How to prevent and treat an oblique strain

Sometimes you can experience discomfort on one or both sides of your abdomen, near your rib cage. This side pain, which can feel sharp or dull, may be a sign of an oblique strain or injury.

With an oblique strain, movements like twisting or bending sideways can feel uncomfortable. While exercising may — understandably — be the last thing on your mind, targeted stretches and gentle low-impact activity can help heal an oblique strain, says Emily Davis, PT, DPT, a physical therapist with Hinge Health. 

Ahead, learn more about ‌an oblique strain, including what it feels like, its causes, and how to treat it — especially with exercises from Hinge Health physical therapists.

What is an oblique strain?

An oblique strain is a pulled or partially torn oblique muscle. It can happen when one of your oblique muscles is overstretched. There are two types of oblique muscles that run along the sides of your abdomen: external and internal. “These muscles enable you to bend to the side and forward,” Dr. Davis says. “They also help you rotate your torso when you put on a seatbelt in the car, or swing a bat while playing baseball.” 

Your oblique muscles are strong and resilient, but sometimes they can become strained if your body isn’t used to certain movements, or if you quickly increase your activity level. “I see oblique strains in weekend warriors, or people who are sedentary all week and then go overboard on their weekend workouts and activities,” Dr. Davis says.

Common causes of oblique strains

Oblique strains can happen from an injury, such as a quick or forceful twisting motion, or gradually over time from overuse, Dr. Davis says. 

• Playing certain sports. Oblique muscle strains can occur when engaging in activities that involve a lot of twisting or quick, powerful movements, such as baseball, gymnastics, soccer, rowing, golf, and tennis. “We often notice this injury happen to athletes as they do forceful actions like swinging a golf club,” Dr. Davis says.

• Repetitive motion. Doing the same movement over and over — even something you enjoy — can leave your muscles feeling tired or sore. Maybe you powered through extra bicycle crunches in your workout, or spent longer on the rowing machine than usual. That extra effort can lead to oblique strain.

• Lifting. It’s common for your obliques to feel sore after lifting something heavy, like moving boxes. “When you lift from the ground, you might naturally twist your upper body, which can make your obliques work harder,” says Dr. Davis. Sometimes, this can lead to ‌muscle strain. But that doesn’t mean you should steer clear of lifting heavy items or weights. It just means your muscles need time to adapt and become stronger.

• Coughing or sneezing. Ever had a stubborn cold or respiratory virus that just won’t go away? Sneezing and coughing for several days or weeks (say, during allergy season) can strain your core muscles, which include your obliques. 

• Muscle imbalance. If parts of your core, back, or hip muscles are weak or tight, your oblique muscles might work harder to pick up the slack, says Dr. Davis. Over time, this extra effort can lead to ‌strain.

Oblique strain symptoms 

In general, you may notice the following:

• Sharp or dull pain on one side of your abdomen. “It may worsen with certain movements, like twisting,” Dr. Davis says. “In some cases, it may hurt to take a deep breath.” 

• Difficulty bending down or to the side. 

• Pain when you sit or stand. “Your oblique muscles are more engaged when you sit or stand, compared to when you lie down,” Dr. Davis says.

• Pain spreads across your stomach and even into your lower back.

• Swelling or bruising. “These two symptoms are often a sign of a muscle tear,” Dr. Davis says.

The above exercises are recommended by Hinge Health physical therapists to treat oblique strain. When you’re experiencing pain from an oblique strain, dynamic stretches and gentle exercises like these can offer relief by increasing blood flow to the area and easing muscle tension. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for oblique strain 

Oblique strain can be painful, but it’s very treatable. Many people don’t even have to stop playing their favorite sport or doing their preferred workouts. With conservative treatments these, you can keep doing what you love while promoting healing. 

• Try physical therapy and targeted exercises. Targeted exercises can help ease tension in strained oblique muscles. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Stay active. “Oblique strains can be a bit challenging because these muscles are working throughout most of the day, except when you sleep,” says Dr. Davis. While everyday activities like sweeping the floor or lifting objects from the ground can be uncomfortable with an oblique strain, movement is medicine. Staying active increases blood flow to the area, which promotes healing, says Dr. Davis. Low-impact activities such as walking, cycling, and yoga are just a few examples of activities that support healing.

• Apply ice or heat. Ice can help tame inflammation and swelling within the first 48-72 hours after an injury, says Dr. Davis. Heat promotes blood flow to the affected area, easing tension in tight muscles. Consider using both methods, or sticking to the one that feels best for you. 

• Consider over-the-counter medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for oblique pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Wear external support. You can use an abdominal brace to help you stay more active. Choose one that’s elastic and flexible for comfort. As an alternative, you can wear a snug, compression shirt to support your obliques as you stay active and do your targeted exercises.

• TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle electrical impulses to interact with your nervous system and help reduce pain associated with an oblique strain. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

When to see a doctor

An oblique strain often improves on its own with conservative treatments and time, Dr. Davis says. But if your oblique strain is severe, getting worse, or causing difficulty with daily activities, see a healthcare provider. It’s also a good idea to get care if you have other symptoms, including:

• Pain that’s so intense it becomes difficult to breathe (this can increase the risk of developing pneumonia)

• Unusual symptoms like fever, chills, nausea, vomiting, or dizziness with pain (could be signs of a problem inside the abdomen)

• Lumps or masses you can feel in the abdomen (can be a sign of a hernia)

• Pain that causes a lot of worry or difficulty when working or exercising

Tips to prevent an oblique strain 

If you’ve already had an oblique strain, you may be more prone to another one, Dr. Davis says. You can prevent that from happening with these strategies:

• Warm up. “Before you start activities with a lot of twisting, like golf, tennis, or football, it’s helpful to do some gentle movements that let your body bend forward and side to side,” says Dr. Davis. Consider warming up with a diaphragmatic breathing exercise and child’s pose with a side bend (found above).

• Balance it out. Aim to include a mix of aerobic, strength, and flexibility exercises in your routine, says Dr. Davis. Try some of the exercises listed above, or even yoga or tai chi. “Prioritizing restorative movements can help keep your oblique muscles both strong and flexible,” Dr. Davis says.

• Space your workouts throughout the week. There’s nothing wrong with saving longer or more vigorous workouts for the weekend. But, if that’s your main exercise for the week, your body may not be ready for more intense movement. “Spreading out your activity — like doing 30 minutes every other day or daily — can help your body build up to activity and lower your chances of overdoing it,” Dr. Davis says. 

• Lift heavy objects intentionally. You’re naturally stronger in certain positions, so it can be useful to take a moment to assess your body position and find a firm stance before lifting a heavy load. When lifting something from the ground, try to avoid twisting your torso, because it can put extra stress on your oblique muscles, says Dr. Davis. Using a combination of movements—like bending your knees to squat and hinging at your hips—can help you feel more steady and supported when lifting.

PT tip: Twist it out

It may sound counterintuitive to do the motion that can trigger an oblique strain, but doing so carefully and slowly can help promote blood flow and support your recovery. “Include exercises with gentle twisting, like side bends, in your daily routine to keep your obliques strong and flexible,” says Dr. Davis. Even simple movements — like taking a movement break at your desk to look over each shoulder — can help support these muscles.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Tenner, Z. M., Lamba, A., Camp, C. L., Griffith, T. B., & Conte, S. (2024). Abdominal Oblique and Rectus Muscle Injuries in Major and Minor League Baseball Players: An Updated Epidemiological Review. Orthopaedic Journal of Sports Medicine, 12(11). doi: 10.1177/23259671241293454

2. Komatsu, S., Kaneko, H., & Nagashima, M. (2022). Characteristics of internal oblique muscle strain in professional baseball players: a case series. BMC Sports Science, Medicine and Rehabilitation, 14(1). doi: 10.1186/s13102-022-00510-5

3. Flynn, W., & Vickerton, P. (2020). Anatomy, Abdomen and Pelvis, Abdominal Wall. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK551649/