You may well be shocked by how extensive the trigger point pain maps are for the external oblique muscle, just take a look! It’s not just the pain maps that are extensive; trigger points in the external oblique muscle have been implicated in a wide range of abdominal symptoms. From abdominal pain and tenderness to groin pain, testicular pain, bladder pain, nausea, colic, dysmenorrhea, diarrhea, viscerosomatic pain, irritable bowel syndrome, urine retention and even bedwetting in children. The muscle runs from the lower eight ribs anteriorly to the front half of iliac crest, and into an abdominal aponeurosis that terminates in the linea alba (a tendinous band extending downward from the sternum). The pain maps are quite extensive sometimes radiating into the testacies (we have seen this several times).
The external oblique muscle typically becomes inhibited when stressed. It is a mistake to is to isolate the obliques in exercise programs in relation to the other abdominal muscles. Acute conditions can also be associated with hyperventilation disorder which can literally change the internal pH of the body.Testicular pain is a feature! Trigger points in the external oblique muscle are definitely worth considering as part of a differential diagnosis for testicular pain. We have seen two cases recently of testicular pain of unknown origin. The trigger points which really seemed to make a difference for BOTH patients where about 5cm lateral to the umbilicus and about 1cm down.
How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.