Low Back & Pelvis

What It Is

The rectus abdominis muscle is the large muscle located in the centre of your abdomen, commonly known as the six-pack. It extends from the front of the pelvis (the pubic bone) all the way up to the ribs (Cleveland Clinic, 2024). Injuries to this muscle can occur in varying degrees. Minor strains result in the muscle being overstretched, while more severe strains involve a tear in the muscle (Cleveland Clinic, 2021). An abdominal muscle strain may also increase your risk of getting a hernia (Cleveland Clinic, 2021).

Even though it is entirely possible to strain other muscles in the abdomen, the rectus abdominis is commonly affected. If you play sports or do physical labour, you are at an increased risk of straining the abdomen. Lifting heavy objects and twisting suddenly can cause a labour-related strain. Intense or excessive exercise, poor form when exercising, and sports that involve a lot of reaching and side-to-side trunk movements, such as football and tennis, can also cause strains to this muscle (Cleveland Clinic, 2021).

For those who are out of condition, you can develop this strain if you do physical activities without preparing properly, for example without warming up. In certain instances, chronic (long-lasting) coughing or sneezing can also trigger one of these strains (Cleveland Clinic, 2021).

Rectus Abdominis Strain Anatomy

The rectus abdominis is one of the five main muscles that make up the abdominal musculature. The others are the small pyramidalis muscle at the bottom of the abdomen, the transversus abdominis, which lies deepest within the abdomen, and the external and internal obliques, which sit on either side of the rectus abdominis (Cleveland Clinic, 2024). The main purpose of the rectus abdominis is to allow you to move the part of your body between the ribcage and the pelvis, and to keep your body stable during movement (Cleveland Clinic, 2024).

When you look at the muscle externally, it forms the classic six-pack when the abdomen is well-toned.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Rectus Abdominis Strain

1. Rest

For those suffering with a mild or moderate strain, taking the time to rest and stop the activities that caused pain in the first place is often beneficial (Cleveland Clinic, 2021). Avoid sit-ups, crunches, or other abdominal exercises until the pain has resolved, or until you have seen your physiotherapist or me. Avoid lifting or straining. Once you can move without the pain stopping you, try to keep moving so the muscle does not become stiff (NHS, 2024).

2. See Your Doctor

You should get an appointment with your family doctor or nurse practitioner if you think you may have a hernia. A hernia is where part of an internal organ pushes through a weak area in the muscle. Most hernias develop in the tummy or the groin: an umbilical hernia occurs near the belly button, and an inguinal hernia in the groin (NHS, 2026). Both can cause pain in the abdomen, like a muscle strain. A hernia usually causes a lump or bulge, which may get bigger when you cough, sneeze or strain (NHS, 2026; Cleveland Clinic, 2021). If you notice a lump, or pain while coughing, straining, or on exertion, then definitely get it checked for a hernia.

Get urgent medical attention or call 911 for an ambulance if you have a hernia and you have pain in or around it, you feel or are being sick, you are constipated, or your tummy is bloated (NHS, 2026).

3. Ice

For the first 2 to 3 days, apply an ice pack (or a bag of frozen vegetables) to the area for up to 20 minutes every 2 to 3 hours. Make sure to wrap the ice in a tea towel to prevent an ice burn from occurring on the skin (NHS, 2024). Try to avoid heat, such as hot baths and heat packs, for the first couple of days (NHS, 2024).

4. Abdominal Brace/Support

An abdominal brace can support the stomach muscles and help minimise swelling (Cleveland Clinic, 2021). It is not a reason to start lifting again (which you should avoid!).

5. Physiotherapy/Manual Therapy

A physiotherapist can teach you stretching and strengthening exercises (Cleveland Clinic, 2021). I can also guide you through stretching and strengthening once healing has started, and use hands-on work to ease pain and tension. See the My Approach tab for how I work.

Avoid massage for the first couple of days after the injury (NHS, 2024); after that, I can advise whether massage may help with your pain.

Tips

Whenever lifting anything heavy, make sure to practise proper lifting techniques to avoid causing injury to the midsection, and ask for help with heavy items (Cleveland Clinic, 2021).
For those who are overweight and out of condition, try to lose a few pounds and ease into physical activity so as to avoid injuring yourself.
If you are doing any athletic activity, take the time to warm up before rushing into a routine, and cool down afterwards (Cleveland Clinic, 2021).
Anytime you are participating in an athletic event, pay attention to your body. If you start to feel pain, you need to stop and give the body a chance to recover to prevent strains.
Avoid sit-ups or abdominal strengthening exercises until advised by your doctor or by me.
Contact your doctor if you have difficulty walking, pain that interferes with daily activities or sleep, or signs of a hernia (Cleveland Clinic, 2021).

Treatment

My Approach

A rectus abdominis strain can be anything from an overstretched muscle to a tear, so the first step is working out which path you're on.

If it's a mild or moderate strain (grade 1 or 2), I treat it directly. You can usually still move, sit up and manage daily tasks, just with pain.

If it's a severe tear (grade 3, a complete tear), or you can feel a gap, have marked weakness, or have a lump or bulge that could be a hernia, see your family doctor or nurse practitioner first. Once you've been checked, I provide supportive care that follows their advice.

I start by assessing how your trunk moves, what hurts, your strength and breathing, and any signs that need a doctor.

Early On

I leave the injured spot alone for the first couple of days and ease the guarding in your back and ribs
Cool applications in the clinic, and I'll show you how to use ice safely at home
Very gentle, pain-free tummy tightening and easy breathing
Help deciding whether an abdominal brace would help and how to get one

As It Heals

Massage around the injured area, then myofascial work and gentle stretching
Strengthening once healing has started, from gentle holds to controlled trunk exercises
Lifting technique and bracing, drawing on my years working with powerlifters, then gym-based progressions
A home programme, and a gradual return to sport with a proper warm-up

After a Severe Tear

Supportive care within your doctor's advice, easing the back and hips as they work harder to protect your trunk
A slower, graded return to strength

If you have a hernia with pain, sickness, constipation or bloating, get urgent help (see 2. See Your Doctor).

What to Expect

Typical Course

Typical course: For a mild strain, most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, and mild strains usually settle within a few weeks. After a severe tear, visits start once your doctor has checked it, follow their plan and space out as you get stronger; recovery usually takes a couple of months or more.

What I Focus On

Assessment

Protect Early

Trunk & Back Release

Graded Core Strength

Lifting Technique & Return to Activity

Sources

References

Cleveland Clinic (2021) Abdominal Muscle Strain (Pulled Stomach Muscle). Available at: https://my.clevelandclinic.org/health/diseases/21807-abdominal-muscle-strain (Accessed: 7 October 2026).
Cleveland Clinic (2024) Abdominal Muscles. Available at: https://my.clevelandclinic.org/health/body/21755-abdominal-muscles (Accessed: 7 October 2026).
NHS (2026) Hernia. Available at: https://www.nhs.uk/conditions/hernia/ (Accessed: 7 October 2026).
NHS (2024) Sprains and strains. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooRectus Abdominis Strain

What It Is

Rectus Abdominis Strain Anatomy

Self-Care & Treatment

How to Treat a Rectus Abdominis Strain

1. Rest

2. See Your Doctor

3. Ice

4. Abdominal Brace/Support

5. Physiotherapy/Manual Therapy

Tips

My Approach

Early On

As It Heals

After a Severe Tear

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooRectus Abdominis Strain

What It Is

Rectus Abdominis Strain Anatomy

Self-Care & Treatment

How to Treat a Rectus Abdominis Strain

1. Rest

2. See Your Doctor

3. Ice

4. Abdominal Brace/Support

5. Physiotherapy/Manual Therapy

Tips

My Approach

Early On

As It Heals

After a Severe Tear

Typical Course

References

Related Conditions

Cervical Facet Joint Sprain

Oblique Muscle Strain

Acute Back Pain

Cervical Disc Herniation

Book a session