Muscle News Vol I.23:  Rectus Abdominis  
 
Is Your Back Pain Coming From Your Abs?
Brrr!  A lot of our country is experiencing some pretty cold weather!  For those of us in snowy climates, 'tis the season for shoveling ... and low back injuries!   However, you don't have to have a shovel in your hand to hurt your back.  Many people hurt their backs reaching down to pick up a pen off the floor or grabbing something out of the bottom drawer of the fridge!  

In this issue of Muscle News, we learn that all you really have to do to experience low back pain is have TRIGGER POINTS in your Abs! 

When Dr. Janet Travell first realized the importance of trigger points, it was because she noticed how frequently pain in the front of the shoulder was actually coming from taut bands of muscle in the back of the shoulder.  Thanks to her extensive research, we now know all about this mystery called Referred Pain (pain in a spot distant from the source of the problem).  

Dr. George Goodheart, a brilliant and humorous chiropractor in Michigan who invented the field of Applied Kinesiology, bluntly put it this way about the mystery of pain:  "Often where it is, it ain't."

So, if you've been following along with previous issues, it should come as no surprise that pain in your back could be coming from trigger points in the muscles of your front.

Take a look at the referred pain pattern above (image from Travell & Simons' Myofascial Pain and Dysfunction:  The Trigger Point Manual).  The two most common areas where back pain is experienced (the waist and the bra line) are both completely covered by the referred pain (shown in red).  What is the muscle responsible for creating this pain pattern?  

The Rectus Abdominis.  This important muscle in the front of your body runs from your sternum down to your pubic bones and is best known for the sought after 'six pack' look.  

Trigger points in this muscle can be a real pain in the back, so let's perform the simple tests and self-care techniques below.  If you are one of the lucky ones who gets to shovel snow each year (or even just a midnight snacker who wants to grab something out of the fridge without fear) working on the Rectus Abdominis could be a good way to prevent an injury before it happens!  PASS IT ON!
 
*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional.  Please consult your physician to determine whether these self-care tips are appropriate for you.
Do You have Trigger Points in Your Rectus Abdominis?

Follow the instructions below to test whether myfoscial trigger points in your Rectus Abdominis might be causing pain and problems in your back:

PALPATION TEST

Remember, palpation just means pressing, feeling and squeezing to evaluate body tissue.  To best palpate the Rectus Abdominis, lie on your back and use the tips of your fingers or back of your knuckles to press into the muscle.  A Not Passing result occurs whenever you find any taut bands of muscle fiber or tender areas while you are palpating.  A Passing result is when you can press into the entire span of the muscle without finding any taut bands or tender spots.
  
The important landmarks for finding your Rectus Abdominis are just below your sternum (Shown as the top big X in the picture to the left) and just above your pubic bone (Shown as the bottom big X).  

The top X is the point in the muscle most likely to cause referred pain across the bra line.  The bottom X is the point most likely to cause referred pain across the waist.  The big X in the middle, a little lower than the belly button, is also a common spot to find a trigger point, but causes front hip and lower abdominal pain, not back pain.

Press gently to tolerance over all the x's, paying careful attention to the areas around the big X's until you have covered the entire span of the muscle shown.  Feel for taut bands of muscle tissue and notice if any pain or other symptoms increase when you press into them.

 

Simple Self-Care Remedies

Here are simple self-care tips for relieving myofascial pain and dysfunction in your Rectus Abdominis:

 

Step 1:  Warming Up with Moist Heat

To relax and warm up the fibers of the Rectus Abdominis, take a warm bath or place moist heat such as a Fomentek bag over the abdomen for 10-15 minutes. 


Step 2:  Compression

Start by lying on your back in a comfortable position.


Press the contact point of your chosen self-care tool into the tender areas you identified in your Rectus Abdominis.  Compress to pain tolerance ("good pain" - not pain that is sharp or makes you want to withdraw).  Hold for 10 seconds while completing at least two full breaths in and out.  Then continue on to the next trigger point until the whole muscle is covered.



Now let's move to the wall and use a 7" Therapy Ball.  Start by standing (if comfortable) and placing the ball between the wall and your Rectus Abdomnins (as shown).  Lean into the ball to tolerance and hold for 10 seconds over each tender spot.  Then roll the ball down to the next tender spot.  Always treat both sides.

For a more advanced compression, lie on the floor on top of the ball, propping yourself up on your elbows with one knee drawn up for balance and support (as shown).  This will add deeper compression as well as some valuable stretch as you lean back while compressing.

    








Step 3:  Stretching for the Rectus Abdominis

For proper function of the Rectus Abdominis, it must shorten completely and relax, as well as stretch to its full length.  To accomplish this, we use two poses:  Child's Pose and the Cobra PoseOnly perform these stretches to tolerance (not pain).  If you have sustained an injury to your back, it is best to consult a qualified healthcare practitioner for guidance.

Position 1: 
Child's Pose

This pose is extremely useful for many cases of back pain.  It relaxes and shortens the Rectus Abdominis fully.  

Start in an all fours position on your hands and knees.  Bring your buttocks back and down toward your heels as you relax the chest down toward your knees, head toward the floor, and arms outstretched above your head.  Hold for 30-45 seconds.

Position 2:  Cobra Pose

This pose will stretch your Rectus Abdominis fully.  Please seek medical advice before performing this pose if you have had a recent back or wrist injury.  Avoid this pose if you are pregnant.

Start lying face-down on the floor with the tops of your feet resting on the floor.  Place your palms on the floor under your shoulders with your elbows in at your sides and press up while looking straight ahead or slightly up if you are able.  Hold the pose for 30 seconds and then relax slowly down to the floor again. 

It is often good to finish with another Child's pose after completing the Cobra pose.  Perform twice a day after heat and compression.

We hope you stay warm this holiday season and enjoy all the festivities! 
  
  
Sincerely,
  
Your Friends at The Pressure Positive Co.
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Link Highlights:

NAMTPT LOGO National Association  of Myofascial Trigger Point Therapists

________________
Trigger Point Therapy for Low Back Pain: A Self Treatment Workbook by Mary Biancalana MS CMTPT LMT (Author) , Sharon Sauer CMTPT LMT (Author) , Bernard Filner MD (Foreword)

Learn the secrets to lasting pain relief: finding and deactivating trigger points, the underlying cause of most low back pain. Treating trigger points that refer pain to the low back and buttock areas, rather than addressing only the specific sites of your pain, is the best way to comprehensively treat occasional or chronic discomfort and prevent it from coming back.

Packed with illustrated treatment techniques, Trigger Point Therapy for Low Back Pain offers effective strategies beginners can practice at home and detailed hands-on protocols health care practitioners can use while working with patients. Find out which of eleven muscles could be causing back pain, then learn specific trigger point treatments and correct underlying perpetuating factors to immediately relieve soreness and tension in these muscles.
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