Adam Rufa - 6/6/2006

Question
I beleive that I have injured my external abdominal oblique muscle on my right side. I
have been experiencing pain on my right flank for about 6 months now. I feel it on my
lower ribs, on the right side of my belly button, sometimes down near my hip bone,
extending right my lower ribs into my back (just below the hip bone but below the
ribcage) on my back. I have had an MRI done, but everything was normal. However, my
doctor said that injuries such as this do not always show up on an MRI. Is that correct??
Also, how far does the external abdominal oblique muscle extend into the back?
I am wondering why this injury is taking so long to heal. It has been 6-7 months now. Is
that normal? I'm wondering if I keep reinjuring it in some way, but I do not exercise much
at all anymore due to this, I only walk. Sometimes at a moderate to brisk pace though. I
notice the pain is worse when I sit at my desk. Perhaps this is prolonging it from healing?
I also notice the pain increase on an empty stomach while trying to remove a bowel as well.
Since this injury, I've been having severe muscle tightness in my back, on both sides while
I'm sitting, or standing for long periods at a time. I'm unsure how to stop this from happening
and I'm also unsure as to how to heal this injury. The external oblique muscles are in constant
use all the time. And I'm raising my right arm to reach for my headset, telephone, and to type
for work. A few days ago, I moved my telephone and headset to the left side of my desk, but I
am still needing to raise my right hand to use my mouse, and to type. Could this be hurting it
more? What can I do to heal this injury? How much time does it take to normally
heal? Thank you.

Answer
1) MRIs can and do miss things.
2) Your injury may/may not be due to an abdominal strain.
3) Musculoskeletal injuries can take time to heal but 6-7 months is a long time.
4)Find a good manual based/evidence based physical therapist in your area and see them.
Look on aaompt.org web site and/ or look for a PT who is a certified orthopedic clinical specialist.

Your symptoms could be an abdominal strain but there are other possibilities.

Adam