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Pulled stomach muscle? How to diagnose & fix it!

Pulled stomach muscle

A pulled stomach muscle often causes lots of pain. It can come on without an obvious cause. And it’s persistent, hanging around for weeks.

But those symptoms are the same for many abdominal issues – digestive problems and the like. So how do you confirm that it’s an abdominal muscle strain?

And once you’ve confined it, how do you get rid of it? Pulled stomach muscles are notoriously frustrating. It seems to settle down, only to flare up quickly with sprints or planks.

So here’s our Sports Physio’s tips and tricks to diagnosing and fixing abdominal muscle injuries.


  • An abdominal strain needs excessive muscle loading to become symptomatic
    • Common causes include unaccustomed abdominal strength exercises (eg. Crunches) and high intensity or sudden abdominal loading (eg. Sneezing or coughing)
    • Symptoms begin within a few hours to two days after the overload
    • If there are no obvious causes of muscle overload, you should be wary of non-muscle causes of abdominal pain. These include reproductive and digestive conditions
  • Symptoms can be stirred up with abdominal stretch or abdominal contraction
    • Like any muscle injury, the pain can be aggravated by activating or stretching the muscle
    • However, in the case of organ-related symptoms, this can also generate symptoms due to compression of the area. Due to this, pain on muscle contraction or stretch shouldn’t be used to determine the diagnosis
  • It usually feels better overnight but gets sore again with daily activities
    • The muscles get a chance to relax and recover overnight, so they feel better on waking. They still may cause discomfort initially while trying to find a comfortable sleeping position
    • Non-muscle causes, such as digestive issues, may worsen overnight and cause discomfort during sleep
  • It doesn’t worsen when you’re sitting
    • Sitting down puts the muscles in a shortened, relaxed position and reduces or eliminates symptoms
    • Conversely, symptoms caused by abdominal organs can worsen in sitting


To fix a pulled stomach muscle, you first need to know what may contribute to further overload. These include:

  • Fast or strong twisting forces
    • Examples include a golf swing or tennis backhand
  • Repetitive or excessive stretch
    • Examples include sprinting or fast running or overhead lifting
  • Muscle contraction in a stretched position
    • This includes a tennis serve or butterfly swimming technique

Each of these elements should be avoided in the early stages of recovery. As the symptoms begin to subside, you can gradually reintroduce each type of loading. It’s this reloading period that carries the greatest likelihood of reaggravation.

As symptoms allow, you can progress through a strength program. This is to improve the tolerance of the muscles to loading.

  1. Wall push up
  2. Elevated plank
  3. Plank on elbows
  4. Mountain climbers
  5. Russian twists
  6. Inch worm

You can also begin to introduce other strength work, such as squats, as soon as they’re comfortable. Keep all strength work to double leg exercises in the early phases.


  • Inguinal hernia
    • A hernia tends to ache a lot after exertion and is slow to settle
  • Inguinal ligament strain
    • A ligament strain at the bottom of the abdominal wall, this injury is similar to an abdominal muscle strain. The rehab program for it is very similar to a abdominal muscle strain
  • Digestive or reproductive condition
    • These conditions can get worse at rest or without obvious muscle loading. If in doubt, get it checked out!
  • Hip flexor injury
    • This will feel like a deep muscle strain in the lower abdominal area. The rehab for it is slightly different from abdominal muscle injuries