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Transversus abdominis is the deepest of the abdominal wall muscles, each side wraps under the ribs to the midline. It’s clear from the anatomy that this muscle is used to hold, support and contain the forces of the abdominal cavity. The pain map is extensive and reaches down to the testicle. Onset is usually after direct trauma often from over exercise. We recently treated a case of two years’ onset with abdominal and testicular pain. He had seen many physicians. All investigations were NAD (nothing abnormal diagnosed). On questioning the patient reported symptoms after 2 hours of kayaking. He was overweight and not in a great shape to start with. Examination revealed trigger points 5cm laterally and slightly inferior to the umbilicus which mimicked symptoms. Treatment twice with soft tissue techniques and IMS gave a 100% improvement.


By: Bob Gerwin

Testicular pain is a feature! 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.

How do you treat trigger these trigger points? We’d be delighted if you want to share your own best practice.

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