Pain in the abs

Considering that the rectus abdominis is structured in such a way that its fibers form the coveted “cubes,” most often pain in the abdominal muscles occurs in it.

It is believed that prelum abdominale - abdominal muscles - are 4 types of muscles:

1. Transversus abdominis is a transverse muscle that is responsible for the precise positioning and support of the abdominal organs.
2. Musculus obliquus internus abdominis is the internal oblique abdominal muscle, responsible for twisting and circular movements.
3. Musculus obliquus externus abdominis is the external, external oblique muscle of the abdomen, one of the widest abdominal muscles, responsible for turning and bending the body to the sides.
4. Musculus rectus abdominis is a straight muscle that actually forms the press, in addition, it is involved in stabilization, support of the spinal column, and is responsible for inclined movements.

In general, the abdominal muscles together with the diaphragm control the process of intra-abdominal pressure, participate in reflex acts - coughing, defecation. If the abdominal muscles are weakened, their atony provokes displacement of internal organs (prolapse, ptosis), gastrocardiac syndrome. Abnormal contraction, hypertonicity or muscle injury is accompanied by pain and can lead to pressure on organs and their dysfunction.

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Causes of abdominal muscle pain

The most common causes of abdominal muscle pain are:

• Physiological - during pregnancy, pain in the abdominal muscles often occurs in elderly people due to atony of muscle fibers.
• Functional - pain after training. Microtraumas of muscles, sometimes their ruptures can lead to hemorrhage (bleeding) in the posterior zones of the rectus muscle or to a hernia of the tendon jumpers, diastasis, hernia of the "white line".
• Combined syndromes, which can be both functional and pathological – ARS syndrome (dysfunction of the pelvic semiring in combination with asymmetric shortening of the thigh muscles, oblique and rectus abdominal muscles and damage to the symphysis tendons).
• Compression - a syndrome of the rectus abdominis muscle that develops as a reflex protective spasm during protrusion, herniation of intervertebral discs in the lumbosacral region or lower thoracic region.
• Inflammatory – myositis, phlegmon of the vagina (vagina musculi recti abdominis) of the rectus muscle, which developed as a result of a hematoma.
• Myofascial syndrome is a complex of symptoms of a non-inflammatory nature, which in turn has many causes, both functional and pathological.

About 75% of cases of abdominal pain in the rectus abdominis area are associated with functional factors, thus, the causes of pain in the abdominal muscles are most often provoked by sports injuries, strains, and excessive stress on muscle tissue.

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How does abdominal muscle pain manifest itself?

Considering that the main complaints about abdominal muscle pain are made by those who do strength training, bodybuilding, sports and other types of physical activity, myogenic symptoms are most often delayed, the so-called post-workout pain. The pain is aching, pulling in nature, this is due to microtraumas, minor injuries, ruptures of muscle fibers. As a rule, the symptoms subside after 2-3 days, the pain decreases as the muscles recover, their crepitus.

Other symptoms of abdominal muscle pain:

1. Diastasis recti without hernial formations is characterized by a peculiar protrusion of the edges of the divergence of the aponeuroses in the upper part of the white line. The pain is felt in the navel area, but can also be diffuse, accompanied by constipation, dyspepsia, flatulence, a feeling of heaviness in the abdominal area. In addition, men often experience pain in the groin, the muscle pain symptom is localized in the lower abdomen. The pain can intensify with reflex movements - coughing, sneezing, sudden movements.
2. Hematoma, hemorrhage in the sheath of the rectus abdominis muscle is considered a pseudotumor and is accompanied by clearly localized pain at the site of hemorrhage. If the hematoma is in an advanced state, ischemia and necrosis of the surrounding muscle tissues may develop, the clinical picture of this condition resembles the symptoms of appendicitis and other diseases of the digestive organs.
3. ARS syndrome is a complex of symptoms that develops not only in the abdominal muscles, but also in the pelvic semi-ring, in the ligaments of the pubic symphysis. The subjective description of sensations can be varied, but complaints of pain in the lower part of the abdomen, radiating to the groin, possibly to the upper thigh along the muscle fibers, are quite typical. The syndrome significantly limits motor activity, in addition, inflammation of the tendons can cause an increase in body temperature.
4. Hernia of the tendon ligaments (jumpers) of the rectus abdominis muscle, Hernia lineae albae – hernia of the white line. Symptoms of pain in the abdominal muscles develop as the hernia forms – the formation of a lipoma, protrusion of the abdominal cavity, formation of a hernial sac. Often, hernias develop asymptomatically and manifest themselves only when strangulated, which causes acute pain in the muscles with the slightest tension of the abdomen, nausea, dyspepsia and other symptoms that can be similar to the clinical picture of many diseases of the abdominal organs.

Symptoms and signs of abdominal muscle pain in myofacial syndrome depend on which muscle tissue is damaged:

• Upper zone of the rectus abdominis muscle. The pain manifests itself both in the muscle itself and can be reflected in the middle of the back. A trigger point of tension in the lower part of the rectus muscle provokes pain in the lower back, as well as in the lower abdomen. The pain is often accompanied by heartburn, flatulence, spasms in the groin area. The menstrual cycle in women diagnosed with MFPS (myofascial pain syndrome) is much more painful, with severe tension and pain in the rectus muscle.
• Trigger points in the oblique abdominal muscles cause spasms of the bladder, problems with urination, pain in the groin, pain in the testicles in men, and pain in the ovaries in women.
• Myofascial tension points in all four types of abdominal muscles provoke noticeable dysfunction of the digestive tract, as well as pain in the genitourinary system in both women and men.

Obviously, the simplest in terms of clinical recognition are the symptoms of abdominal muscle tension caused by extra-abdominal functional factors. Other signs and clinical manifestations of abdominal muscle damage require careful, comprehensive diagnostics.

Diagnosis of abdominal muscle pain

According to statistics provided by the World Organization of Endoscopists and Gastroenterologists, the accuracy of identifying the causes and diagnosing pain in the abdominal area is only 50%. This figure is especially alarming in terms of diagnosing myogenic manifestations in the abdomen. This is due to the non-specificity of the symptoms, as well as the insufficient study of myalgia as a phenomenon in principle.

The main method used by doctors to determine the causes of muscle pain, including abdominal pain, is the palpation method. However, finding trigger points of tension in the abdominal muscles can be difficult, since it is very difficult to differentiate the oblique muscles, and the straight muscles as well in a number of such cases:

• Reflexive protective tension of all abdominal muscles, reminiscent of the clinical picture of "acute abdomen".
• Significant fat layer in case of overweight patient. Asthenic body type can also complicate diagnosis, especially in patients with anorexia.
• Pain in the abdominal area is combined with previous surgical interventions in the epigastric region (cesarean section, cyst removal, others).
• The patient's anxious state, psycho-emotional tension, which does not allow him to relax the abdominal muscles.

Diagnosis of abdominal muscle pain should exclude serious pathologies of internal organs, acute conditions requiring emergency care. The doctor should be alerted by the following accompanying symptoms:

• Weakness, dizziness, loss of appetite.
• Hypotension.
• Increased heart rate, tachycardia.
• The patient is feverish, hyperthermia.
• Uncontrollable vomiting.
• Absence of characteristic peristaltic noises.
• Ascites.
• Significant tension in the abdominal muscles (the “board” symptom).
• Presence of the Shchetkin-Blumberg symptom.
• Defecation or urination with blood.

Differential diagnostics of myogenic pain in the abdominal area generally consists of the following stages:

1. Questioning and examination of the patient.
2. Palpation of the abdominal muscles, starting from the most painful areas in a horizontal position and with maximum muscle relaxation.
3. Percussion of the abdominal area.
4. Auscultation of the abdomen to determine peristaltic sounds.
5. Electromyography.
6. If alarming symptoms are present, rectal or vaginal examinations may be prescribed.
7. Contrast radiography as indicated.
8. Ultrasound of abdominal organs according to indications

Methods such as gastroscopy, colonoscopy, and angiography can also be used, but these are exceptions rather than rules in diagnosing abdominal muscle pain.

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Treatment of abdominal muscle pain

If the pain symptom is caused by sports overloads, treatment of abdominal muscle pain consists of eliminating the load on the damaged area, rest, but not strict bed rest, which not only does not give results, but can aggravate the pain.

As a rule, no other methods of therapy are required, simple microtraumas of muscle tissue recover on their own within 2-3 days. Many fitness and bodybuilding experts recommend continuing training, ignoring the pain. Perhaps such advice is useful, but only if you are sure that the symptom is caused by poor warming up of the muscles before training and a small stretch. If the pain does not subside after a few days, a muscle rupture may have occurred, in which case immobilization of the lumbar region, tightening of the abdominal region with an elastic bandage, bandage and complete rest are required. During the first day, neither warming nor cooling the muscle should be allowed, on the second or third day, depending on the nature of the pain, thermal or cooling procedures are indicated. Gentle rubbing with ointments containing anti-inflammatory components (Voltaren, Diclofenac) is also effective.

Hernia of the white line of the abdomen, ARS syndrome and other more serious diseases require medical care. Most often, muscle pain is treated on an outpatient basis with timely treatment at a medical institution.

Threatening symptoms, severe pain, high temperature, drop in blood pressure - this is a reason to call emergency medical care.

How to prevent abdominal muscle pain?

Preventive measures to prevent abdominal pain are typical advice from trainers, bodybuilding and fitness instructors:

• Before training, it is essential to warm up and stretch your muscles.
• The training load should be created with the help of a specialist who will analyze the physical condition, muscle tone, and the body's readiness to achieve the desired results. Only a trainer should create a training program.
• In sports, the golden rule is regularity and gradualness. Jerks, excessive loads, long workouts are a sure way to ensure that pain in the abdominal muscles will accompany the entire process of improving the body.
• Pregnant women and those who have recently had abdominal surgery, including cesarean section, are not allowed to engage in strength sports.
• During training, you need to take breaks and give your muscles rest.
• During exercise you should drink the required amount of liquid, usually 100-150 milliliters of water during breaks.

Prevention of abdominal muscle pain, as well as other more serious pathologies, involves regular visits to the doctor for a medical examination, adherence to basic rules of a healthy lifestyle, including a balanced diet.

Pain in the abdominal muscles indicates, first of all, that the entire muscular system is not sufficiently trained, therefore, it needs to be strengthened both to form a beautiful belly and to maintain normal digestive organs.

In the process of restoring muscle tone and strength, you need to observe moderation and remember that the coveted “six-pack abs” will appear sooner or later, the main thing is not to overdo it in this pursuit.