What is Abdominal Tear? What was the risk for Rafael Nadal to Play in Wimbledon Semifinals?

Like many sports, playing tennis can also lead to serious injuries. These injuries can occur mostly in the upper body, due to the sudden force required to hit the ball over and over again. The most common injuries that can occur while playing tennis during Wimbledon, Australian Open, US Open, etc, include Torn Abdominal Muscle, Lateral Epicondylitis, Ankle Sprain, and many more. Injuries often happen when an individual has not followed a predefined stretching regime before activity or if a particular muscle has been under too much strain.  One such injury related to tennis is abdominal muscle tear which can be quite painful and can hamper the player’s performance. In this blog, we have discussed all about abdominal muscle tear and its underlying physiotherapy treatment. 

 

What is an Abdominal Tear?

The abdomen wall is comprised of many muscles, the rectus abdominis is the outermost muscle, which lays out in the front of the stomach and is most visible when toned, the external and internal oblique muscles run down the side of the abdomen wall. Usually, individuals train all of these muscles to have a tightened and toned midsection area. When an individual is injured and has a torn stomach muscle, in a sports-related activity, pain is often immediate, is hard to flex or stretch it out, there is a lack of movement, cramping, and muscle spasms, and shooting pain is all associated with a torn abdominal muscle. There can also be swelling and bruising shortly after the injury. These injuries are caused by excessive overload and sudden changes in intensity and position. This is usually due to the frequent excessive exertion during sports and occurs especially in high-intensity sports.

Grades:

Abdominal tears--are categorized into grades, each of which describes the degree of tearing with the injury. Grade I is slight discomfort, an individual could carry on and continue an activity for a short time. Grade II describes moderate discomfort when an individual cannot continue with activities that involve the abdomen. And finally, grade III is severe discomfort, swelling, cramping, and even the normal day-to-day activities are impossible to do until healing is complete.

 

Treatment for a Torn Abdominal Muscle:

Rest:

The torn muscle will need complete rest. If it is a muscle tear in the leg, it may be best to use crutches if an individual needs to walk. Your physiotherapist will advise to limit the amount of activity and avoid any activity that causes further pain or injury to the abdominal muscles to enhance healing. As it is impossible to stop any movement of the abdomen muscles, reducing excess activity is necessary. Giving time and remaining inactive is the only way to heal a torn abdomen muscle and it is important to avoid exercise until the tear is healed.

 

Compression bandage:

To keep the muscles under slight tension pressure. Wrapping the abdomen with an elastic bandage not only promotes lymphatic draining but also reduces inflammation.

 

Cryotherapy:

During the first few days after the muscle Cryotherapy or ice is applied to the injured part for the first 48 to 72 hours for 15 to 20 minutes every few hours helps to reduce swelling and the damage that can occur with that process.

 

Isometric Exercises:

During the second week, isometric exercises are recommended. These exercises help to increase the strength and endurance of the muscle. Isometric exercises do not require any movement of the torso. One such exercise is the abdominal drawing-in given below. To do this exercise:

• The patient is asked to lie on the back with the knees bent and feet flat on the floor.
• Press the lower back to the floor, while contracting all of the abdominal muscles.
• Hold this position for 10 seconds, then release.
• Repeat 10 times.

 

Concentric Exercises:

After gaining a range of motion and strength concentric exercises are recommended in which there is a shortening of the abdominal muscles:

An example is a curl-up, in this Exercise:

• The patient is asked to lie on the floor with the knees flexed and the feet flat.
• Extend the arms at a 45-degree angle, parallel with the thighs.
• Contract the abdominal muscles and lift the head and shoulders off the floor without crunching the neck.
• Hold this position for 5 seconds, then return to the starting position.
• Repeat 12 times.

Diagonal curl-up:

The patient lies down with the knees bent and the feet flat on the floor.

• Extend the arms in front.
• Curl the shoulders and upper back off the floor while rotating slightly to the right. Reach the fingertips to the right side of the knees.
• Hold this position for 5 seconds, then return to the starting position.
• Repeat 12 times.
• Switch sides.

 

Isokinetic Exercises:

Slowly more physical activities can be added to the program until the patient is fully recovered, approximately in the fourth week after the muscle tear occurred and is fit for sports. If the tear is a more severe third-degree tear of the abdominal muscle the recovery period may take up to four months before the individual can return to normal activity.

A muscle tear is a serious condition, therefore must be treated immediately.  One has to be patient for a full recovery. Abdominal tears can be stubborn because of their location, as the abdominals are part of the core muscles, and they are active during every activity. Therefore, the movements should be modified. A rehabilitation program should be strictly followed even if the individual no longer feels pain or has swelled. As the muscles still need time to heal and regain strength before they are subjected to intense activity. Do not ignore your symptoms as this may make the injury worse and difficult to recover from.

This article was first published at CB physiotherapy