The obliques are two separate muscles, the external oblique, and the internal oblique, making up the abdomen's sides. People sometimes refer to the obliques as the waist muscles.
The oblique muscles can cause referred pain throughout the abdominal area and bands of pain across the back.
Oblique strain pain occurs at the site of the injury. Soreness may cover a large area around the muscle, but there will be a very tender and painful spot where the tear in the muscle fibers occurred. Depending on the severity of the strain, there may be redness, bruising, and swelling.
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 strong connective tissue shown as the shaded gray sheets in the images above.
For detailed anatomy information: Oblique Muscle Anatomy Page.
What Do The Oblique Muscles Do?
- External Oblique
- 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)
- Internal Oblique
- Works with the external oblique
- Bending the body side to side like doing a side bend (flexion)
- Twisting the body side to side (rotation)
- Aids with bending the body forward
- Assists with forced exhalation (forcing air out when breathing)
Interesting Facts:
- The oblique muscles can contribute to pain and discomfort in the abdomen and groin area. It can contribute to burning and discomfort in the urinary tract bladder and incontinence. If you are suffering from these symptoms, you should have a medical evaluation to rule out underlying medical conditions.
- When taking a deep breath, pain in the back can signal trigger points in the obliques and/or the rectus abdominis muscles.
Oblique Muscles Pain Symptoms
The symptoms:
- Pain in the waist area
- Pain in the groin area
- Pain in the low abdomen
- Finger-like projections of pain through the abdomen
- Band of pain across the upper back below shoulder blades
- Band of pain across the lower back just above hips
- Heartburn and indigestion
- Pain in the upper/middle back when inhaling deeply
The obliques location means the muscles are always working. Twisting, turning, bending at the waist, taking deep breaths and exhaling are movements that we do subconsciously. Pain and soreness caused by trigger points will quickly remind you how often you use these muscles.
Trigger points in the oblique muscles can cause, mimic, and contribute to many medical conditions. It is crucial that you consult with your doctor if you are experiencing ongoing pain. Abdominal pain can be a sign of a serious medical condition and should not be ignored.
What Causes Oblique Muscles Pain?
- Sitting for long periods of time
- Slouching posture
- Over-exercising muscles (twisting and side bending exercises)
- Raking leaves
- Lifting using tools like shovels or pitchforks to dig and pick up heavy items
- Chronic coughing
- Abdominal scars from surgery
- Constipation
Sports and activities that affect the oblique muscles:
- Lifting Weights
- Golf
- Rowing
- Bowling
- Baseball
Other muscles, including the oblique muscles, contribute to these conditions
ABDOMINAL PAIN | APPENDICITIS | BLADDER PAIN | BREATHING TROUBLE | COLIC | CONSTIPATION | COSTOCHONDRITIS | DIVERTICULOSIS | ENDOMETRIOSIS | GALLBLADDER DISORDERS | GROIN PAIN | HIATAL HERNIA | INGUINAL HERNIA | LOW BACK PAIN | MID BACK PAIN | OVARIAN PAIN | PANCREATITIS | PELVIC PAIN | PROSTATITIS | RIB PAIN | SPLEEN DISORDERS | STENOSIS | TESTICLE PAIN | ULCER | UPPER BACK PAIN | URINARY TRACT INFECTION
Other muscles that should be considered and examined:
Muscles With Similar Pain Patterns
Satellite trigger points associated with the oblique muscles:
Trigger points in the oblique muscles will cause TrPs to develop in other muscles. These are known as satellite trigger points. You will need to check these muscles for additional TrPs.
What Are Trigger Points?
Oblique Muscles Pain Treatment
Warning: The abdominal cavity is the location of most of our internal organs. Do not ignore the pain in the abdomen. If you are uncertain of the origin of your pain, you should see your doctor and rule out a medical condition.
Trigger points in the oblique muscles and other abdominal muscles can mimic other medical conditions. A physician should always examine persistent pain in the abdomen.
When a medical cause is ruled out, we recommend finding a massage therapist, physical therapist, or a chiropractor trained in trigger point therapy to show you how to apply proper treatment. Improper treatment can lead to more pain and may contribute to digestion issues.
Once you understand how to search, find, and treat trigger points in the abdominal area, The Trigger Point Therapy Workbook is an excellent book to learn how to treat oblique trigger points and other trigger points throughout the body.
Keep in mind trigger points respond better to several short treatments throughout the day. Over-stimulation and prolonged pressure tend to aggravate trigger points which will add to your discomfort.
How Long Before I Feel A Reduction In Pain?
It depends. If the trigger point has developed recently, a few days of treatment will usually take care of it. However, if the trigger point has been in place for an extended period, deactivating it may take a few weeks.
It is also important to remember that if trigger points are discovered in the obliques, there are likely other TrPs in other abdominal muscles. These will also need to be deactivated for maximum pain relief.
The good news is that you will feel some pain relief and better mobility with each treatment. You should continue treatment until the trigger point is deactivated (gone) for the treatment to stick and be successful.
How To Avoid Development of Trigger Points In The Oblique Muscles
- Sitting for hours a day especially slouching while sitting, can cause the obliques to shorten and become tight. It is important to take breaks to stand up, walk around, and do stretches 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.
- Exercise targeting the abs and obliques. Be sure to warm up before starting and stop when muscle fatigue begins.
- When lifting items, do not twist the body. Bend at the knees and use your legs to lift the object. Secure the item before moving, turning your body, NOT twisting 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, low back, and pelvic region. If you tend to have frequent constipation, talk to your doctor about dietary changes and other methods to help bring relief.
Products We Use and Recommend For Oblique Muscles Pain
There are cheaper braces, but none better.
Pain from the oblique muscles can affect your mobility and breathing. Compression and warmth can ease your discomfort. If your pain is in the lower back, we highly recommend the Professional's Choice Back Brace to reduce your pain and stiffness. The waist wrap and 2 side straps are easily adjusted and provide support compression to the low back and abdomen.
If your pain is higher in the middle of the back, consider a rib wrap.
The Cureve Hot Cold Pack can be used for warm and cold treatments. The gel pack stays flexible even when frozen. The pack is large and can be used to treat all areas of the body.
It is recommended that you use cold packs for injuries, swelling, and after a TrP treatment. Use a warm treatment when the muscle is tight and needs to relax.
Trigger Point Therapy Workbook
Sombra Warm Therapy Gel is recommended for relaxing muscles and relieving pain. It warms without the burning heat of other gels. An excellent choice for pain caused by trigger points, muscle/joint over-use and stiffness, and arthritis. (Not sold in stores)
Biofreeze Professional Gel is recommended for the pain and symptoms of muscle strains. It provides excellent pain relief and may help reduce inflammation caused by a strain. Recommended by medical professionals and trainers.
An adjustable standing desk can help alleviate abdomen, back, hip and leg pain. The convertible desk risers come in several sizes and set-ups to fit your desk and your working needs.
External And Internal Oblique Strains
When you strain an oblique muscle, you immediately know it happened. Because the obliques play a role in most movements in the trunk, a slight movement in the trunk of the body produces pain.
Symptoms of a strain:
- Pain and stiffness in the abs, waist, and sometimes the lower back
- There is an extremely tender area where the muscle strain occurred
- Movements such as bending over or twisting to the side may cause pain
- Laughing, coughing, and sneezing may be painful
- Your abdominal muscles may feel weak
- There may be redness, bruising, and swelling in the area of the muscle strain.
What Causes Oblique Strains?
Oblique strains are caused by overextending or stretching the muscle. Some examples are:
- Chronic coughing and sneezing can cause a strain in the obliques.
- Lifting a heavy item and twisting at the waist throws the body off balance, resulting in a strain.
- Golfers, tennis players, and batters in baseball can strain the obliques when players swing with arms extended and twisting at the waist.
- Baseball pitchers shot putters, javelin throwers, and bowlers strain the muscle when twisting, pushing off, and extending the arm while throwing.
Oblique Strain Treatments
First, stop the activities that cause pain. You may have to sit out sports activities, stop exercising, and limit bending and twisting of the trunk muscles as much as possible for a time. Because the obliques are muscles that aid in holding the body upright, standing and sitting for extended periods may be painful. Take breaks throughout the day and lay flat on your back to give the muscle a chance to relax. A support brace can help if you sit or stand for long periods.
Chronic coughing and sneezing are stressful for the oblique muscles and can cause extreme pain. Laying down flat can make coughing and sneezing worse. You may want to use pillows to prop up the upper body. Use a recliner in a laid-back position to relieve the muscle and keep your upper body elevated enough to suppress coughing and sneezing.
Use Warm and Cold Packs
Warm/cold packs are also helpful for relieving pain. In the first 48 - 72 hours after the onset of pain, it is better to use cold therapy for 20 minutes per treatment. Treatments should be at least an hour apart and be reapplied several times throughout the day.
After 72 hours, you can begin alternating cold and warm treatments. Use cold therapy for 20 minutes, wait at least an hour, and apply a warm pack for 20-30 minutes. Do this as often as needed throughout the day.
Warm and Cold Gels
Warm and cold creams and gels are excellent to relieve pain between warm and cold treatments. Sombra Warming Gel is a favorite of many people for its gentle warming and superb pain relief. It warms the area without the hot burning of many other over-the-counter warming creams.
Biofreeze is also another recommended favorite. It is the best product to use immediately after an oblique strain because it cools the area. It also provides excellent pain relief.
These analgesic gels are highly recommended and can be used several times a day if needed. Honestly, it comes down to personal preference as to which to use.
Use Compression and Support To Relieve Pain
Providing support and compression to an oblique strain not only helps relieve pain but can also aid in speeding up the healing process. A Velcro low back brace works well to support the oblique muscles. Look for a wideband brace that will provide support from the bottom of the ribs to the hip bone for lower oblique strains. A rib brace provides the best support if the strain is up high around the sternum and high ribcage.
How Long Does It Take For An Oblique Strain To Heal?
Healing times can vary depending on the severity of the strain. Mild strains can heal in a couple of weeks. However, severe strains can take several months to heal.
Mild or Grade 1 Strain
Mild strains happen when a small number of muscle fibers tear. If a small number of fibers tear, you will feel it, and after a few minutes, the pain recedes. You can continue with normal activities, but there will be soreness around the strain area. The more fibers tear, the more pain and soreness you will experience. Mild strains typically heal within a few days to 3 weeks.
Moderate or Grade 2 Strain
Moderate muscle strains happen when a significant number of muscle fibers tear. There is immediate pain, sometimes accompanied by a tearing or popping sensation. Again depending on the number of muscle or tendon fibers torn, moderate strains take 3-12 weeks to heal.
Severe or Grade 3 Strain
Grade 3 strains are the most serious and usually require medical care. A severe strain occurs when over half of the fibers in a muscle tear. Severe strains take a minimum of 10-12 weeks but can take up to 6 months to heal. Thankfully, grade 3 oblique strains are rare.
Time, Patience, and Rest Are The Keys To Healing The Oblique Muscles
The external and internal obliques are workhorses of our bodies. They are involved directly or assist other muscles in most trunk movements. There are no quick remedies to speed healing. Time, patience, and rest are required for healing and reducing the risk of reinjury.
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.
Image Credit: Depositphotos
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