Muscle in your stomach

Abdominal muscles - Better Health Channel

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Summary

Read the full fact sheet

The abdominal muscles support the trunk, allow movement and hold organs in place by regulating internal abdominal pressure.
The deep abdominal muscles, together with muscles in the back, make up your 'core' muscles and help keep your body stable and balanced, and protects your spine.
Causes of abdominal muscle strains include overstretching, overuse or a violent, poorly performed movement of the trunk.

The abdominal muscles are located between the ribs and the pelvis on the front of the body. The abdominal muscles support the trunk, allow movement and hold organs in place by regulating internal abdominal pressure.

Consult with your doctor, physiotherapist or sports physician for proper diagnosis and treatment of abdominal muscle injuries.

Abdominal muscles explained

The four main abdominal muscle groups that combine to completely cover the internal organs include:

transversus abdominis – the deepest muscle layer. Its main roles are to stabilise the trunk and maintain internal abdominal pressure
rectus abdominis – slung between the ribs and the pubic bone at the front of the pelvis. When contracting, this muscle has the characteristic bumps or bulges that are commonly called ‘the six pack’. The main function of the rectus abdominis is to move the body between the ribcage and the pelvis
external oblique muscles – these are on each side of the rectus abdominis. The external oblique muscles allow the trunk to twist, but to the opposite side of whichever external oblique is contracting. For example, the right external oblique contracts to turn the body to the left
internal oblique muscles – these flank the rectus abdominis and are located just inside the hipbones. They operate in the opposite way to the external oblique muscles. For example, twisting the trunk to the left requires the left side internal oblique and the right side external oblique to contract together.

Core muscles

Think of your core as a strong column that links the upper body and lower body together. Having a solid core creates a foundation for all activities. All our movements are powered by the torso – the abdominals and back work together to support the spine when we sit, stand, bend over, pick things up, exercise and more.

Your core muscles are the muscles deep within the abdominals and back, attaching to the spine or pelvis. Some of these muscles include the transversus abdominis, the muscles of the pelvic floor, and the oblique muscles.

Another muscle that is involved in moving the trunk is the multifidus. This is a deep back muscle that runs along the spine. It works together with the transversus abdominis to increase spine stability and protect against back injury or strain during movement or normal posture. Proper ‘core strengthening’ techniques, learned from a skilled allied health professional, can support the combined function of these muscle groups.

Effective abdominal exercises

When you decide to add some abdominal exercises to your exercise program, be careful about which ones you choose. A qualified fitness instructor can help you develop a safe, effective program. If you have a pre-existing injury or medical condition, consult an exercise physiologist or physiotherapist.

Incorporate exercises to train your core muscle group, rather than standard crunches that target separate muscles. Some effective abdominal muscle training methods include:

Pilates (pronounced Pi-lah-teez) is an exercise technique traditionally used by dancers for deep-body conditioning and injury rehabilitation.
The stability ball (or fitball, Swiss ball or exercise ball) is an extra-large, inflatable ball designed to improve balance while targeting specific muscle groups. You can use exercise balls in a variety of ways to challenge balance, stability and torso strength.

Muscle strains

You can strain your abdominal muscles from overstretching or overuse. Prevention strategies include regular stretching, warming up prior to exercise and cooling down afterwards, and keeping good form while playing sport.

Where to get help

Your doctor
Doctor specialising in sports medicine
Physiotherapist
Exercise physiologist
ESSA Exercise & Sports Science Australia Tel. (07) 3862 4122
Sports Doctors Australia Tel. (02) 8116 9815
Sports Medicine Australia – Victoria Tel. (03) 9674 8777

Things to remember

The abdominal muscles support the trunk, allow movement and hold organs in place by regulating internal abdominal pressure.
The deep abdominal muscles, together with muscles in the back, make up your core muscles.
Your core muscles help keep your body stable and balanced, and protect your spine.
Muscle strains can be prevented by regular stretching, warming up prior to exercise and cooling down afterwards, and keeping good form while playing sport.

Cramps and stitches,Australian Institute of Sport.
Barr KP, Griggs M, Cadby T, 2005, Lumbar stabilization: core concepts and current literature – part 1, PubMed, US National Library of Medicine. More information here.
Barr KP, Griggs M, Cadby T, 2007, Lumbar stabilization: a review of core concepts and current literature – part 2, PubMed, US National Library of Medicine. More information here.

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Content disclaimer

Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

Reviewed on: 30-06-2015

Abdominal muscles - Better Health Channel

Actions for this page

Summary

Read the full fact sheet

The abdominal muscles support the trunk, allow movement and hold organs in place by regulating internal abdominal pressure.
The deep abdominal muscles, together with muscles in the back, make up your 'core' muscles and help keep your body stable and balanced, and protects your spine.
Causes of abdominal muscle strains include overstretching, overuse or a violent, poorly performed movement of the trunk.

Consult with your doctor, physiotherapist or sports physician for proper diagnosis and treatment of abdominal muscle injuries.

Abdominal muscles explained

The four main abdominal muscle groups that combine to completely cover the internal organs include:

transversus abdominis – the deepest muscle layer. Its main roles are to stabilise the trunk and maintain internal abdominal pressure
rectus abdominis – slung between the ribs and the pubic bone at the front of the pelvis. When contracting, this muscle has the characteristic bumps or bulges that are commonly called ‘the six pack’. The main function of the rectus abdominis is to move the body between the ribcage and the pelvis
external oblique muscles – these are on each side of the rectus abdominis. The external oblique muscles allow the trunk to twist, but to the opposite side of whichever external oblique is contracting. For example, the right external oblique contracts to turn the body to the left
internal oblique muscles – these flank the rectus abdominis and are located just inside the hipbones. They operate in the opposite way to the external oblique muscles. For example, twisting the trunk to the left requires the left side internal oblique and the right side external oblique to contract together.

Core muscles

Effective abdominal exercises

Incorporate exercises to train your core muscle group, rather than standard crunches that target separate muscles. Some effective abdominal muscle training methods include:

Pilates (pronounced Pi-lah-teez) is an exercise technique traditionally used by dancers for deep-body conditioning and injury rehabilitation.
The stability ball (or fitball, Swiss ball or exercise ball) is an extra-large, inflatable ball designed to improve balance while targeting specific muscle groups. You can use exercise balls in a variety of ways to challenge balance, stability and torso strength.

Muscle strains

Where to get help

Your doctor
Doctor specialising in sports medicine
Physiotherapist
Exercise physiologist
ESSA Exercise & Sports Science Australia Tel. (07) 3862 4122
Sports Doctors Australia Tel. (02) 8116 9815
Sports Medicine Australia – Victoria Tel. (03) 9674 8777

Things to remember

The abdominal muscles support the trunk, allow movement and hold organs in place by regulating internal abdominal pressure.
The deep abdominal muscles, together with muscles in the back, make up your core muscles.
Your core muscles help keep your body stable and balanced, and protect your spine.
Muscle strains can be prevented by regular stretching, warming up prior to exercise and cooling down afterwards, and keeping good form while playing sport.

Cramps and stitches,Australian Institute of Sport.
Barr KP, Griggs M, Cadby T, 2005, Lumbar stabilization: core concepts and current literature – part 1, PubMed, US National Library of Medicine. More information here.
Barr KP, Griggs M, Cadby T, 2007, Lumbar stabilization: a review of core concepts and current literature – part 2, PubMed, US National Library of Medicine. More information here.

This page has been produced in consultation with and approved by:

Give feedback about this page

Was this page helpful?

More information

Content disclaimer

Reviewed on: 30-06-2015

Anatomy of the abdominal muscles | KinesioPro

The abdominal muscles form the anterior and lateral abdominal wall and include the external and internal obliques, rectus abdominis, and transversus abdominis. Together, these muscles form a strong wall that protects the internal organs and helps maintain the upright position of the body. In addition, the contraction of these muscles aids in exhalation and increases intra-abdominal pressure during sneezing, coughing, urinating, defecation, heavy lifting and childbirth.

The external oblique muscle of the abdomen

The oblique abdominal muscle is the largest and most superficial of the four muscles and lies on the sides and in front of the abdomen. It is wide and thin, its muscular part occupies the lateral side, and the aponeurosis - the anterior wall of the abdomen. It departs from the outer surface and lower borders of the last eight ribs. Fibers (inferior) from the lowest ribs run almost vertically downward and insert on the anterior half of the iliac crest; the middle and upper fibers, directed downward and anteriorly, terminate in an aponeurosis approximately in the middle of the clavicular line and are attached to the xiphoid process, the white line of the abdomen, the pubic crest and the pubic tubercle.

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Innervation

The LCM of the abdomen is innervated by six lower thoracic nerves, iliohypogastric and ilioinguinal nerves.

Function

Working together, the external obliques flex the spinal column, pulling the pubis towards the xiphoid process. Contraction of one LCM results in ipsilateral lateral flexion and contralateral rotation of the trunk.

Internal oblique muscle of the abdomen

The abdominal ICM is also a wide, thin muscle layer that lies deep in relation to the abdominal ICM. It originates from the thoracolumbar fascia, the anterior two-thirds of the iliac crest, and the lateral two-thirds of the inguinal ligament. Muscle fibers spread in the superomedial direction and attach to the lower borders of the lower three ribs and their costal cartilages, the xiphoid process, the linea alba and the pubic symphysis. Near their insertion, the lowest tendon fibers join with similar fibers of the transversus abdominis muscle to form a united tendon.

Innervation

The abdominal ECM is innervated by the six lower thoracic nerves, the iliohypogastric and ilioinguinal nerves.

Function

Unilateral contraction of the ECM of the abdomen results in ipsilateral lateral flexion and rotation of the trunk. This is achieved by contracting along with the NKM of the abdomen, located on the opposite side. This muscle also contributes to an increase in intra-abdominal pressure by pushing the internal organs up towards the diaphragm, which leads to forced exhalation.

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Transversus abdominis

The transversus abdominis is the deepest of the abdominal muscles, lying medially relative to the ECM of the abdomen. This is a thin layer of muscle, the fibers of which are directed horizontally and anteriorly. The transverse abdominis muscle rises as fleshy fibers from the deep surface of the lower six costal cartilages, the lumbar fascia, the anterior two-thirds of the iliac crest, and the lateral third of the inguinal ligament. It connects to the xiphoid process, the linea alba, and the pubic symphysis. The inferior tendon fibers connect with similar fibers of the abdominal ECM to form a united tendon attached to the pubic crest and pectineal line.

Innervation

The transversus abdominis is innervated by the six lower pectoral nerves, the iliohypogastric and ilioinguinal nerves.

Function

Contraction of the transversus abdominis has a corsetopodal effect, narrowing and flattening the abdominal cavity. Its main function is to stabilize the lumbar spine and pelvis before movement of the lower and/or upper limbs occurs.

Rectus abdominis

The rectus abdominis is a belt-like muscle that extends the entire length of the anterior abdominal wall. It is wider at the top and lies closer to the midline, separated from other muscles by the white line of the abdomen. It rises with two heads from the anterior part of the pubic symphysis and the crest of the pubic bone and is attached to the 5th, 6th and 7th costal cartilages and the xiphoid process. Each rectus abdominis muscle is divided into three distinct segments by three transverse fibrous intersections. It is enclosed between the aponeuroses of the external and internal oblique abdominal muscles and the transverse abdominal muscle, which form the sheath of the rectus abdominis muscle.

Innervation

This abdominal muscle is innervated by six lower pectoral nerves.

Function

The rectus abdominis is an important postural muscle. With a fixed pelvis, its contraction leads to flexion of the lumbar spine. When the chest is fixed, contraction of this muscle results in a posterior tilt of the pelvis. It also plays an important role in forced expiration and increased intra-abdominal pressure.

Source: Physiopedia - Abdominal Muscle Anatomy.

Diastasis of the rectus abdominis muscles - symptoms, signs, degrees, causes and treatment in men and women in Moscow in the "SM-Clinic"

The surgeon deals with the treatment of this disease

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What is diastasis rectus abdominis?
About disease
Species
Symptoms of diastasis recti
Causes of diastasis recti
Diagnostics of diastasis of the rectus abdominis muscles
Expert opinion
Treatment of diastasis recti
Surgical treatment of diastasis recti
Prophylaxis
Rehabilitation after surgery
Questions and Answers
Sources

About the disease

The disease is based on stretching and expansion of the white line of the abdomen - a tendon that is located between the rectus muscles, connects and holds them. This is a strip of connective tissue, consisting of several layers, located in the middle of the abdomen vertically from the xiphoid process to the pubic joint.

Due to an increase in intra-abdominal pressure or a violation of the properties of the connective fibers, the structure of the tendon changes, it weakens, becomes thinner and stretches. The trigger mechanism is prolonged pressure on the abdominal wall associated with pregnancy or visceral obesity. An aggravating factor is the loosening of the white line against the background of collagenopathy, the effects of relaxin, the immaturity of cellular structures, etc.

As a result, the white line becomes thinner and stretched. Normally, its dimensions are restored with a gradual decrease in the abdomen or as the properties of the connective tissue normalize. Thus, physiological diastasis is eliminated during the neonatal period or in women after childbirth.

If abdominal training is started early in the postpartum period, this leads to a contraction of the rectus muscles and a simultaneous increase in intra-abdominal pressure, and the white line is fixed in a stretched position and does not hold the internal organs well. As a result, unaesthetic vertical folds form on the abdomen, a rounded protrusion appears, dysfunction of the digestive tract occurs and the risk of hernia formation increases.

Species

Depending on the magnitude of the stretching of the tendon ligament, there are 3 degrees of diastasis of the rectus abdominis muscles:

first - the muscles move away from each other by 2.5-5 cm;
second - ligaments diverge by 5-8 cm;
third - the line is stretched more than 8 cm.

According to the localization of the place of maximum stretching, supra-umbilical, sub-umbilical and mixed forms of diastasis are distinguished.

According to the degree of involvement of other muscles of the anterior abdominal wall, the pathology is classified into types:

A - classical divergence of muscles after natural childbirth;
B - relaxation of the lower lateral sections of the muscles;
C - expansion affects the region of the ribs and the xiphoid process;
D - diastasis is combined with a curvature of the waist line.

Symptoms of diastasis of the rectus abdominis muscles

Manifestations of BPMD increase as the pathology progresses. In women, a vivid clinical picture manifests itself abruptly (shortly after childbirth), while in men the disease develops gradually.

At the onset of the disease, there may be no symptoms at all. The patient then notices a characteristic rounded vertical protrusion in the center of the abdomen. With deliberate tension of the press, the inner edges of the rectus muscles and the groove between them are clearly visible. Due to muscle dysfunction, pain in the spine, lower back, fatigue, and posture disorders are possible.

With the progression of the pathology, manifestations of dysfunction of the gastrointestinal tract join:

heartburn;
belching;
flatulence;
abdominal pain;
constipation.

In the third stage of diastasis, patients are faced with the formation of hernias, which are formed due to structural defects in the white line. Possible ptosis (omission) of internal organs and serious disturbances in the work of the intestines (in severe cases, intestinal obstruction develops). Women often experience urinary incontinence, renal colic.

Causes of diastasis recti

Increase the risk of developing diastasis pathology of the connective tissue and increased pressure in the abdominal cavity. In different categories of patients, the causes of the development of PMSD are different.

Divergence of muscles in children is due to the failure of the musculature and tendons. After 2-12 months after birth, the muscles come into tone, the ligaments and tendons are strengthened - the process resolves itself. In premature babies and infants with intrauterine developmental pathologies, this may take longer. With Down syndrome, there is a risk of maintaining diastasis for life.

Pregnancy is the provocateur of diastasis of the rectus abdominis muscles in women. The growing uterus puts considerable pressure on the linea alba, stretching it. Under the action of hormones, the synthesis of collagen fibers is inhibited, the ligaments become looser. But a few months after the birth, the white line of the abdomen is normally restored.

In men, BMD is often provoked by obesity, physical activity and hereditary collagenopathies. The risk of diastasis increases with a tendency to constipation, as well as with chronic respiratory diseases accompanied by coughing.

Treatment of pathology by conservative methods is possible with a small diastasis. At the later stages of development, the pathological divergence of muscles is eliminated with the help of abdominal plastic surgery.

Get advice

If you experience these symptoms, we recommend that you make an appointment with your doctor. Timely consultation will prevent negative consequences for your health.

You can find out more about the disease, prices for treatment and sign up for a consultation with a specialist by phone:

+7 (495) 292-39-72

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Diagnosis of diastasis of the rectus abdominis muscles

Identification of BPMD is not difficult, since the disease has characteristic clinical manifestations. With signs of diastasis, you should contact the surgeon.

An increase in the space between the rectus muscles is determined during palpation of the abdomen. To conduct the test, the patient is asked to lie on his back, legs slightly bent at the knees, and then tighten the abdominal muscles, raising his head and shoulder blades. In patients with obesity, the doctor is not always able to fully explore the width of the white line.

The exact size of the stretch is determined by ultrasound. This diagnostic method also allows you to detect complications (hernia, displacement of internal organs). In order to differentiate the symptoms of diastasis and manifestations of chronic diseases of the gastrointestinal tract or the genitourinary system, consultations of specialized specialists are prescribed.

Expert opinion

Surgeons warn that diastasis of the rectus abdominis muscles is asymptomatic for a long time. Therefore, in the presence of predisposing factors (recent pregnancy and childbirth, chronic constipation, obesity) or non-specific complaints, you should independently feel the white line of the abdomen in the navel. If the distance between the rectus muscles is more than 2.5 cm, contact the surgeon. Also, do not delay the visit in any doubtful cases. Only a doctor can establish the correct diagnosis, self-examination does not exclude the need for an in-person consultation.

Egiev Valery Nikolaevich, surgeon, oncologist, doctor of medical sciences, professor, head of the Department of Surgery and Oncology, FPC MR MI RUDN University

Treatment of diastasis recti

Functional diastasis in newborns and puerperas does not require treatment. Doctors use expectant tactics, recommend adhering to the principles of rational nutrition, doing massages, and doing gymnastics. The observation period can last up to 12 months. If after this time the problem persists, the surgeon decides on an operative method of correction.

Conservative treatment

Patients are prescribed a diet to prevent constipation and excessive gas formation, as well as to gradually reduce weight. In the postpartum period, incl. after a caesarean section, women are advised to wear a bandage, support the stomach during sneezing and coughing. The general strengthening of the muscles allows you to quickly restore the tone of the anterior abdominal wall, so patients are prescribed exercise therapy, swimming, yoga classes. It is important to exclude any training of the abdominal muscles. You can not perform exercises in the knee-elbow position, as well as in the emphasis (bar). Such loads can be resumed after the restoration of the size of the white line. Conservative treatment is effective only at the 1st stage of BPMD.

Surgical treatment of diastasis of the rectus abdominis muscles

In case of complicated and uncomplicated diastasis of the rectus abdominis muscles of the 2-3rd degree, surgical treatment is indicated. It is possible to use the following techniques of the operation:

Tension plasty using own tissues. It involves stitching the edges of the muscles with the removal of excess connective tissue. To date, it is not used due to the high risk of recurrence.
Tension-free repair with a mesh prosthesis. It implies the introduction of an endoprosthesis under the site of stretching.
Tension plastic with prosthesis installation. It involves the removal of excess connective tissue, suturing the edges of the muscles and strengthening the zone with a polypropylene mesh.
Combined technique. Includes muscle suturing, mesh strengthening, removal of excess adipose tissue and stretched skin.

Prevention

To reduce the risk of developing diastasis rectus abdominis, you should keep your body in shape - engage in regular exercise, train your muscles. However, do not overdo it: lifting weights can, on the contrary, become the main cause of muscle divergence.

It is also important to eat a complete and balanced diet - a lack of nutrients will lead to a decrease in the elasticity of the connective tissue.

It is necessary to control your weight - body mass index should not exceed 26 kg/m3. Obesity, especially of the abdominal type, is an important risk factor for BLV.

Prevention and timely treatment of chronic lung diseases accompanied by cough, pathologies of the digestive system, occurring with constipation, will reduce the possibility of increasing intra-abdominal pressure and, as a result, the likelihood of diastasis.

Rehabilitation after surgery

After surgery, the patient is under inpatient observation, receiving analgesic and antibiotic therapy. Full recovery lasts 1-3 months. During this period, the patient is prescribed a diet to normalize defecation, it is recommended to avoid significant physical exertion, weight lifting. To prevent excess tension, it is necessary to wear a bandage.

Questions and answers

A surgeon deals with the treatment of pathology.

In the stronger sex, obesity and connective tissue dysplasia are considered to be the main cause of BMD. Sharp weight loss or weight gain, excessive passion for power loads are capable of provoking muscle divergence. If a man or close relatives have hernias, varicose veins, valgus flat feet, hemorrhoids, this is regarded as an increased tendency to PMSD.

There is no need to rush in this matter. Just the desire to quickly get in shape is the main reason for the progression of diastasis in women. Physical activity can be resumed 1-2 months after delivery. You can start with hiking or yoga. Abdominal exercises can be performed soon after the white line is reduced to 2 cm. It is advisable to pay attention to the diet. A smooth decrease in weight and volume of visceral fat will ensure gradual and timely muscle contraction. Sharp weight loss, on the contrary, can increase diastasis.

You can lie on a hard surface on your back, tense your abs. With gentle movements of the fingers, you should begin to probe the stomach in the middle in the navel. With a normal width of the white line and with diastasis, a depression will be found - this is the median ligament. If its width is equal to or greater than the width of two fingers, you should contact the surgeon. Constipation, bloating and abdominal pain should be alarming. If there are such symptoms, it is necessary to get to the surgeon in the near future.

Pathogenesis and treatment of ventral hernias and diastasis of the rectus abdominis muscles: Abstract of the thesis / Zagirov U.Z. - 1995.

Comparative aspects of methods for eliminating diastasis of the rectus abdominis muscles / Topchiev MA, Bondarev VA, Elderov S.Sh.// Astrakhan medical journal. - 2010.

Jessen M. L., Öberg S., Rosenberg J. Treatment Options for Abdominal Rectus Diastasis // Front Surg. - 2019. - No. 6. - R. 65

Diseases referred by the Surgeon

Appendicitis Atheroma femoral hernia Crohn's disease Bursitis Hernia Hernia of the white line of the abdomen hiatal hernia Cholelithiasis Lipoma Bowel obstruction Oleogranuloma kidney tumor Inguinal hernia Peritonitis Barrett's esophagus Polycystic kidney disease Postoperative hernia Umbilical hernia Heel spur Stomach cancer Reflux esophagitis (GERD) Thyroiditis Furuncle (boil) Cholecystitis Peptic ulcer of the stomach and duodenum

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