Article provided by Souri Sengdara from Souri’s Myotherapy & Massage

When a client comes to see me with ‘back pain’ I always get them to try and tell me exactly where it is and what brings it on. I’m sure all other therapists do this also but I am very surprised at how the mighty six-pack muscle (rectus abdominus) is overlooked as the source of back pain! This article is both for the interest of the client as well as any soft tissue therapist who’s interested about it.

Rectus abdominus

See above for some photos of the rectus abdominus muscle and it’s pain referral zone (Credit: One of my massage books … Travell & Simons).

Symptoms caused by active trigger points in rectus abdominus.

Pain in the mid-back area or between the shoulder blades. Maybe there is pain under the shoulder blades. This may be accompanied with stomach problems. (Make sure that these symptoms are checked out by a medical practitioner to rule out underlying conditions).

Back pain in the areas mentioned when lying down to go to sleep.

Back pain when sitting or standing.

Symptoms are normally caused by poor posture while sitting,  especially in front of the computer!

Poor posture (the slouch) shortens this muscle causing it to become very tight and activating its trigger points. This leads to pain signals which radiate around the stomach and to the back.

The worse case I have seen was a gentleman whose work load in front of the computer increased dramatically. He went to his doctor with possible gastric problems.  His stomach was painful all over as well as his whole back. Blood tests were ordered and everything came back clear. When he came to my clinic I suggested we work on his stomach muscles, especially his rectus abdominus. He was advised to self-massage regularly and stretch his stomach muscles out. He recovered nicely.

There have been other not so severe cases as that. I treat the rectus abdominus muscle of every client who presents with the pain pattern of this muscle. Most clients will notice a great decrease in pain after the first treatment. For some, the pain is completely gone. This is not to say that the pain will not come back. Poor posture will continually bring on this pain.

How to treat rectus abdominus 

I find that the  most effective treatment of this muscle is massage. I firstly try to de-activate the most active trigger points but may also treat the whole muscle. The most active trigger point is generally the one on the upper part of the muscle. The trigger point will have to be gently prodded at first (therapists call it ischemic compression), then deeper as the client feels more comfortable with it. Some people find that the muscle is just too sore and uncomfortable to touch. I would then gently massage the entire stomach area to get the client to relax or use some heat prior to treating the muscle. The client could also be advised on gentle self-massage to the area to de-sensitise it prior to the next treatment. Regular stretching helps to lengthen the muscle.

Remember that stretches should not feel painful. A stretch should always feel comfortable.

This article was provided by Souri’s Myotherapy & Massage in Melbourne, Doncaster East


Share This

About The Author


Andrew is looking after massageplaces.com.au - The Australian Online Directory for massage clinics and therapists. He is passionate about natural therapies and is responsible for all the fancy stuff on our websites.