How to Repair Torn Muscles in the Abdomen

Severe muscle strains in which the abdominal muscles tear — either partially or completely — are no laughing matter. In fact, laughing when you have a torn abdominal muscle is very painful, as is coughing, sitting or standing up, and deep breathing. Torn abdominal muscles require medical treatment, potentially including surgery.

Abdominal muscle strain occurs when the muscle fibers become overstretched, sometimes to the point of tearing. Typically, the cause is an acute injury, such as a sudden twisting movement, picking up a heavy item or exercising too intensely. In addition, underuse, from a sedentary lifestyle, and then overuse can weaken the muscle fibers leaving them more prone to strains.

Muscle strains are categorized according to their symptoms and severity:

‌Grade I strains‌ are mild injuries caused by a few muscle fibers becoming overstretched. This may cause pain, tenderness and swelling, but nothing severe. Grade I strains can usually be treated at home and do not require medical attention.

‌Grade II strains‌ are moderate, affecting more muscle fibers that may be overstretched or partially torn. They will cause more pain, tenderness and swelling, and they may also cause muscle weakness. A doctor will provide a diagnosis and treatment protocol.

‌Grade III strains‌ are severe and involve a complete tear in the muscle. The pain and swelling can be severe, and there may be a complete loss of function. Grade III strains typically require immobilization or surgery.

If your pain is moderate to severe and you experience muscle weakness and significant swelling, you should see your doctor as soon as possible. She will ask you questions about your symptoms and what happened when the strain occurred. She will likely ask you if you heard a popping sound at the time of injury — the sound of muscle tissue separating.

She may ask you to do a physical test, such as a situp, to gauge muscle function. Depending on these initial results, she might order additional tests such as X-rays and magnetic resonance imaging (MRI). If your doctor determines that your abdominal muscle has been torn, she may refer you to an orthopedic specialist. Some severe muscle tears can be healed by immobilizing them in a brace or cast; for other tears, the orthopedist may recommend surgery.

If your abdominal muscle tear is not serious enough to require a specialist consultation, your doctor will send you home with treatment instructions. Typically this involves rest, ice and compression, meant to protect the muscle from further injury and reduce pain and swelling. General recommendations for this home treatment are:

‌Rest:‌ Avoid any activity that causes further pain or injury to the abdominal muscles.

‌Ice:‌ Apply an ice pack for 20 minutes at a time every hour or four to eight times per day. Ice reduces blood flow to the injury site to control swelling and pain.

‌Compression:‌ Wrapping the abdomen with an elastic bandage promotes lymphatic draining and further reduces inflammation. Wrap the area snugly but not so tightly that you have trouble breathing.

Your doctor will likely also recommend over-the-counter pain medications, such as acetaminophen or a nonsteroidal anti-inflammatory drug, or prescription pain medications if the pain is more severe.

Until you no longer have pain and swelling and your doctor gives you the green light, you should refrain from any vigorous activity that could cause reinjury of your abdominal muscles. How long this will take is highly individual, but moderate strains typically take two to three months to heal and severe strains can take several months of rehabilitation. It is crucial that you follow the treatment protocol determined by your doctor, orthopedist and physical therapist for the duration of the recovery period.

Your medical providers will also tell you when it is safe to start a rehabilitative exercise program, which is crucial for restoring strength and regaining optimal functioning of the abdominal muscles. You may start your exercise program under the supervision of a physical therapist and then continue to do these exercises on your own for a prescribed period of time.

Isometric exercises are a good place to start because they do not require any movement of the torso. One such exercise is the abdominal drawing-in maneuver. To do this exercise:

• Lie on your back with your knees bent and your feet flat on the floor.
  
• Press your lower back into the floor, while contracting all of the abdominal muscles.
  
• Hold for 10 seconds, then release.
  
• Repeat for a total of 10 repetitions.
  

Once you have regained some strength and range of motion, you can begin to perform concentric exercises in which there is a shortening of the abdominal muscles:

‌Curl-up:‌

• Lie on the floor with your knees flexed and your feet flat.
  
• Extend your arms at a 45-degree angle, parallel with your thighs.
  
• Contract your abdominal muscles and lift your head and shoulders off the floor without crunching your neck.
  
• Hold for five seconds; then return to the starting position.
  
• Repeat for a total of eight to 12 reps.
  

‌Diagonal curl-up:‌

• Lie down with your knees bent and your feet flat on the floor.
  
• Extend your arms in front of you.
  
• Curl your shoulders and upper back off the floor while rotating slightly to your right. Reach your fingertips to the right side of your knees.
  
• Hold for five seconds; then return to starting position.
  
• Repeat for a total of eight to 12 reps.
  
• Switch sides.

Abdominal tears can be stubborn because of their location. Your abdominals are part of your core — the center of your body — and they are active in everything you do. Modify your movements and ask for help when you need to carry or move something.

Stick to your treatment plan and do not stop your rehabilitation program just because you no longer feel pain or have swelling. Your muscles still need time to heal and regain strength before they are subjected to intense activity.