Abdominal Obliques Trigger Points

Name and Area

  • Name: Abdominal Obliques

  • Area: Lateral and anterior abdominal wall, running diagonally along the sides of the torso

Indications

Abdominal oblique trigger points can contribute to the following presentations:

  • Abdominal Pain

  • Bloating/Nausea/Abdominal Cramps

  • Diarrhea

  • Front of Chest Pain

  • Irritable Bowel

  • Lax, Pendulous Abdomen

  • Menstrual Problems, Pelvic Pain

  • Reflux Esophagitis

  • Urinary Frequency, Urine Retention, "Kidney" Pain

  • Painful Intercourse

These indications highlight the extensive role of the abdominal obliques in torso movement and stability.

Muscle Action

  • Trunk Rotation: Rotates the torso to the opposite side (external oblique) or the same side (internal oblique)

  • Trunk Flexion: Assists in bending forward

  • Lateral Flexion: Helps bend the torso sideways

  • Compression of the Abdomen: Supports breathing, posture, and core stability

These functions are vital for core stability, athletic performance, and postural alignment.

Signs and Symptoms

Patients with abdominal oblique trigger points often report:

  • Sharp or Dull Pain in the Side of the Abdomen

  • Pain That Mimics Digestive Disorders (IBS, Heartburn, Appendicitis)

  • Increased Pain with Twisting or Side Bending Movements

  • Discomfort with Deep Breathing or Coughing

  • Referred Pain Extending to the Lower Back or Groin

Perpetuating Factors

Several factors can aggravate or sustain abdominal oblique trigger points:

  • Sudden Twisting Movements (e.g., sports, reaching to the side)

  • Prolonged Sitting or Poor Posture

  • Chronic Coughing or Heavy Breathing

  • Pregnancy or Strained Core Muscles

  • Repetitive Trunk Rotations

  • Incorrect Abdominal Exercises

Trigger Point Referral Pattern

Abdominal oblique trigger points are typically divided into the following referral areas:

  • Upper External Oblique TrPs:

    • Refer pain to the upper abdominal region, ribs, and lower chest

    • May mimic heartburn or gallbladder pain

  • Lower External Oblique TrPs:

    • Refer pain to the lower abdomen, groin, or testicular area

    • Can be mistaken for hernia pain

  • Internal Oblique TrPs:

    • Refer pain to the side and back

    • Often confused with kidney or lower back issues

These referral patterns can mimic internal organ dysfunctions, making accurate assessment essential.

Differential Diagnosis

When assessing abdominal oblique trigger points, consider:

  • Gallbladder Issues

  • Appendicitis

  • Kidney Stones

  • Hernias

  • Irritable Bowel Syndrome (IBS)

  • Intercostal Muscle Strain

A thorough examination helps rule out these overlapping conditions.

Associated Trigger Points

Abdominal oblique trigger points often coexist with those in:

  • Rectus Abdominis

  • Quadratus Lumborum

  • Latissimus Dorsi

  • Lower Thoracic Paraspinals

  • Iliopsoas

Addressing these muscles can provide comprehensive relief.

Anatomy and Innervation

  • Origin: Lower ribs (external obliques); Iliac crest and inguinal ligament (internal obliques)

  • Insertion: Linea alba, pubic tubercle, and iliac crest

  • Innervation: Intercostal nerves (T7–T11), subcostal nerve (T12), and iliohypogastric/ilioinguinal nerves (L1)

Patient Examination

Evaluating abdominal oblique trigger points should include:

  • Palpation: Identifying tender nodules along the muscle fibers

  • Pain Mapping: Checking for referred pain in expected locations

  • Functional Tests: Assessing trunk rotation, side bending, and deep breathing

Corrective Actions

Effective management of abdominal oblique trigger points involves:

  • Manual Therapy: Myofascial release, deep tissue massage, and trigger point compression

  • Stretching: Side bends and controlled trunk rotations

  • Core Stability Exercises: Avoiding excessive twisting while engaging the core properly

  • Postural Corrections: Improving sitting and standing alignment

  • Breathing Techniques: Addressing dysfunctional breathing patterns

Summary Table: Abdominal Obliques Trigger Points Overview

Field Details
Name & Area Abdominal Obliques; lateral and anterior torso muscles
Indications - Abdominal Pain - Bloating/Nausea/Abdominal Cramps - Diarrhea - Front of Chest Pain - Irritable Bowel - Lax, Pendulous Abdomen - Menstrual Problems, Pelvic Pain - Reflux Esophagitis - Urinary Frequency, Urine Retention, "Kidney" Pain - Painful Intercourse
Muscle Action Trunk rotation, lateral flexion, trunk flexion, abdominal compression
Signs & Symptoms - Side abdominal pain - Pain mimicking gallbladder/kidney issues - Increased pain with twisting - Discomfort with deep breathing
Perpetuating Factors - Twisting motions - Poor posture - Chronic coughing - Pregnancy - Incorrect ab exercises
Trigger Point Referral - Upper external oblique: upper abdominal pain, mimicking heartburn - Lower external oblique: lower abdominal/groin pain - Internal oblique: side/back pain
Differential Diagnosis Gallbladder issues, hernias, IBS, kidney stones, intercostal strain
Associated TrPs Rectus abdominis, quadratus lumborum, latissimus dorsi, iliopsoas
Anatomy & Innervation Origin: ribs, iliac crest Insertion: linea alba, pubic tubercle Innervation: T7–L1 nerves
Patient Examination Palpation for tender nodules, pain mapping, functional trunk movement tests
Corrective Actions Manual therapy, stretching, core strengthening, posture correction, breathing techniques

Conclusion

Abdominal oblique trigger points can lead to misleading pain patterns that mimic digestive and organ issues. A comprehensive approach—including manual therapy, stretching, posture correction, and functional exercises—can effectively alleviate these trigger points and restore healthy movement.

Sources:

Travell, J. G., & Simons, D. G. (1983). Myofascial pain and dysfunction: The trigger point manual (2nd ed.). Williams & Wilkins.