Abdominal oblique strain (internal oblique tear at the rib attachment)

What it is

The obliques are the sheets of muscle that wrap the sides of your abdomen and drive rotation and side-bending. The internal oblique attaches to the lower ribs by a thin fibrous edge, and that junction is where the tissue usually fails. Most tears are small, involving fibres near the rib attachment. A larger one can pull away a slice of that attachment and produce visible bruising over the following days.

How volleyball causes it

During the cocking phase the trunk arches, rotates away from the hitting arm and side-bends, which puts the obliques on the side opposite the hitting arm on maximum stretch. Those same muscles then have to contract hard to reverse the rotation and whip the trunk through, so they are lengthening and firing at the same time, which is exactly how muscle tears. Jump serving is the highest-risk version because the athlete chooses full arch and full speed with no compromise, and the classic moment is the first hard serving day of preseason or the first session back after a break. For a right-handed player, the left side is the usual casualty, although either side can go.

ServingAttacking

What it feels like

• A sudden sharp catch or pop in the side of the abdomen or over the lower ribs during a serve or swing, often at the moment the trunk whips forward
• You can point straight to it, and pressing on it reproduces it
• Coughing, sneezing, laughing and sitting up from lying all hurt
• Rolling over in bed and getting out of bed are surprisingly painful
• Reaching the arm overhead on that side pulls at the spot
• Bruising along the side or lower ribs appearing two to four days later in a bigger tear

Stop and get it seen if

• Sharp pain with breathing in, plus a tender point directly on a rib, which points to a rib stress fracture or rib injury rather than muscle
• A bulge in the abdominal wall that appears when you lift your head or strain, which can mean a hernia or a full muscle rupture
• Abdominal pain with swelling, nausea, dizziness or feeling faint, which needs urgent assessment for internal injury or bleeding
• Flank pain with fever, or pain on urinating or blood in the urine, which is a kidney problem and not an oblique
• Pain spreading to the tip of the shoulder after a blow or a hard twist. Shoulder-tip pain from an abdominal injury is referred from under the diaphragm and can mean internal bleeding. Get same-day emergency assessment.

What recovery usually looks like

Stages, not a schedule. Everyone moves through these at their own pace, and the ranges are wide because real recoveries are.

1. 1. Protect the tear

   1 to 2 weeks

   Let the torn fibres knit without pulling them apart again, which mainly means avoiding rotation, coughing hard and sitting straight up from lying.

   • Coughing and sneezing no longer produce a sharp stab
   • Can get out of bed by rolling without bracing the side with a hand
   • Walking and daily movement are comfortable
   • The area is still tender to press, which is normal here

2. 2. Restore rotation and load tolerance

   2 to 4 weeks

   Get full pain-free trunk rotation and side-bend back, then start asking the muscle to produce force again.

   • Full range of side-bend and rotation in both directions with no catch
   • Resisted rotation is uncomfortable at worst rather than sharp
   • Can sit up from lying and hold side-lying positions without symptoms
   • No morning soreness in the spot after the previous day's work

Ready to play again when

• Full pain-free rotation and side-bend in both directions
• Coughing, sneezing and sitting up from lying produce nothing
• Full-speed swings at practice volume with no soreness the next morning
• Jump serving at full effort, repeated across a session, with no return of the catch
• No tenderness left when pressing on the rib attachment

Keeping it from coming back

This is ordinary training, so unlike the rest of this page it does tell you what to do.

• Side plank progressions, including long-lever side plank and side plank with rotation, to build endurance in the exact tissue that fails.
• Pallof press plus band chops and lifts, which train controlled rotation and anti-rotation rather than raw crunching.
• Rotational medicine ball throws into a wall, built up over preseason weeks, so the first violent rotation of the year is not a jump serve at full effort.
• Ramp jump-serve volume across preseason instead of taking fifty maximum serves on day one back. Most oblique tears happen in the first two weeks of a block.
• Open-book and thread-the-needle thoracic rotation drills, so the upper back supplies rotation range and the rib attachment does not get taken to end range every rep.
• 90/90 breathing with a full exhale to keep the ribs down, which improves how the obliques sit and load during the arch.