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What Does an Oblique Injury Feel Like? Causes, Treatment

An oblique injury often results in an initial sharp pain in the rib cage that evolves into a sense of tightness on the lower ribs over time.

An oblique injury, also called side strain, can feel like sharp pain in the rib cage the first time the oblique muscle gets injured. Over time, you may experience a sense of tightness and pressure on the lower ribs or the front side of the abdomen. The pain gets aggravated when you twist your body from a sitting position or when rising from a bed.

Oblique injury refers to the injury to any of the oblique muscles, internal oblique or external oblique, which are located on the outer surface of the sides of the abdomen.

  • The external oblique lies superficially (closer to the skin) with the internal oblique lying underneath.
  • These muscles run from the lower ribs to the pelvis and help you twist your body.
  • They help in other movements, such as sideways and forward bending, breathing movements, and increase the pressure inside the abdomen for purposes, such as passing stools or during childbirth.

What causes an oblique injury?

Sports activities that involve planting the feet and twisting with maximum effort can injure the oblique muscle.

Examples of such sports include:

  • Ice hockey
  • Soccer
  • Wrestling
  • Golf
  • Tennis
  • Basketball
  • Soccer

How is an oblique injury diagnosed?

Your doctor will ask about the symptoms and how the injury occurred. They will perform a physical examination, wherein they will likely ask you to do a sit-up or flex your trunk against resistance.

If they suspect that you have torn your oblique, they may order X-rays or magnetic resonance imaging scans. They may order bone scans or other tests to rule out other possible causes of the pain.

How is an oblique injury treated?

Mild oblique injuries, such as oblique strains, resolve in one to two weeks with typical treatment that involves:

  • Home remedies
    • Resting is an important part of treatment in the initial 7 to 10 days.
    • Applying ice on the affected area for 15 to 20 minutes about three to four times a day helps alleviate the pain and inflammation.
    • Your doctor may advise you a compress or wrap if you have groin swelling.
  • Medications
    • Over-the-counter pain medications, such as acetaminophen, naproxen, or ibuprofen, can help resolve the inflammation and help you get rid of the pain in case ice packs do not help.
    • If your symptoms do not improve with the above pain medications, your doctor may suggest a cortisone injection, which is a steroid medicine.
  • Physical therapy
    • Two weeks after your injury, your doctor may advise you to do physical therapy exercises or refer you to a physical therapist for the same.
    • These exercises are aimed at improving strength and flexibility in your abdominal and inner thigh muscles.
  • Surgery
    • Depending on the severity and location of the oblique injury, the doctor may immobilize the oblique muscle into a cast for two to four weeks or recommend surgery to repair the torn muscle.
    • Most athletes can resume sports 6 to 12 weeks after surgery.
    • More than 90 percent of patients are successfully treated for oblique injuries either with medical or surgical treatments and can resume sports. Sometimes, returning to sports activities can injure or tear the oblique muscle again, necessitating a repeat surgery.

How to prevent oblique injuries

There is no single thing that can guarantee the prevention of oblique injuries if you are an athlete involved in sports activities that require frequent rotation and twisting of your body. 

However, you can minimize your risk by taking a few precautions that include:

  • Avoid improper twisting or improper bending of the trunk to prevent any muscle strain on the oblique muscles. Learn the right technique.
  • Do not forget to perform warm-up or cool-down exercises that target all your muscles, including oblique muscles.
  • Perform exercises that also target improving muscle flexibility and strength to prevent strains from occurring.

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Medically Reviewed on 12/29/2021

References

Image Source: iStock Images

American Academy of Orthopaedic Surgeons. Sports Hernia (Athletic Pubalgia). https://orthoinfo.aaos.org/en/diseases–conditions/sports-hernia-athletic-pubalgia/

Connell DA, Jhamb A, James T. Side strain: a tear of internal oblique musculature. AJR Am J Roentgenol. 2003 Dec;181(6):1511-7. doi: 10.2214/ajr.181.6.1811511.

Shian B, Larson ST. Abdominal wall pain: clinical evaluation, differential diagnosis, and treatment. Am Fam Physician. 2018 Oct 1;98(7):429-36. https://www.aafp.org/afp/2018/1001/p429.html

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