Symptoms
Sudden, cramp-like, unpleasant pain in the abdominal area is one of the typical symptoms of abdominal muscle strain. In addition, severe forms of abdominal muscle strain can lead to local bleeding into one or more abdominal muscles. In the course of these bleedings, bruises (haematomas) develop which are not always visible from the outside.
Typically, however, the bruises can be palpated if the abdominal muscle is bruised. Immediately after the bruise has developed, an elastic-rubber-like bulge must be palpated in the area of the abdomen. This begins to harden as the bruise progresses.
After some time the organism begins to reduce the bruise and the typical bump disappears. In addition, a slight pulling of the abdominal muscles can provoke stabbing or pulling stretch pains. In some cases these pains can radiate into the hip joints.
In the case of a simple muscle strain, the pain can usually be relieved by immobilising the affected area of the body. Stress on the abdominal muscles, on the other hand, leads to an increase in the intensity of the pain felt by the patient. This fact provides a decisive criterion for distinguishing between a contusion of the abdominal muscles and a torn muscle fibre.
In the case of a torn muscle fibre, the complaints hardly noticeably subside even under resting conditions. The diagnosis of an abdominal muscle strain proceeds in several steps. The most important step is the detailed doctor-patient consultation (anamnesis).
Already during this conversation, the symptoms described by the patient can give a first indication of the presence of an abdominal muscle strain. Probably the most important differential diagnosis of abdominal muscle strain is a torn muscle fibre. These two diseases differ both in the quality and intensity of the pain perceived by the patient.
While a pulled abdominal muscle causes cramp-like, rapidly increasing pain, a torn muscle fibre is typically characterised by sudden, stabbing pain. Most of the patients affected state that the pain caused by the injury is so strong that straining the muscles is hardly possible. The doctor-patient consultation is usually followed by an orienting physical examination.
During this examination, the appearance and behaviour of the muscle is examined. Above all, loading the affected muscle against a resistance is considered a particularly suitable method in the diagnosis of abdominal muscle strain. During this test, the patient is asked to tense the abdominal muscles against a resistance.
If an abdominal muscle strain is present, the patient usually adopts a relieving posture. In addition, a spindle-shaped swelling can often be palpated if an abdominal muscle strain is present. In the case of a torn muscle fibre, superficial bruises (haematomas) are often visible.
In addition, visible dents that appear immediately after the onset of the first symptoms indicate the presence of a torn muscle fibre. If the suspected diagnosis “abdominal muscle strain” could be confirmed by the doctor-patient consultation and the physical examination, a rough estimate of the extent of the injury must be made. Ultrasound examinations are considered a particularly suitable method in this context.
Determining the extent of the injury is particularly important because the most appropriate treatment measures depend to a large extent on the severity of the muscle injury. Above all, the presence of heavy bleeding can make hospital admission necessary. Indications of the presence of bleeding between the individual muscles include the rapid subsiding of the swelling and prompt functional efficiency of the injured area. If there is bleeding into the affected muscle itself, the swelling typically increases rapidly. In addition, in these cases it is often possible to observe shifts in the bruising and a significant impairment of the muscle’s ability to contract.
