Rectus Abdominis: Pain & Trigger Points

The rectus abdominis muscle is one of your abdominal muscles. If it gets too tight or harbors trigger points, it can trigger pain in your belly as well as in your lower and mid back.

Excessive physical exercise and emotional stress are common causes for that kind of pain.

What is great though, is that very often you can relieve this muscle and thus its associated pains by massaging it yourself.

On this page you will learn how to do this, and more.

If you cannot wait, just jump to the palpation and massage chapter.

Additionally to the info on how to feel and massage the muscle, you will learn…

  • about its attachment points
  • about its functions
  • about the zones where it can send pain to
  • about what circumstances create tightness and trigger points in this muscle
  • which movements might be impaired with the presence of the latter

Pain Patterns & Symptoms of the Rectus Abdominis Muscle

1.1 Pain patterns

As you can see in the two pictures, the rectus abdominis can send pain to the lower region of your belly as well as to your lower and mid back.

The deeper the red, the more common it is to experience pain if this muscle is too tight or afflicted with trigger points.

Note: While the pain on/in your belly occurs on the side of the rectus abdominis that is affected, the back pains can be due to trigger points from one or both sides of the muscle.


1.2 Symptoms & complaints

Trigger points in the rectus abdominis muscle can mimic unpleasant and dangerous conditions.

If you got already checked for the following symptoms without clear results, it might be that they have their origin in your abdominal muscles.

Symptoms and misdiagnosis from trigger points in the area X3

  • heartburn
  • cardiovascular chest pain that mimics the one from a heart attack
  • indigestion
  • vomiting
  • feeling of fullness

Symptoms and misdiagnosis from trigger points in the area X2

  • colic
  • stomach cramping

Symptoms and misdiagnosis from trigger points in the area X1

  • dysmenorrhea and (excessive) menstrual pain, respectively
  • acute appendicitis

Note: The symptoms from points X3 and X1 often occur with emotional stress or during menstruation – in case of women –.

1.3 Impaired or painful movements

Especially movements that require strong activation of your abdominal muscles or where you move your belly might be painful.

Besides that, it is typical to lean forward and make yourself a little bit smaller if the rectus abdominis is too tight or harbors trigger points.

So, be aware of your posture.

It might be that you prefer to sit in a slumped or sleep in the fetal position, because your rectus is too tight and elongating it to its normal length is already unpleasant or painful for you.

2. Attachment Points of the Rectus Abdominis Muscle

The rectus abdominis spans from the pubic bone to the 5th – 7th rib and the xiphoid process, which is the lowest part of your breastbone.

The Xs display the areas where trigger points are common to develop. Hence, those are the locations you want to check properly when practicing your massage.

3. Function of the Rectus Abdominis Muscle

The rectus abdominis’ two main functions are the flexion of your spine and the increase in intraabdominal pressure, which is created during coughing, for example.

Besides that, this muscle is also active right before and during gait in order to stabilize your spine.

Furthermore, carrying additional weight, like a backpack, increases the activity of the rectus abdominis. This extra activity prevents you from falling back to much. It keeps you upright and your spine stabilized.

4. Trigger Point Activation

There are many ways how you can develop excessive muscle tension and/or trigger points in your rectus abdominis muscle.

Below I listed a few examples

Postural stress

  • Sitting in a bent forward position – mostly due to a lack of back support –
  • “Victim posture” – crouched/slouched back and bent forward position; making yourself small –

Both scenarios shorten the muscle fibers permanently – especially in the latter case –, which is detrimental to the muscle´s health and is known to create trigger points.

Emotional stress

Emotional stress increases the tension of your muscles in general,  especially in all your flexors – remember the rectus’ function –.

This is because emotional stress is related to fear, which is caused – mostly unconsciously – when we are running out of options/solutions in a given situation or with a challenge in life.

Your body’s response to fear is always the activation of your flexor muscle groups or at least an increase in their tension.

If this tension doesn’t get relieved – via stretching, massage, breathing exercises, etc. – trigger points can develop, and thus pain.

In case of the rectus abdominis, even pain that mimics visceral disease.

Common reasons for emotional stress…

  • You are in an unfulfilling relationship.
  • You pursue a career you don’t like but can’t or don’t have the guts to quit.
  • Huge financial problems.
  • Serious disease or death of a close friend or family member
  • Stress at school

All these examples can put massive amounts of stress on you, your body and your muscles. Don’t underestimate that.

Active stress and trauma

In this category belongs everything that puts strong mechanical forces on the rectus abdominal.

  • Heavy weightlifting
  • Excessive training of your abs
  • Surgery on your abdomen – here, abs have to be cut –
  • Strong activation of the abs on stool due to constipation


The rectus abdominis muscle not only can mimic visceral disease but also can develop trigger points due to it.

This is quite unfortunate as they will persist even after the disease itself has healed.

This might leave you with pain, and you and maybe also your doctors with confusion – if trigger points are not regarded –.

  • Flue: Lots of coughing, which can overload the muscle
  • Peptic ulcer
  • Infestation with intestinal parasites

5. Rectus Abdominis Palpation

Locating this muscle is a no brainer as it is so easy to feel it during contraction.

Just lay down on the ground. Then lift your head and shoulders a little bit, as if you were attempting to do a crunch.

Now you can feel the muscle running from your chest bone and your ribs, down your entire belly until it reaches your pubic bone.

6. Rectus Abdominis: Self-massage

When massaging your rectus abdominis, it will be important that you can differentiate pain created by intestines – which lie below your abs – from pain that caused by the muscle itself.

To do so, contract the muscle, get your fingers on the area you want to massage and then loosen it up again.

Now slowly palpate this area and press into your belly and search for tender spots. If you find a painful location, exert only as much pressure as needed to initiate that pain.

Then contract your abs again while increasing your pressure on the muscle.

If the pain gets worse, it is a sign that it is created by your rectus abdominis muscle. If your pain decreases, it might be more likely related to visceral problems. In any case, it makes highly sense to double check with your doctor here!

Now let’s move on to the actual massage part.

Note: In case you would like to access all this info also offline, have a look at my eBook, which contains all the info published on this website!

The best way to massage your rectus abdominis, is by lying on your back and using the finger-technique.

That means, you will search for tender spots, and then massage each of them with very short and slow strokes –.

Also make sure to keep the muscle relaxed and bear in mind to only focus on tender spots.

Use a maximum of 15 strokes on each tender spot. That is absolutely sufficient.

With treating trigger points, it’s better to keep your massage sessions short and to repeat them frequently.


  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print