Oblique Muscles Pain

The obliques consist of two separate muscles, the external oblique and internal oblique. The muscles are located at the side of the abdomen and are often referred to as the waist muscles.

Trigger points in the muscles can cause referred pain throughout the abdominal area and bands of pain across the back. The abdominal pain mimics many medical conditions such as heartburn, urinary tract infections, and hernias. If you are experiencing unexplained abdominal pain it could be trigger points in the obliques.

Oblique strain pain is contained in the area of the strain, it does not refer to other areas of the body. Soreness may cover a large area around the muscle but there will be a spot that is more tender and painful when pressed. Depending on the severity of the strain there may be redness, bruising, and swelling.

Contents Of Article:

Muscle Location

Trigger Point Symptoms 

Trigger Points Cause

Trigger Point Prevention

Trigger Point Treatment

Interesting Facts 

Oblique Muscle Strain

Muscle Strain Cause

Strain Treatment

Muscles With Similar Pain Patterns

Oblique Muscles Trigger Points Symptoms:

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 almost constantly. Pain and soreness caused by trigger points or a muscle strain will quickly remind you how often these muscles are used.

Trigger points in the oblique muscles can cause, mimic, and contribute to many medical conditions. It is important that if you are experiencing ongoing pain or symptoms listed below that you consult with your doctor. Abdominal pain can be a sign of a serious medical condition and should not be ignored!

Other 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 low back just above hips
  • Heartburn and indigestion
  • Pain in the pelvic area
  • Testicle pain
  • Bladder pain and incontinence

Oblique Muscle Referred Pain Pattern

Trigger Points Information

Trigger points are small knots found in the muscle that when pressed increase pain in the area or send referred pain to another area of the body. To learn more about trigger points read Muscle Trigger Points and How They Contribute To Muscle and Joint 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 strong sheets of connective tissue shown as the shaded gray sheets in the images.

What movements do the oblique muscles control?

  • 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 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)
obliq_muscles1
Oblique Muscle Anatomy Information

Looking for detailed muscle anatomy? The External and Internal Obliques Anatomy has origin, insertion, innervation, and blood supply information. It also lists agonists and antagonists for each muscle action.

What Causes Trigger Points To Develop?

  • Abdominal scars from surgery
  • Constipation
  • Over-exercising muscles (twisting and side bending exercises)
  • Lifting Weights
  • Golf
  • Rowing
  • Bowling
  • Raking leaves
  • Lifting using tools like shovels or pitchforks to dig and pick up heavy items
  • Chronic coughing
  • Sitting for long periods of time
  • Slouching posture
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How To Avoid Development of Trigger Points In The Oblique Muscles

  • Sitting for hours a day and 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 to sitting and standing. If you tend to slouch while sitting, consider using a lumbar support to help maintain proper alignment of the spine 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 item. 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 and feel your chest and abdominal muscles becoming sore, talk to your doctor about medications that suppress chronic coughing and sneezing.
  • Constipation not only affects the oblique muscles but 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 that can help bring relief.
TWD Recommends:
Alternating standing and sitting during your workday can help reduce muscle pain throughout the body. The VariDesk Pro Plus 30 is a highly recommend convert desk that will fit on most desktops.

It is natural to slump while sitting. The Vertteo Full Lumbar Black Support is larger than other supports and helps you sit up straight comfortably reducing back and abdominal pain.

Obliques Trigger Point Treatment

Warning: The abdominal cavity is the location of most of our internal organs and pain in this area should not be ignored. 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 serious medical conditions. Severe and persistent pain in this area should always be examined by a physician.

When a medical cause is ruled out I 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 not only oblique trigger points but also other trigger points throughout the body.

Keep in mind trigger points respond better to several short treatments throughout the day. Overstimulation and prolonged pressure tend to aggravate trigger points.

TWD Recommends:

The best resource to learn how to treat small painful knots is The Trigger Point Therapy Workbook. The authors explain trigger points and their effects in everyday language, not medical speak. I recommend this book to anyone interested in learning to treat their own muscle pain.

How Long Before I Feel A Reduction In Pain?

It depends. If the trigger point is fairly recent it can be resolved in a few days of treatments. However, if the trigger point has been in place for an extended period it may take a few weeks to fully deactivate.

It is also important to remember that if trigger points are found in the obliques it is likely there are 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 must continue treatment until the trigger point is totally deactivated (gone) for the treatment to stick and be successful.

TWD Recommends:

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)

Interesting facts:

  • The oblique muscles can contribute to pain and discomfort in the abdomen and groin area. It can also contribute to burning and discomfort in the urinary tract, bladder and can contribute to incontinence. If you are suffering from any of these symptoms, a medical evaluation should be done to rule out underlying medical conditions.
  • Pain in the back when taking a deep breath can signal that there are trigger points in the obliques and/or the rectus abdominis muscles.

Oblique muscle pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

  • Painful rib syndrome
  • Slipped Rib
  • Costochondritis
  • Acid Reflux
  • Heartburn
  • Appendicitis
  • Ulcers
  • Gallbladder Disorder
  • Hiatal Hernia
  • Inguinal Hernia
  • Colic
  • Constipation
  • Urinary Incontinence
  • Urinary Tract Infection and Disease
  • Pancreatitis
  • Diverticulosis
  • Testicle Pain
  • Ovarian Cyst
  • Endometriosis
  • Prostatitis
  • T6 T7 T8 T9 T10 T11 T12 radiculopathy
  • L1 L2 L3 or L4 radiculopathy
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Other muscles that should be considered and examined:

 

Satellite trigger points

If you find trigger points in the oblique muscles,  you will likely find trigger points in other muscles. These are known as satellite trigger points. Be sure and check these muscles:

  • Serratus anterior
  • Iliocostalis thoracis
  • Longissimus thoracis
  • Adductor Longus
  • Adductor Brevis
  • Adductor Magnus
  • Pectineus
  • Gracilis

Relax While Easing Your Pain and Stiffness

Heated Massage Pad to relieve back pain.
You’re tired, your lower back and hips are stiff and hurt. All you want to do is lie down and be able to relax.

The Snailax Vibrating Massage Mat With Heat is made for those times. The mat features a full-body vibrating massage and has multiple settings for massage and heat. The remote allows you to adjust settings with a push of a button. A wonderful way to ease aches and pains in the back, hips, and legs at the end of the day! 69 inches (5′ 9″) long.

Muscle Strain Information

Muscles strains occur when fibers in a muscle or tendon tear. Muscle Strains: Causes and Treatment explains how strains happen, how to know if you have strained a muscle, and recommended treatment.

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 slight movements produce 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 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 where the stain is located

What Causes Oblique Strains?

Oblique strains are caused by overextending or stretching the muscle. Some examples are:

  • Chronic coughing and/or sneezing can cause a strain in the obliques
  • Lifting a heavy item and twisting at the waist throws the body off balance and can result 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

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 must sit or stand for long periods.

Chronic coughing and sneezing are extremely stressful for the oblique muscles and can cause extreme pain. Laying down flat can make the coughing and sneezing worse. You may want to use pillows to prop up the upper body or better yet use a recliner in a laid back position. This will provide relief to the muscle but keep your upper body elevated enough to suppress coughing and sneezing.


If you have rounded shoulder, forward head posture, or have a habit of slouching, correcting your posture will reduce your muscle pain. I  recommend the HailiCare Posture Corrector The corrector fully supports the back and abdominal area while gently pulling your shoulders back which helps retrain muscle memory to maintain proper posture. You will immediately notice a reduction of pain and tension. Start slowly, wearing the brace only 20-30 minutes a day slowly increasing the time you wear it.

Use Warm and Cold Packs

Warm/cold packs are also helpful for relieving pain. 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 should be applied several times throughout the day. See the article P.R.I.C.E. Protocol for more information about treating a recent muscle strain.

After the initial 72 hours, you can begin alternating cold and warm treatments. Use a cold treatment for 20 minutes one hour, wait at least an hour and apply a warm pack for 20-30 minutes. Do this as often as needed throughout the day.

If you are looking for a hot/cold pack the Cureve Hot Cold Pack is excellent for abdominal and back treatments. The large size provides a full treatment, it can be warmed in the microwave, chilled in the freezer and best of all it remains pliable when cold. I use Cureve products and recommend them.

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 provide support to 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. If the strain is up high around the sternum and high ribcage a rib brace provides the best support.

If you have low back pain or need abdominal support, the Professional’s Choice Back Brace will help 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. It is the only low back brace I recommend because it works!

Warm and Cold Gels

Warm and cold creams and gels are an excellent way to relieve pain between warm and cold treatments. Sombra Warming Gel is a favorite of mine as well as my clients 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.

Both 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.

NSAIDS

NSAIDS (non-steroidal anti-inflammatory medications) such as Advil, Aleve, and Motrin can also help relieve pain. Personally I recommend these only when needed. NSAIDS are safe when used in moderation, but can cause digestive issues, and has been linked to an increase in heart attacks, and decreased collagen production. Collagen is a necessary component of healing.

TWD Recommends:

Biofreeze Professional Gel is what I recommend 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. 

How Long Does It Take For An Oblique Strain To Heal?

Healing times can greatly vary depending on the severity of the strain. Mild strains can heal in a couple of weeks but severe strains can take several months to heal.

Mild or Grade 1 Strain

A mild strain happens when a small number of muscle fibers tear. If a minuscule number of fibers, you feel it, and after a few minutes the pain recedes and you continue on with soreness around the area of the strain. 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 are when a significant number of muscle fibers tear. There is immediate pain sometimes accompanied with a tearing or popping sensation. Again depending on the number of 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 happens 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 movements of the trunk. There are no quick remedies to speed healing. Time, patience, and rest are required for healing and reducing the risk of reinjury.

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Other muscles with similar pain patterns:

Iliopsoas Muscles

Rectus Abdominis

Donna Martin

Massage Therapist Owner: thewellnessdigest.com Twelve years of experience working with clients with chronic pain, post injury pain, and post surgery pain. Muscle dysfunction is often overlooked but can hold the key to many pain conditions.

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