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Muscle strains (an injury to the muscle itself or to the ligament connected to the muscle) and sprains (an injury to the connective tissues attached to a muscle) can occur just about anywhere in the body, including the abdominal muscles.

Who gets injuries to the abdominal muscles? They are most common in women who have recently delivered a child. They also occur in weightlifters of both sexes. They can occur during contact sports. Any injury that "knocks the wind out of you" can result in an abdominal strain or sprain.

When these injuries occur in the abdomen, however, it's not like you can just put ice on them and rest them while you go about your day. You use your abdominal muscles constantly, and helping them heal after injuries can be a little tricky.

But here's what you can do:

  • Going to the bathroom more often than usual can be helpful if you have had an abdominal sprain or strain. It can also help to urinate before you exercise. A blow to your bladder could rupture it, although this is a relatively rare event, since most of us don't exercise on a full bladder. However, the pressure on abdominal muscles from a full bladder increases risk of injury.
  • Eat smaller meals. Don't overhydrate.
  • While you are healing, avoid exercise, especially any exercise that can cause a spasm in your abdominal muscles. This just is not the time to try to build your six-pack.
  • The first 48 hours after an injury, apply ice to relieve pain. After the first 48 hours, apply heat to keep the muscles loose.
  • Ultrasound and TENS (transcutaneous electroneural stimulation) may relieve pain. Both ultrasound and TENS units are available without a prescription.
  • Therapeutic massage may also help.

If your injury interferes with walking, sitting, standing, eating, or going to the bathroom, see your physician.

A more serious kind of abdominal injury that affects millions of people every year is a hernia. An abdominal hernia is a hole in the wall of the abdomen that allows an organ beneath it to get caught. If circulation to the organ is strangulated by the hernia, a life-threatening condition may result.

An uncomplicated abdominal hernia may cause:

  • A visible bulge in the abdomen, usually round in shape.
  • A dull ache at the site of the hernia.
  • No clearly identifiable inflammation of the hernia.
  • Increase in size of the hernia on standing or after eating or drinking.

An "incarcerated" hernia may cause:

  • Intense pain.
  • Vomiting, nausea, or bowel obstruction.

It isn't possible to move an incarcerated hernia through the the hole in the abdominal wall.

There was a time when abdominal hernias might have been treated with a compound called an escharotic. A chemical like silver nitrate or merbromin would be applied to the hernia with the intention of killing the tissue. Of course, if it's a vital organ that is causing the hernia, this is a very unhelpful approach.

Abdominal hernias have also been treated with compression dressings. Over a period of five to ten days, constant pressure on the hernia would be hoped to move the tissue back inside the abdomen. 

Neither of these approaches is anything you should try at home. And both are seriously outdated and only used when surgery is not possible.

Modern surgery is usually successful for simple hernia repair. If the hernia has cut off circulation to part of the intestines or another abdominal organ, however, there is a mortality rate of about 10 percent.

Hernias aren't something you should ever try to take care of on your own. They can imitate many other conditions, including:

  • Ascites (accumulation of fluid due to liver failure).

  • Constipation,

  • Chronic obstructive pulmonary disease (COPD).

  • Chronic cough.

  • Groin abscess.

  • Hematoma (accumulation of blood after an injury).

  • Lipoma (fatty tumor).

  • Lymphadenitis (an inflammatory condition of the lymph glands).

  • Obstructive uropathy (blockage in the urinary tract).

  • Pseudoaneurysm (bulge in an artery due to pressure building up around an obstruction).

  • Spermatocele (cyst in the tube that carries sperm from the testes).

  • Tumor.

  • Undescended or retracted testes (in baby boys).

  • Varicocele (varicose veins in the spermatic cord).

Don't bear the burden of diagnosis all by yourself. Any time an abdominal sprain, strain, or hernia doesn't resolve on its own in three or four days, or interferes with your daily activities, let your doctor treat it.

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