Pulled Abdominal Muscles or Hernia: 7 Easy Ways to Tell the Difference

Pulled Abdominal Muscles vs. Hernia

Knowing the difference between a pulled abdominal muscle and a hernia can be a challenge. Both hernia and pulled muscles in your abdomen can cause some pain and abdominal discomfort. However, it is important to tell the difference between the symptoms of a strained, stretched or pulled abdominal muscle and a hernia because treating the conditions is different.

Pulled or Strained Abdominal Muscles: What is it?

Your abs comprise of a group of muscles in the stomach area just above the pelvis and below your chest. Your abdominal muscles form part of your core and are important when it comes to body movement and supporting your back. Pulled abdominal muscles can happen by overusing, injuring, or straining your muscles. Pulled abdominal muscles are also called strained abdominal muscles and can cause varying degrees of pain depending on the severity of the muscle pull.

Hernia: What is it?

Hernia occurs when fatty tissue or an organ pushes through a weak spot in the abdominal muscle wall. Hernia usually occurs in the abdomen or groin area and can cause a noticeable bulge or lump around your stomach area in your pelvic region. The area may be tender to touch and you might have pain and a burning sensation near the bulge.

This article will help you tell apart the different symptoms of a pulled abdominal muscle and hernia. This will help you know how best to treat the pain and discomfort that both of these conditions cause and when you should see a doctor.

Pulled Abdominal Muscles vs. Hernia – 7 Ways to Tell the Difference

First, let’s look at the differences between abdominal muscle strain and having a hernia.

1. Bulge

One of the easiest ways to tell if your pain is caused by a hernia or pulled stomach muscle is if you have a bulge or not. A hernia will usually cause a distinct bulge where the tissue or organ pushes through the muscle wall. Abdominal muscle strains don’t cause a bulge or visible lump.

2. Pain

A pulled abdominal muscle will cause varying degrees of pain that gets worse when you move. Not all hernias are painful and may just be sore when you move. However, a pulled abdominal muscle feels more like a stabbing pain in the area where the strain happened whereas a hernia causes a burning-like sensation that is more like a dull ache or a feeling of fullness.

3. Abdominal cramping

One way to tell the difference between hernia and pulled abdominal muscles is that hernia doesn’t necessarily cause any abdominal cramping. In fact, you may only realize you have a hernia when you see a bulge in your stomach or groin. Stomach muscle pain can be “crampy” when caused by exercising or overuse.

4. Muscle stiffness and spasms

Hernia doesn’t cause muscle stiffness or other spasms around the bulge. If you have been exercising, working out, or lifting heavy items, you may experience stiff abdominal muscles or stomach spasms after strenuous physical activity.

5. Bruising

Hernia doesn’t cause bruising but will look like a skin-colored bulge that may be red because of inflammation. For example, a hernia around your navel will look like an “outie” belly button. However, abdominal pain may show signs of bruising if it was caused by a severe muscle strain or injury to your stomach.

6. Gastrointestinal problems

Abdominal pain doesn’t usually cause nausea and vomiting or other gastrointestinal issues. Some types of hernias can cause nausea and vomiting. This can happen because the hernia in your abdominal region pushes on your colon or bowel and causes an obstruction. Because of this, hernias can also make it difficult to have a bowel movement.

7. Causes

Some types of physical activity can cause both pulled abdominal muscle pain and hernia. For example, hernia generally isn’t caused by intense exercising or sudden movements. However, straining during a bowel movement if you have constipation, not lifting heavy items properly, or chronic coughing or sneezing can all result in strained abdominal muscles and/or a hernia.

Pulled or Strained Abdominal Muscle: Symptoms, Causes, and Treatments

Let’s look in more detail at what can cause pain in your abdominal region that is the result of pulling, straining, or tearing an abdominal muscle.

Your abdominal core muscles include the following muscles:

  • Rectus abdominis
  • Transverse abdominis
  • Internal obliques
  • External obliques

According to a sports injury website, pulling or tearing an abdominal muscle can happen when lifting heavy objects or quickly changing direction when running. Usually, it’s the rectus abdominis muscle that is affected when pulling a muscle, and this causes sudden sharp pain in your stomach area. However, any of your abdominal muscles can suffer injury.1

Symptoms of pulled abdominal muscles

You know if you’ve pulled or strained an abdominal muscle because you will experience a sharp, shooting pain in the area above your pelvis and below your chest.

According to doctors on WebMD, a torn abdominal muscle can also cause tenderness, stiffness, or deep aches in your abdominal region. The abdominal pain may intensify if your bend over, and even sneezing, laughing, or coughing can cause stabbing pain in your stomach area.2

The degrees of pain caused by pulled abdominal muscles can be divided into 3 categories:

  • Grade I ab muscle strain. This results from a mild abdominal muscle pull and will generally only cause mild discomfort.
  • Grade II ab muscle strain. An abdominal muscle that gets completely torn will cause more severe pain and you may have to restrict body movements until the torn ab muscle heals.
  • Grade III muscle strain. The most severe kind of injury from pulling an abdominal muscle that usually requires surgery.

A pulled abdominal muscle may also result in a hernia and you might notice a new bulge in your stomach.

Dr. William Blahd on WebMD says that pulled muscles can also cause bruising, weakness in the muscle, and muscle pain when resting.3 There are also many other reasons why women suffer from lower abdominal pain.

Causes of pulled abdominal muscles

Most of the reasons for stomach muscle pain involve stretching, pulling, or tearing a muscle in your abdomen.

Doctors from the Summit Medical Group say that pulled abdominal muscles are commonly the result of over-straining your abs when incorrectly lifting heavy objects or twisting awkwardly. However, hard coughing or sneezing have also been known to result in mild abdominal muscle strain.4

How to treat pulled abdominal muscles

There are various ways to treat abdominal muscles, and if you have pain from a pulled ab muscle, you will need to rest the muscles until they heal properly.

Cold treatment for initial injury

As soon as you can after the initial injury, you should ice the affected area. According to Dr. William Blahd on WebMD, applying a cold pack just after straining or pulling an abdominal muscle helps to control bleeding and reduce swelling.3

This is how to make your own ice pack to speed up recovery from a pulled abdominal muscle:

  1. Put crushed ice in a plastic bag and seal it to prevent water escaping.
  2. Wrap the ice pack in a thin towel and apply to the painful pulled abdominal muscles.
  3. Hold the cold pack on the stomach area where you strained the muscle for 20 minutes.
  4. Repeat every hour.

An ice pack, frozen gel pack, or even a bag of frozen peas can be used on the muscle strain and applied every hour or so for up to 2 days. This first-aid treatment for muscle strains helps to keep swelling down and prevent bruising. Please remember, never to apply ice directly to your skin.

Heat treatment for pulled abdominal muscles

If you still have sore abdominal muscles after 2 days and you no longer have swelling around the injury site, you can apply a heat pack to help the muscle heal quickly.

According to Dr. Carol DerSarkissian on WebMD, heat helps pulled or strained muscles heal quicker. Heat pads are also good for treating muscle spasms and helping muscles to relax.4 Physiotherapists say that sometimes moist heat helps the warmth to penetrate the muscles easier and helps muscle strains recover faster.5

To use heat to treat a pulled abdominal muscle that is sore, you can make a moist heat pad this way:

  1. Fill an old, clean sock with rice almost to the top. Tie the sock closed.
  2. Microwave the rice-filled sock for 2 minutes.
  3. Dip a clean washcloth in warm water and wring out the excess water.
  4. Wrap the heat pack in the damp warm towel.
  5. Place the heat pack on your pulled abdominal muscles and keep for 20 minutes to help increase blood flow to the damaged muscles.
  6. Repeat 3-4 times a day until you no longer have any pain from the strained abdominal muscle.

Essential oils for pain relief

There are many essential oils that provide relief from muscle pain and strain. Essential oils penetrate the skin and help to relax sore muscles. Also, an abdominal massage has tremendous health benefits as well as helping to increase blood flow to accelerate healing of a pulled muscle.

Here is one way that you can make your own muscle pain-relieving essential oil treatment:

  1. Mix 10-12 drops of peppermint oil, lavender oil, or chamomile oil in 1 oz. (30 ml) of carrier oil.
  2. Massage the pain relief oil into your sore abdominal muscles 2 times a day.
  3. Use daily until the muscle pain in your stomach has gone.

You can also use the essential oil pain-relief method in conjunction with a moist heating pad.

In my article on how to get rid of muscle soreness quickly using home remedies you can find other methods to get rid of muscle soreness, such as the R.I.C.E method, Epsom salt bath, consuming certain nutrients, warming up before exercising and more.

How to prevent pulling abdominal muscles

The best way to avoid pulling an abdominal muscle is to strengthen your core. Doctors recommend keeping your abs flexible and strong to decrease the risk of injury when lifting heavy objects or engaging in strenuous physical activity.3

For example, you can try plank exercises to help strengthen your core and prevent abdominal muscle injuries. There are also many easy exercises you can do at home to improve stomach tone and strengthen your abdominal muscles.

Hernia: Symptoms, Causes, and Treatments

A hernia feels like a round lump that bulges from your stomach or groin.

According to Dr. Benjamin Wedro on MedicineNet, hernia often occurs around the abdominal region when tissue pushes through stomach muscles. However, hernia can also appear in the pelvic area on either side of your genitals, in your diaphragm, or around your belly button.7

The most common types of hernias are:

  • Inguinal hernia. This hernia occurs in men more than women and will cause a painful bulge in the groin or scrotum.
  • Femoral hernia. A femoral hernia occurs in the floor of the abdomen near the upper leg. They occur more often in women.
  • Umbilical hernia. A bulge near the belly button is usually a sign of an umbilical hernia. They are often present at birth.
  • Hiatal hernia. When part of the stomach pushes into the esophagus, this can cause a hiatal hernia and symptoms of gastroesophageal reflux disease (GERD).

Symptoms of a hernia

You know that you have a hernia because you will more than likely have a bulge in your abdominal area or pelvis.

According to Dr. Melinda Ratini on WebMD, inguinal, femoral, umbilical, and incisional hernias will cause a bulge that may disappear when you lie down. The symptoms of a hernia include a heavy, pressing feeling in the abdomen and you may have constipation or blood in your stool.8

Not all hernias cause pain. Some are completely painless or just cause a mild ache. However, hernia isn’t tender to touch and you may be able to push the lump back into your stomach.

Abdominal hernia of the diaphragm like hiatal hernia can cause symptoms like heartburn or pain in your upper abdominal area. This type of hernia doesn’t cause a bulge but will be observable if a doctor checks your esophagus with an endoscope.

Causes of hernias

Hernias are generally caused by excess pressure in your abdominal cavity. Dr. Jerry Balentine on eMedicnineNet says that hernias can run in families and increase your risk of developing a hernia. Any weakness in the walls of your stomach muscles or abdominal cavity can cause a tissue mass to break through and create a bulge on your stomach.9

Dr. Balentine says that other contributing factors that can cause hernias are:

  • being overweight
  • lifting heavy objects
  • persistent coughing or sneezing
  • straining excessively during a bowel movement
  • chronic lung disease
  • fluid in the abdominal cavity

How to treat a hernia

According to Dr. Balentine, most doctors recommend a “wait and see” approach and may recommend some support trusses or supporting belts. However, all hernias should be repaired surgically to prevent further complications. Even if the hernia can be pushed back into the abdominal cavity, there is always the risk that it will reappear.10

How to prevent a hernia

Dr. Gregory Thompson on WebMD says that most hernias can’t be prevented. However, there are many steps that you can take to reduce your risk of a hernia. For example, losing weight, enjoying a healthy diet with plenty of fiber, stopping smoking, and making sure to lift heavy items properly.11

Abdominal Pain – When to See a Doctor

You should never ignore any abdominal pain that lasts for longer than 2 days or comes on suddenly and is severe. Many vital organs are located in your abdominal cavity and what you think may be a pulled ab muscle could be a painful symptom of a medical condition.

Doctors from the Mayo Clinic say that you should visit a doctor promptly for a suspected pulled abdominal muscle in the following circumstances:12

  • You still have severe pain for 3 days after an injury to your abdomen.
  • There is severe tenderness and/or swelling of your abdomen.
  • You pass bloody stools.
  • You have nausea and vomiting that doesn’t go away.

If you have a suspected hernia and notice a bulge in your groin or abdomen, doctors from the National Health Service advise visiting a doctor in the following circumstances:13

  • The hernia suddenly becomes very sore and painful.
  • You have difficulty passing a bowel movement.
  • The hernia becomes firm or tender and won’t move when you try to push it back in.
  • You have nausea and vomiting.

Read my other related articles:

Article Sources

  1. SpotsInjuryClinic. Abdominal strain.
  2. WebMD. Strengthen your core, prevent injury.
  3. WebMD. Muscle strain.
  4. SumitMedicalGroup. Abdominal muscle strain.
  5. WebMD. Try heat or ice.
  6. Spine-health. How to apply heat therapy.
  7. MedicineNet. Hernia.
  8. WebMD. Understanding hernia – symptoms.
  9. eMedicineNet. Hernia.
  10. eMedicineNet. Hernia.
  11. WebMD. Inguinal hernia – prevention.
  12. MayoClinic. Abdominal pain.
  13. NHS. Hernia.


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