trigger Point Therapy Workbook: Your Self-Treatmend Guide For Pain Relief (3rd ed.). Oakland, CA: New Harbinger Publications
Finando, D., Finando, S. , (2005). Trigger Point Therapy for Myofascial Pain: The Practice of Informed Touch (1st ed.) Rochester, VT: Healing Arts Press.
Muscolino, J., (2016) Kinesiology: The Skeletal System and Muscle Function (3rd ed.). Maryland Heights, Missouri: Mosby.