Oblique strain? Physical therapy can help.

St. Joseph’s/Candler physical therapist answers four questions about this abdominal injury

Do you experience sudden, sharp pains near your rib cage? Does it hurt when you cough or take a deep breath? One possible diagnosis may be an oblique strain or tear.

It’s even more likely that’s the case if you frequently twist or rotate your torso – think golfers or baseball players. Oblique muscle injuries also can happen from overuse of the muscle, such as repeated sit-ups, from heavy or awkwardly lifting objects repeatedly or as a result of direct trauma to the abdominal wall.

“Oblique muscle strains and tears are especially common with individuals who participate in sports that require forceful twisting, rotating or hyperextension of the spine,” says Jordan Brown, physical therapist at the Pooler Outpatient Rehabilitation Center.

What is the oblique muscle?

There are two different types of oblique muscles that span between your ribs and pelvis, making up the waist, Brown explains. External and internal oblique muscles work together to rotate the trunk and assist the trunk in bending. External oblique muscles are the larger muscles that lie close to the skin surface, while the internal oblique muscles lie deep inside of the abdomen, Brown says.

What are the symptoms of an oblique muscle strain?

The hallmark symptom of an oblique strain or tear is a sudden, sharp pain near the rib cage, Brown says. You may also experience:

• Stiffness, especially in the morning
• Aching
• Muscle weakness
• Swelling
• Bruising

Coughing, sneezing and deep breathing can exacerbate your symptoms, Brown says.

How do you diagnose an oblique strain?

Proper diagnosis of your injury is the first step to feeling better. The symptoms of an oblique strain can be similar to a hernia, which occurs when an internal organ or body part sticks out through the wall of a muscle or tissue.

Related Article: Gut check: Understanding causes, types and treatment for hernias

If you experience any of the symptoms above, you should consult your primary care physician. He or she can then examine you to determine the cause of your pain and recommend treatment.

How can physical therapy help?

One of the most common ways to treat an oblique strain or tear is with physical therapy. Licensed physical therapists will work with you to develop a comprehensive plan of care to reduce inflammation and properly strengthen and stretch the abdominal muscles to ensure full recovery, Brown says.

Immediate treatment of an abdominal strain involves the P.R.I.C.E. principle, which stands for Protection, Rest, Icing, Compression and Elevation, Brown explains.

“Protection and rest would involve limiting physical activities and any excessive trunk movement for several days until the pain decreases,” Brown says. “An ice pack should be applied to the strained area for 20 minutes every one to two hours for the first two or three days following the injury. Compression can be achieved by wearing a large ace bandage around the injured area to minimize swelling.”

Once the pain subsides, you will then work with your physical therapist doing mild stretching and isometric contractions (contractions without muscle length change) of the oblique muscles. Stretching and strengthening will progress carefully to avoid any re-injury, Brown says.

For less severe strains, you can expect to work with your physical therapist twice a week for about four weeks. More severe injuries may require two to three visits a week for six to eight weeks. Individual physical therapy sessions last between 45 minutes to an hour.

Brown says it’s important to be patient and follow the instructions of your physical therapist. Just because you’re not in any more pain doesn’t mean it’s time to hit the golf course again.

“There is a high recurrence rate of oblique strains due to symptoms commonly resolving within the first few weeks even though the strain or tear hasn’t healed,” Brown says. “This quick resolution of pain causes some people to think they are ready for high level activity before allowing the tissue ample time to fully heal and strengthen.”

St. Joseph’s/Candler has five outpatient physical therapy locations in Savannah, Pooler and Rincon. A physician’s referral is required. For more information, visit our website or request an appointment here.