[seekadvice]

Unusual Abdominal Injury

Thank you again for taking the time to help. I have tried to allow for complete rest, but it seems impossible to isolate the abdominal muscles, as the core works with every movement. As mentioned previously, I have been walking and trying to stand tall to maintain some fitness but, other than that, have been allowing the injury to heal. The injury is not as bad as when it first happened in late October 2014, but I still feel that it has a ways to go before fully healing. The physical therapist says that the transverse abdominal muscle typically has a baseline level of tightness that can decrease as a person ages, particularly with less activity. My level of tightness seems to have decreased overnight as a result of this indescribable injury, which the physical therapist cannot really explain, as I have stayed in shape and am very lean with little body fat percentage. In addition, my abdominal muscles exhibited tone and firmness when they were being dry needled while I was relaxed on my back. No one has quite solved this injury, but your explanation seems to make sense. I am keeping my fingers crossed that the injury continues to heal and hopefully fully heals.

[seekadvice]

Unusual Abdominal Injury

Thank you, Dr. Towfigh and Dr. Goldstein, for taking the time to help. I have a much better understanding of the injury and what I need to do as the injury continues to heal.

Dr. Towfigh, I appreciate your advice concerning dry needling. You mentioned that dry needling is not good in the acute stage, but I did have it done 6 days after the injury. Would this have set me back or done any damage? Does 6 weeks refer to 6 weeks after late October 2014, when the injury happened? I am about 6.5 months into the healing process. Can a muscle tear take this long to heal? I completely understand that these questions might not have any clear answers.

You also mentioned that imaging can show the girth of each muscle. Would an MRI provide this imaging?

Thanks again.

[seekadvice]

Unusual Abdominal Injury

Thank you for reading through my lengthy post and offering helpful advice. I looked online for information about diastasis and checked myself by lying on my back, lifting my head slightly, and feeling along the linea alba. I did not notice a separation.

I appreciate your suggestions for exercises. I have not done crunches in years, due to suggestions that the flexion created by crunches can injure the back, and prior to the injury, mostly did planks and other variations using an inflatable exercise ball. The physical therapist gave me an exercise closer to the initial injury date where, lying on my back with my knees bent and feet flat on the floor, I placed fingers on each ASIS and slowly raised and lowered each foot, one at a time, without allowing each ASIS to drop. I am supposed to slightly flatten my back to maintain a neutral position. This exercise is supposed to teach my abdominal muscles to work without having to consciously tighten them.

Do you know how long it could take an injury of this nature to heal? The strange thing is when I saw something pop out for a few seconds, it felt weird but not painful. I did not really notice much soreness until the next day. I assumed a tear or contraction strong enough to produce a brief bulge would be painful. Do I need to worry about scar tissue, or are the types of exercises that you suggest sufficient for providing an adequate healing process? Do you have any opinions about dry needling? I am guessing that it is more of a coincidence that my current symptoms happened a week after the injury but only a day after the dry needling session. I am thinking about trying it again, as it is supposed to help recovery from injuries.

I mentioned that I suffered a right groin strain about two weeks after the injury, probably due to my body overcompensating. Do I need to be more careful to make sure that I do not set back the healing process for that injury, or can I rely on whether the soreness there increases during exercise? One thing that I have noticed is that if I stand tall with a neutral spine and the feeling like a rope is pulling my head towards the ceiling, I will feel a slight stretching sensation in my abdominal area. This sensation has decreased over the past 6 months, but I want to make sure that I do not do anything that will set it back or make any potential tear worse. I do not know if continuing to exercise after the injury caused my current symptoms, but I made sure not to force anything. I am very perplexed concerning how the particular movement from the exercise routine I was following caused the injury.

Lastly, friends have suggested that a gastroenterologist might be able to diagnose the injury. I assume my internist would have mentioned this to me if he thought I needed to see someone else, and my understanding is that a general surgeon is the specialist to see for abdominal muscle issues, but do you have any opinions here?

Thank you again for taking the time to help. Your response has given me more confidence as I continue to recover.