Transverse Abdominis Injury and Hernias | What You Need To Know

If you’ve got a hernia, you’ve also got a transverse abdominis injury. Here’s what you need to know to fix your injured TA and feel stronger.

Figuring out you’ve got a transverse abdominis injury can be tricky. After all, you may not have even known about your transverse abdominis muscle until recently. And, even if you knew you had a transverse abdominis, you may not have known it was injured. That was my case.

When I first started studying to become a certified Pilates instructor, I learned about the transverse abdominis. After all, it’s one of four abdominal muscles, and abdominal muscles are crucial for core strength and back health.

Of course, I knew about it. Yet, as I sat around with my umbilical hernia, wondering why my low back hurt so much; it never occurred to me that my transverse abdominis was the problem.

I had a transverse abdominis injury, and I didn’t even realize it. On top of that, my TA injury was causing debilitating back and hip pain. It wasn’t until after I healed from umbilical hernia surgery that I realized how much pain my transverse abdominis injury was causing.

And, what hurt most was that my struggle with pain was completely unnecessary. For years, I was unable to play with my kids, vacuum my floors, and live my life because of my extreme hip and back pain.

But, I’ve got great news for you. Below, you’ll find everything you need to know about transverse abdominis injuries and how to fix them. Plus, if you’ve got an umbilical hernia, you’ll find a quick pain-relieving technique to help you feel better immediately!

Pssst! Speaking of umbilical hernias, if you’ve got one you’re going to want your own copy of The Beginner’s Guide to Umbilical Hernia Repair. Just click this link for your free copy!

What is the transverse abdominis?

The transverse abdominis, also known as the transversus, bridges the gap between your ribs and pelvis. This deep muscle helps support the ribs, pelvis, and vertebrae while serving as an anchor for your other abdominal muscles.

Why is the transverse abdominis important?

Because of its connection to the ribs, pelvis, and vertebrae; the transverse abdominis is one of many muscles determining whether or not you have back pain. It also is your deepest abdominal muscle and crucial for core strength.

But, one of the most important qualities of a healthy transverse abdominis is that it works like a sausage casing. I like to think of the TA as a sausage casing (and not the body’s natural corset, like some people do) for three reasons.

  1. Your transverse abdominis keeps all the good stuff (your organs) inside.
  2. Like sausage casings, this thin muscle can be ripped or develop holes. When this happens, your internal organs can start to spill out through a hernia.
  3. I would much rather think about eating sausages than think about stuffing myself into a corset.

Aside from helping keep the right amount of space between ribs and hips and keeping your internal organs inside you, the transverse abdominis is an important muscle for breathing.

In fact, breathing is the main form of transverse abdominis activation. This means it’s the main way to work this crucial muscle.

So, whether you’re trying to fix your transverse abdominis injury or whether you’re trying to make your hernia-related pain go away ASAP, take a deep breath and keep reading to find out exactly what to do.

What causes transverse abdominis injuries?

Transverse abdominis injuries can be caused by several issues including:

  • Poor posture,
  • A stomach muscle strain during athletic activity,
  • Poor core strength and stability,
  • Poor body mechanics while exercising,
  • Hard coughing or sneezing,
  • Lifting heavy objects with poor form, and
  • Trauma to the abdominal area.

But honestly, what happens most often is a lifetime of bad habits leads to muscle weakness. Then, one day, you’re doing something completely normal (like coughing) and the next thing you know, you’ve got pain.

3 Exercises to Help Avoid Transverse Abdominis Injury

Let’s think about what we know about the transverse abdominis. First of all, it connects your ribs, spine, and pelvis. Second, it’s used in breathing. Finally, we know that if your pelvis or ribs are angled (even slightly) away from each other when you’re sitting, standing, or lying down; it means your TA is weak.

This means the very best strengthening exercises are the ones where your rib-to-hip connection is absolutely perfect. Then, you move your arms or legs or change your position to challenge your TA’s ability to hold the connection.

Let’s get started strengthening!

1. Pilates breathing

In my opinion, Pilates breathing is the best way to strengthen the transverse abdominis. As you breathe, it’s incredibly important for you to pay attention to what you are doing. Notice the muscles you’re using and make sure you don’t feel any pain in the bottom of your pelvis. If you do feel pain, you need to stop immediately.

picture of pilates breathing to strengthen transverse abdominis
  1. Sit comfortably next to a wall. Feel your bottom press down in to the floor beneath you. Sit up tall.
  2. Make sure to relax the front of your hips. Let your shoulder blades sit on the back of your rib cage like a superhero cape resting on your back.
  3. Inhale through your nose and feel your rib cage expand to the front, sides, and back.
  4. Make sure your rib cage didn’t open forward like it’s spilling out your internal organs. (Not sure what the heck I just said? Check out this post about rib cage placement.)
  5. Exhale through pursed lips (like you’re blowing out candles) and feel your muscles between your ribs and hips evenly draw toward the center of your abdomen.
  6. Inhale and exhale, feeling how your muscles move away from and toward a central point in the middle of your abdomen.

Pro Tip: Feel your waist constrict as you exhale, and you’re doing it right!

2. Table top pose

This simple yoga transition pose is an excellent opportunity to strengthen your transverse abdominis while it works against gravity.

picture of table top yoga pose to strengthen transverse abdominis
  1. Begin on your hands and knees with your hands under your shoulders and your knees under your hips.
  2. Spread your fingers like starfish, and press the floor away. You’ll notice that, as you do this, the eyes of your elbows rotate toward the front of the mat. If the insides of your elbows are facing each other or your thighs, you need to think about opening across the front of your chest and press the floor away.
  3. Bring your pelvis to a neutral position. When you do this, your SITs bones should be pointing to the wall behind you. (So, it’s going to feel like you’re sticking your butt out at whichever wall is behind you.) Feel the length through your spine from your SITs bones through the top of your head. Slightly tuck your chin so your head is in neutral.
  4. Once your pelvis is in neutral, think of hugging your belly toward that spot you found right in the center of your abdomen. (Remember? You did this in Pilates breathing.) Make sure you don’t move your spine.
  5. Press the tops of your feet into your mat.
  6. Once you’ve got everything set to the best of your ability, breathe in through your nose. Exhale through pursed lips like you’re blowing out candles.
  7. Hold here for several rounds of breath.

Pro Tip: If you have a mirror available to check your form while you do this, I highly recommend using it. This is one of those deceptively-simple exercises. It seems easy enough when you read the directions, but holding the correct position for several breaths can be very challenging.

3. Dying bug

Dying bug is one of my absolute favorite Pilates exercises because it’s simple yet effective.

picture of how to do dying bug exercise to strengthen transverse abdominis
  1. Lay down on your back. with your knees bent and your heels about a fist’s distance apart.
  2. Make sure your rib cage is perfectly aligned so it’s pointing right down to your pelvis. If your ribs are slightly angled up, give yourself a little scratch between your bottom ribs, and the muscle you need should kick in and tuck your ribs. Keep your excellent rib-to-hip connection throughout the entire exercise.
  3. Reach both arms straight toward the ceiling with your palms facing each other. Make sure your shoulder blades stay flat on your back.
  4. Warning: You’re going to do two things at once and your brain is going to have to work.
  5. Inhale through your nose and hinge your right arm so it moves in a straight line toward the ground as your left leg slides out straight.
  6. Exhale through pursed lips and bring your right arm and left leg back to center.
  7. Inhale through your nose and hinge your left arm so it moves in a straight line toward the ground as your right leg slides out straight.
  8. Exhale through pursed lips and bring your left arm and right leg back to center.
  9. This makes one set. Complete about 10 sets.

Pro Tip: Make sure you keep your rib-to-hip connection nice and strong throughout the entire exercise.

How can you tell if you have a transverse abdominis injury?

Because the transverse abdominis is such a deep muscle, it can be hard to know for sure whether you’ve got a TA injury. You should absolutely consult with your doctor if you have any sort of abdominal pain since your doctor can order the imaging and exams necessary to ensure you have a muscle-related issue and not anything else.

However, if you’ve come across this article because you’re really trying to find some answers right now, here’s what you can do.

  1. Where do you feel the pain? Is the pain in the space between your bottom rib and the top of your hips somewhere? Does the pain feel very deep inside your body? If so, you’re in the range of the transverse abdominis. However, if your pain feels more superficial, it’s more likely that another abdominal muscle like your external obliques, internal obliques, or rectus abdominis is to blame.
  2. When do you notice the pain? Do you only feel the pain when you take a deep breath? If so, it seems really likely that your pain is caused by a transverse abdominis injury. However, if you notice your pain when you’re moving, it’s more likely one of the other three abdominal muscles is your culprit.
  3. Feel your abdomen. Does your skin feel warm to the touch? If so, you probably have an abdominal muscle strain of some kind. And, if you answered the questions in #1 and #2, you should already have a pretty good idea whether your transverse abdominis is the one to blame.

When you look at your abdomen, does it look normal? A transverse abdominis injury can sometimes lead to a hernia. A hernia is when your intestines bulge through a thin or torn spot in your transverse abdominis. If you think you have some sort of hernia, you definitely have a transverse abdominis injury.

drawing of different types of hernias (from shutterstock)

Can you fix your transverse abdominis injury?

This isn’t a very helpful answer, but honestly, it all depends on the type of transverse abdominis injury you have. For example, if you’ve just strained the muscle, start your recovery by: 

  • Take a couple of days to rest. At the very least, try to avoid doing whatever you think you might have been doing when you first noticed your pain.
  • Ice it. Within the first 24 hours of noticing your pain, try to ice the painful area. This should help reduce inflammation and swelling. 
  • Try some heat. Heat is really comforting to painful muscles. You should especially try a heat pack if you feel like the ice packs aren’t helping. Personally, I love soaking in a hot tub with tons of Epsom salts to help my muscles feel better. The salts help relieve swelling and the heat helps my muscles feel happy again.

However, if you think you might have a hernia such as an umbilical hernia, all the rest, ice, and heat in the world aren’t going to help fix that hole in your abdominal wall.

What types of hernias are caused by transverse abdominis injuries?

Umbilical hernias aren’t the only types of hernias that can develop as a result of transverse abdominis injury. Inguinal hernias (which appear lower in the abdominal wall) and epigastric hernias (which appear above the belly button area) are two other types of hernias that are dependent on a strong and healthy transverse abdominis.

What is an umbilical hernia?

An umbilical hernia is a bulge that happens right around your belly button. Basically, it’s when your “innie” turns into an “outie” all of a sudden. 

What happens is your abdominal wall thins out and rips. Then, your internal organs (normally your intestines) start to push through the hole. Oftentimes, you can relax and push the organs back in. 

However, sometimes the organs won’t go back in. This is a bad sign and a reason to see a doctor ASAP. You should also see a doctor immediately if the area becomes red and swollen or if you start having a fever, nausea, or diarrhea.

In order to best understand what an umbilical hernia is, you should take a moment and imagine a laundry basket. Imagine your abdominal wall is the laundry basket and your internal organs are the clothes it contains. Your umbilical hernia is like a hole in the bottom of that basket, constantly allowing your clothes to fall out. 

Some days, everything might stay put neatly. Other days, it might seem like reminders regularly poke through the bottom—reasserting that you have a hole there. And, as long as everything works as it should, you can just push your clothes back into the basket. Regardless, you’ve still got a hole that could potentially cause significant issues. What can I do? you might wonder. Keep reading and you’ll learn all about how you can temporarily mend that hole in your abdominal wall.

How can I fix my umbilical hernia?

If you are ever going to 100% fix your umbilical hernia, you’re going to need a surgeon’s help. Unfortunately, all the exercises, tricks, and tools in the world won’t cause the transverse abdominis to heal itself and close its gap.

Fortunately, umbilical hernia repair surgery is normally an outpatient surgery. After the surgeon has closed your hernia (either by stitching the hold shut or by applying and securing some mesh), it’s your job to rest, recover, and avoid doing anything that might aggravate your surgical site. Most people can resume their normal activities and exercises after about six to eight weeks.

However, for some people, surgery isn’t the right choice. Maybe you don’t have insurance right now. Maybe you’re nervous about having the in-home help you need to recover after your surgery. Perhaps, you just don’t want to have surgery. No matter what the reason, you’re sitting at home right now wondering Isn’t there something I can do? Isn’t there some way I can find relief from my hernia without having surgery?

Umbilical Hernia Treatment Without Surgery in Adults

Through the years, I’ve had many people ask me about ways to treat umbilical hernias without surgery. For quite a while, I couldn’t really think of anything to be done. After all, the only way to 100% get rid of your umbilical hernia is to have surgery. 

But then, I was inspired.

I was filming the videos for my course, Rebuild, which teaches you how to rebuild your core muscles after umbilical hernia surgery. I even teach you how to close your diastasis rectus abdominis (if you have one) because it’s common in folks with an umbilical hernia. 

And that’s when it hit me.

When you’re working on fixing diastasis rectus abdominis (which you can 100% fix on your own), you use strategic taping methods. And, although taping won’t completely fix your umbilical hernia, it might just be an effective enough therapy to reduce your pain and increase your ability to be active.

How to Treat Your Umbilical Hernia Without Surgery

paper tape and to temporarily patch a hernia

1. You will need to have paper tape and possibly Leukotape. Some people don’t like the extra support the Leukotape provides, while others find it comforting. (These two links go to Amazon products. If you order from these links, I earn a small commission at no extra charge to you.)

2. Feel above and below your hernia area to see if you have any sort of gap in your rectus abdominis. This gap is called a diastasis. If you’re going to create a temporary patch for your hernia, you want to make sure you’re treating the whole area that has been weakened.

3. Take a couple of inches of paper tape, center it on the midline of your body, and apply it over the top spot where you notice a gap. Continue applying paper tape in this manner until any diastasis you may have and your hernia are completely covered.

paper tape and leukotape to temporarily patch a hernia

4. Turn your attention to your first piece of paper tape. Cut a piece of Leukotape that’s a little more than half the length of the paper tape. Use one hand to smush both sides of your abdomen toward your midline. Apply the Leukotape to hold your abdominals together.

Pro tip:  When you cover the spot with your hernia, make sure all your internal organs are tucked inside your body.

5. If you have other pieces of paper tape on your abdomen, work your way down applying Leukotape as you did in step 4.

Variations:  Not everyone likes Leukotape. In fact, it can feel a little aggressive and rigid. A fellow member of the Umbilical Hernia Surgery Recovery community tried this taping method out and he said that he felt like the paper tape by itself worked better than the paper tape combined with the Leukotape. Also, he decided to round the corners of his paper tape so it didn’t catch and peel off as quickly.

a picture of umbilical hernia repair without surgery
Thanks, Joseph!

If you’d like to be part of the Umbilical Hernia Surgery Recovery community, just click here to sign up! Plus, you’ll get a free copy of The Beginner’s Guide to Umbilical Hernia Repair.

When should I call the doctor?

You should call the doctor if you start getting a fever, are nauseous, or have diarrhea. Also, if your belly button area becomes red and swollen or hot to the touch, you need to contact your doctor as soon as possible. If you have several of these symptoms plus your intestines are poking out of your belly button and they won’t go back in, you need to head to the hospital. 

When the intestines are poking out of the belly button and won’t go back in, they can get strangulated. This can lead to serious health issues and could ultimately require you to have a section of your intestines removed. It could also lead to death, so don’t hesitate to call your doctor or go to the hospital if something seems wrong with your belly button.

About Sarah Stockett

Hi, I'm Sarah! After going through umbilical hernia repair, I recovered and used simple exercises to rebuild my abs so they're stronger than ever. Let me help you do the same.

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