Pain in the muscles of the press

Given that the straight muscle is structured so that its fibers form coveted "cubes", most often the pain in the muscles of the press arises precisely in it.

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

1. Transversus abdominis is a transverse muscle that is responsible for the clear location and support of the abdominal organs.
2. Musculus obliquus internus abdominis is the internal oblique abdominal muscle responsible for twisting, circular movements.
3. Musculus obliquus externus abdominis - external, external oblique abdominal muscle, one of the widest abdominal muscles responsible for the corners and slopes of the body in the sides.
4. Musculus rectus abdominis is a straight muscle that actually forms a press, in addition, it participates in stabilization, support of the spinal column, 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 a displacement of the internal organs (ovulation, ptosis), gastrocardial syndrome. Abnormal contraction, hypertension or muscle trauma is accompanied by pain and can lead to pressure on the organs and their dysfunction.

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Causes of pain in the muscles of the press

The most common causes of pain in the muscles of the press: 

• Physiological - in pregnancy, often the pain in the muscles of the press occurs in the elderly due to the atony of the muscle fibers.
• Functional - pain after training. Microtraumas of muscles, sometimes their ruptures can lead to hemorrhage (hemorrhage) in the posterior zones of the rectus muscle or to the hernia of tendinous bridges, diastase, the hernia of the "white line". 
• Combined syndromes, which can be both functional and pathological - ARS syndrome (dysfunction of pelvic half-ring in combination with asymmetric shortening of hip muscles, oblique and direct abdominal muscles and damage to symphysis tendons).
• Compression - a syndrome of the rectus abdominis muscle, developing as a reflex protective spasm in protrusion, herniated intervertebral discs of the lumbosacral region or the lower thoracic region.
• Inflammatory - myositis, phlegmon of the vagina (vagina musculi recti abdominis) of the rectus muscle, which has developed as a consequence of the hematoma.
• Myofascial syndrome is a complex non-inflammatory symptom complex, which in turn has many causes, both functional and pathological.

About 75% of cases of abdominalgia in the zone of the rectus muscle are associated with functional factors, so the causes of pain in the muscles of the press are most often provoked by sports injuries, stretches, excessive strain on muscle tissue.

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How does the pain in the muscles of the press manifest?

If you consider that the main complaints about the pain in the muscles of the press are those who are engaged in power exercises, bodybuilding, sports and other types of physical activity, myogenic symptoms are most often delayed, so-called post-training pains. The pain is aching, pulling character, it is caused by micro-traumas, minor injuries, ruptures of muscle fibers. As a rule, the symptoms subsided after 2-3 days, the pain decreases with the recovery of muscles, their crepitus.

Other symptoms of pain in the muscles of the press: 

1. Diastasis of the rectus muscle without hernial formations is characterized by a peculiar protrusion of the edges of the aponeurosis divergence in the upper part of the white line. The pain is felt in the navel, but it can also be diffuse, accompanied by constipation, dyspepsia, flatulence, a sense of heaviness in the abdominal region. In addition, men often have pain in the groin, a muscle pain symptom is located in the lower abdomen. Pain can increase with reflex movements - coughing, sneezing, sudden movements.
2. Hematoma, hemorrhagia in the vagina of the rectus abdominis muscle is considered to be a pseudo-tumor and is accompanied by a clearly localized pain in the place of hemorrhage formation. If the hematoma is in a neglected state, may develop ischemia and necrosis of surrounding muscle tissue, a clinic of this condition resembles the symptoms of appendicitis and other diseases of the digestive system.
3. ARS syndrome is a complex symptom complex that develops not only in the muscles of the press, but also in the pelvic floor, in the lobular joints (symphysis). A subjective description of the sensations can be varied, but complaints of pain in the lower part of the press that are irradiating in the groin, perhaps in the upper part of the thigh along the muscle fibers, are quite typical. The syndrome significantly limits the motor activity, in addition, the inflammation of the tendons can cause an increase in body temperature.
4. Hernia of tendon ligaments (lintels) of the rectus muscle of the press, Hernia lineae albae - a hernia of the white line. Symptoms of pain in the muscles of the press develop as the hernia forms - the formation of the lipoma, protrusion of the abdominal cavity, the formation of a hernial sac. Often hernias develop asymptomatically and manifest only when infringed, which causes acute pain in the muscles at the slightest tension of the abdomen, nausea, dyspepsia and other symptoms that may be similar to the clinic of a variety of diseases of the abdominal organs.

Symptoms and signs of pain in the muscles of the press in the myofascial syndrome depend on what kind of muscle tissue is damaged:

• The upper zone of the rectus muscle of the press. Pain manifests itself in the muscle itself, and can be reflected in the middle of the back. The 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. The menstrual cycle in women with diagnosed MFBS (myofascial pain syndrome) is much more painful, with strong stress and pain in the rectus muscle.
• Trigger points in the oblique muscles of the press cause bladder spasms, micturition, pain in the groin, in men - pain in the testicles, in women - in the ovaries.
• Myofascial stress points in all four kinds of muscle presses provoke a noticeable dysfunction of the digestive tract organs, as well as pain sensations in the urogenital system in both women and men.

Obviously, the simplest in the sense of clinical recognition are the symptoms of muscle tension of the press, caused by extra-abdominal functional factors. The remaining signs and clinical manifestations of lesion of the muscles of the press need a thorough, comprehensive diagnosis.

Diagnosis of pain in the muscles of the press

According to statistics provided by the World Organization of Endoscopists, gastroenterologists, the accuracy of the detection of the causes, the diagnosis of pain in the abdominal zone is only 50%. This figure is especially alarming in terms of diagnosis of 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 in determining the causes of pain in the muscles, including the abdomen, is the method of palpation. However, in the search for trigger points of tension in the muscles of the press, difficulties can arise, since it is very difficult to differentiate the oblique muscles, and even directly in a number of such cases: 

• Reflex protective tension of all abdominal muscles, reminiscent of the clinical picture of the "acute abdomen".
• Significant fatty layer with excess weight of the patient. Diagnosis can also be complicated by asthenic physique, especially in patients with anorexia.
• Pain in the area of the press is combined with previous surgical interventions in the epigastric region (caesarean section, cyst removal, others).
• Anxious state of the patient, psychoemotional stress, which does not allow to relax the abdominal muscles.

Diagnosis of pain in the muscles of the press should exclude serious pathologies of internal organs, acute conditions requiring urgent care. Physicians should alert such accompanying symptoms: 

• Weakness, dizziness, lack of appetite.
• Hypotension.
• Increased pulse, tachycardia.
• Feverish condition of the patient, hyperthermia.
• Indomitable vomiting.
• Absence of peristaltic characteristic noise.
• Ascites.
• Significant tension in the muscles of the abdominal cavity (a symptom of the "board").
• Presence of the symptom of Schetkin-Blumberg.
• Defecation or urination with blood.

Differential diagnosis of myogenic pain in the press area as a whole consists of the following stages: 

1. Survey and examination of the patient.
2. Palpation of the abdominal muscles, starting with the most painful zones in the horizontal position and the maximum relaxation of the muscles.
3. Percussion of the abdominal zone.
4. Auscultation of the abdomen to determine peristaltic noise.
5. Electromyography.
6. In the presence of anxiety symptoms, rectal or vaginal examinations can be prescribed.
7. Contrast radiography according to indications.
8. Ultrasound of the abdominal cavity according to indications

Methods such as gastroscopy, colonoscopy, angiography can also be used, but these are exceptions rather than the rules for diagnosing muscle pains in the press.

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Treatment of pain in the muscles of the press

If the pain symptom is caused by sports overloads, the treatment of pain in the muscles of the press consists in eliminating the burden on the affected area, rest, but not strict bed rest, which not only does not produce results, but can exacerbate the pain.

As a rule, other methods of therapy are not required, simple microtraumas of the muscle tissue self-repair within 2-3 days. Many experts in fitness and bodybuilding recommend continuing their studies, not paying attention to pain. Perhaps these tips are useful, but only if you are sure that the symptom is caused by a poor warm-up of the muscles before training and a little stretching. If the pain does not subside after a few days, there may have been a muscle rupture, in which case an immobilization of the lumbar region is required, a tightening of the abdominal area by an elastic bandage, bandage and complete rest. During the first day, you can neither warm nor cool the muscle, on the second or third day, depending on the nature of the pain, thermal or cooling procedures are indicated. Also, sparing rubbing with ointments containing anti-inflammatory components (Voltaren, Diclofenac) is also effective.

Herniated belly, APC-syndrome and other more serious diseases require medical attention. Most often, the treatment of muscle pain is done on an outpatient basis with timely treatment in a medical institution.

Threatening symptoms, severe pain, fever, a drop in blood pressure - this is an occasion to call for emergency medical attention.

How to prevent pain in the muscles of the press?

Preventive measures to prevent pain in the press are typical tips of coaches, instructors in bodybuilding, fitness: 

• Before training it is necessary to conduct warm-up, warm up muscles.
• The training load should be made with the help of a specialist who will analyze the physical condition, muscle tone, the readiness of the body to achieve the desired results. The training program should be prepared only by the coach.
• In sports, the golden rule is regularity and gradualness. Jerks, excessive loads, prolonged training - the right way to the fact that the pain in the muscles of the press will accompany the whole process of perfecting the body.
• You can not engage in power sports for pregnant women, those who have recently undergone surgery on the abdominal cavity, including cesarean section.
• During training, you need to take breaks, rest your muscles.
• During the sessions you should drink the right amount of liquid, as a rule, it is 100-150 milliliters of water during the break.

Prevention of pain in the muscles of the press, concerning other more serious pathologies, involves regular visits to the doctor for dispensary examination, observance of elementary rules of a healthy lifestyle, including rational nutrition.

The pain in the muscles of the abdominal press speaks, first of all, that the entire muscular system is not sufficiently trained, therefore, it must be strengthened both for the formation of a beautiful stomach and for maintaining normal digestive organs.

In the process of restoring the tone and strength of the muscles, you must observe the measure and remember that the coveted "cubes" will sooner or later appear, most importantly - do not overdo it.