This article was medically reviewed by Troy A. Miles, MD. Dr. Miles is an Orthopedic Surgeon specializing in Adult Joint Reconstruction in California. He received his MD from the Albert Einstein College of Medicine in 2010, followed by a residency at the Oregon Health & Science University and fellowship at the University of California, Davis. He is a Diplomat of the American Board of Orthopaedic Surgery and is a member of the American Association of Hip and Knee Surgeons, American Orthopaedic Association, American Association of Orthopaedic Surgery, and the North Pacific Orthopaedic Society.
There are 8 references cited in this article, which can be found at the bottom of the page.
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The oblique muscles are located on the sides of your abdomen, between your hip and your rib cage. There are two sets of oblique muscles - external and internal obliques - and together they are responsible for helping your body twist and bend while also supporting your spine. The transversus abdominis is also part of your obliques, but it is underneath the obliques and it goes across your entire abdomen.[1] These muscles along with your back muscles make up your "core." Most injuries to the oblique muscles are caused by tension from excessive repetition of movements or forceful, strained movement. Pulled or strained oblique muscles can be both painful and disruptive to your ability to function regularly, and can take upwards of four to six weeks to fully heal. Because these muscles are so heavily used in the day-to-day functions of the body, it's important to begin treating a pulled oblique muscle as soon as possible. Learning how to treat a pulled oblique muscle can help you speed up the recovery process and get back on your feet.
Steps
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Take pain medicine. A pulled muscle can take several weeks to heal, and in the meantime can cause considerable pain. One of the best ways to alleviate that pain at home is by taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.[2]
- NSAIDs like aspirin and ibuprofen can help reduce pain and inflammation. Reducing inflammation is important for core muscles like obliques, which are crucial for movement.[3]
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Apply ice for the first 48 hours. Ice is helpful for muscle pain, as the cold compress slows down blood flow and reduce swelling and inflammation. If you do not have an ice pack, you can wrap ice cubes in a clean dish towel or use a cold, flexible item like frozen vegetables from the freezer.
- Ice should be applied for no more than 20 minutes, then removed for at least 20 minutes before being reapplied.
- Remove the ice pack if the skin turns red or bright pink.
- Do not apply ice directly to the skin, as this may cause ice burns.[4]
- Ice works best for the first 48 hours after an injury. After 48 hours, switch to heat treatment or alternate between heat and ice.
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Apply heat after 48 hours. Icing an injury is best during the first 48 hours, as it reduces swelling and inflammation. After 48 hours, you can also use heat treatment, such as a heating pad. Heat will help to relax your muscles and re-stimulate blood flow, allowing the tissue to heal.[5]
- Moist heat sources, such as a hot water bottle or hot water bath, may penetrate to the muscle better than dry heat sources.[6]
- Do not apply heat for longer than 20 minutes at a time unless your doctor or physical therapist has instructed you to do so. If your skin becomes uncomfortable or hurts, remove the heat immediately.[7]
- Never lie down on a heating pad, as you may fall asleep. Do not use a heat source if you will be sleeping, as the prolonged heat could cause severe burns.[8]
- Do not apply heat sources directly to the skin, as the heat source may burn your skin. Always wrap heat sources in a clean dish towel before applying to the injury.[9]
- Do not use heat sources if you have poor circulation or diabetes.[10]
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Rest the injury. The best thing for any injury is to let the muscles rest and recover. While the injury is healing, avoid any movements or activities that could further injure the oblique muscles.[11]
- Skip your usual ab workouts until the muscles have healed and avoid movements that aggravate your oblique muscles.
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Know when to seek medical help. The oblique muscles can be quite painful when injured, and may take several weeks to heal. However, some injuries may take longer to heal than others, and may cause greater pain. Contact a medical professional immediately if any of the following occur:
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Take prescription medications. For severe injuries, your doctor may recommend a prescription-strength pain medication to help manage the pain. Always follow your doctor's instructions on taking prescription medications, and avoid driving or operating machinery while taking prescription pain medications.[16]
- Common medications prescribed for injuries include prescription-strength NSAIDs, opioid analgesics, and muscle relaxers, although prescription-strength pain medication is typically reserved for severe, debilitating injuries.[17]
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Consider a rehabilitation program. In cases of severe muscle injuries, some physical therapy or rehabilitation may be necessary. The oblique muscles are crucial for many types and ranges of movement, and they are often prone to repeat injuries. For some people, especially athletes who are at risk of re-injuring the obliques, rehabilitation sessions with a physical therapist will be recommended by a physician.[18]
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Talk to your doctor about surgery. Surgery is rarely recommended for pulled/strained muscles. However, severe muscle injuries, especially injuries in which the muscle is ruptured, may require surgery to ensure the injury heals properly.[19]
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Strengthen and condition your muscles. Before you can resume your previous levels of physical activity after a lengthy injury, you'll need to regain your strength.[20] It's important to develop a strength-training regimen, either on your own or by coordinating with a physical therapist.
- Always stretch before engaging in sports or any kind of physical activity.[21]
- Never stretch to the point of pain, and continue rehabilitative therapy as needed.
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Do upward-facing dog stretches. These stretches work the rectus abdominis, the group of muscles closest to the obliques. Strengthening the rectus abdominis should be a part of your comprehensive oblique rehab plan.
- While lying flat against the ground facing downward, position your hands directly beneath your shoulders. Keep your feet hip-width apart, your gluteal muscles squeezed, and your spine and neck held straight and level.
- While keeping your lower body flat against the ground, slowly straighten your arms to raise your upper body.
- Hold this pose for five seconds, then return to the floor. Complete 10 repetitions, as long as the stretch doesn't cause any pain.
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Practice standing stretches. Standing stretches are another excellent routine to help strengthen the rectus abdominis. When practiced in conjunction with upward-facing dog and other rehabilitative techniques, standing stretches can help return your normal range of motion after an injury.
- Stand straight upright with your feet shoulder-width apart.
- Keep your back straight, and raise your hands over your head.
- Slowly and gently lean to one side until you begin to feel some stretch through your abdomen.
- Hold that position for five seconds, then switch to the other side. Complete ten repetitions on each side, as long as the stretch does not cause you any pain.
Signs of a Pulled Oblique Muscle and Schedule to Return to Physical Activity
Expert Q&A
Video
Tips
References
- ↑ http://www.humankinetics.com/excerpts/excerpts/functional-anatomy-of-the-core-the-abdomen
- ↑ http://www.emedicinehealth.com/muscle_strain/page6_em.htm#muscle_strain_home_remedies
- ↑ http://www.emedicinehealth.com/muscle_strain/page6_em.htm#muscle_strain_home_remedies
- ↑ http://www.emedicinehealth.com/muscle_strain/page6_em.htm#muscle_strain_home_remedies
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4483
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4483
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4483
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4483
- ↑ http://www.emedicinehealth.com/muscle_strain/page6_em.htm#muscle_strain_home_remedies
- ↑ https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=1&ContentID=4483
- ↑ http://www.emedicinehealth.com/muscle_strain/page6_em.htm#muscle_strain_home_remedies
- ↑ http://www.emedicinehealth.com/muscle_strain/page4_em.htm#when_to_seek_medical_care_for_a_muscle_strain
- ↑ http://www.emedicinehealth.com/muscle_strain/page4_em.htm#when_to_seek_medical_care_for_a_muscle_strain
- ↑ http://www.emedicinehealth.com/muscle_strain/page4_em.htm#when_to_seek_medical_care_for_a_muscle_strain
- ↑ http://www.emedicinehealth.com/muscle_strain/page4_em.htm#when_to_seek_medical_care_for_a_muscle_strain
- ↑ http://www.mountsinai.org/patient-care/health-library/diseases-and-conditions/muscle-strain
- ↑ http://www.rxlist.com/pain_medications-page2/drugs-condition.htm#for_what_conditions_are_pain_medications_used
- ↑ http://www.mountsinai.org/patient-care/health-library/diseases-and-conditions/muscle-strain
- ↑ http://www.mayoclinic.org/diseases-conditions/sprains-and-strains/basics/treatment/con-20020958
- ↑ http://www.mayoclinic.org/diseases-conditions/sprains-and-strains/basics/prevention/con-20020958
- ↑ http://www.mayoclinic.org/diseases-conditions/sprains-and-strains/basics/prevention/con-20020958
About This Article
A pulled oblique muscle can be quite painful, but by taking painkillers and treating the swelling, you can ease the worst of your discomfort. Try taking an over-the-counter NSAID, like ibuprofen or aspirin, which will alleviate your pain and reduce inflammation. During the first 48 hours, you should also apply an ice pack or bag of frozen vegetables wrapped in a towel to your oblique muscle. Hold it there for about 15 minutes a few times a day to help reduce inflammation and numb the pain. After 48 hours, switch to a heat pad or hot water bottle to re-stimulate your blood flow and help the tissue heal. While your oblique muscle is injured, rest as much as possible to avoid doing any further damage. If your hear a popping sound when you move, can’t move at all, or have a fever, seek medical help so they can treat your symptoms. For more tips from our Medical co-author, including how to ease yourself back into physical exercise after a pulled oblique muscle, read on!
Reader Success Stories
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"Pulled muscle in my right side by loading a milk cooler. Did not feel any pain for 5 hours. It wasn't too bad, but repeated the same action the next day, and within 4 hours was in a lot of pain. Insurance was changing as company was being taken over by a new one, so I decided to tough it out. Pain when I take deep breaths, uncomfortable sleeping and sitting caused me to seek out online advice. I was doing most of what your site said except resting the injury."..." more