The oblique muscles support and aid in side-to-side movement, helping maintain back strength and healthy posture. There are two oblique muscle sets, the internal and external obliques. Maintaining a strong core is one recommended way to protect the body and spine. However, many forget to train and strengthen all of the oblique muscles. Individuals tend to focus on the superficial core muscle, or rectus abdominis, and not enough or any attention goes to the lateral stabilizers or the internal and external obliques. Chiropractic and functional medicine can restore musculoskeletal flexibility, mobility, and function.

Oblique Muscles

The external obliques make up a large part of the trunk area. There are two external obliques on either side of the body, located on the lateral sides of the abdominal region. These muscles have an essential role in daily movements.

External

• External obliques help with trunk rotation and support spine rotation.
• They assist with pulling the chest down to compress the abdominal cavity.
• They help with bending from side to side.
• Any strain or injury to these muscles can lead to abdominal, hip, and back issues.
• Maximizing external oblique strength is important to maintain a strong core.

Internal

The internal oblique is a muscle deep within the lateral side of the abdomen.

• The internal oblique muscle is one of the main stabilizers and functions to flex the trunk and compress the chest.
• Its positioning makes it invisible, but it still has an essential role in body movement.
• This muscle can function bilaterally, meaning both sides can operate at the same time.
• These muscles provide spinal and posture support.
• Strain or injury in this area can cause posture problems and abdominal, hip, and back issues.

Rotation and Mobility

The internal and external obliques are the primary rotators of the spine and provide thoracic spine mobility.

• The internal obliques work with the external obliques and the rectus abdominis for lateral spine flexion of the quadratus lumborum and lumbar paraspinals.
• The internal obliques are part of the reflexive core stabilization system, responsible for maintaining intra-abdominal pressure or IAP.
• They attach to the diaphragm, transverse abdominis, and thoracolumbar fascia, contributing to core stabilization.
• A quadratus lumborum muscle spasm can result from muscle inhibition in the obliques.

Inhibition

If the internal obliques are inhibited, compensation can cause an alteration in the sequence patterns of the posterior oblique subsystem.

• When this system is not functioning correctly, individuals usually complain of discomfort in the hips and shoulders.
• A common sign of oblique inhibition is individuals holding their breath during basic movement patterns to gain stability, indicating dysfunction in the intrinsic stabilization subsystem.
• Simple movements include walking gait, single-leg stance, flexion, extension, etc.

Symptoms of Dysfunction

• Rounded shoulders
• Shoulder pain
• Flexion posture – Janda’s upper-crossed syndrome.
• Internally rotated hips.
• Decreased hip extension.
• Knee instability and discomfort.
• Sacroiliac joint locking and soreness.
• Lower back discomfort and soreness.
• Lumbopelvic hip destabilization.
• Decreased ability in acceleration and deceleration when walking.

Dysfunction in one area leads to imbalances in other areas, affecting movement and causing impairment syndromes that can include:

• Muscle imbalances.
• Decreased stamina.
• Decreased strength.
• Increased fatigue.
• Central sensitization
• Increased stiffness and tightness in myofascial structures and kinetic chains.
• Increased risk of injury from unbalanced movement patterns and reaction times.

Chiropractic Reset

Chiropractic care, massage, and decompression therapy can restore body balance through:

• Soft-tissue release of the thoracolumbar fascia.
• Mobilization to subluxated areas of the thoracic spine, pelvis, and hips.
• Manual therapy
• Instrument-assisted soft-tissue release. 
• Muscle stimulation
• Laser therapy
• Ultrasound
• Corrective and strengthening exercises

Chiropractors and spinal rehabilitation specialists recommend specialized exercise regimens to target these muscles that include:

• Power Plate training
• Bodyweight exercises
• Yoga
• Pilates
• High-intensity interval training – HIIT

If you are experiencing waistline, hip, and low back stiffness or tightness and pain, consult our professional chiropractic team. We’re ready to help!

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Oblique Anatomy and Movement

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References

Calais-Germain, Blandine, and Stephen Anderson. Anatomy of Movement. Seattle: Eastland, 1993.

Cook G. Movement: Functional Movement Systems: Screening, Assessment, and Corrective Strategies. Aptos, CA: On Target Publications, 2010.

Elphinston J. Stability, Sport and Performance Movement: Practical Biomechanics and Systematic Training for Movement Efficacy and Injury Prevention. Lotus Publishing, 2013.

Huxel Bliven, Kellie C, and Barton E Anderson. “Core stability training for injury prevention.” Sports health vol. 5,6 (2013): 514-22. doi:10.1177/1941738113481200

Myers TW. Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists. Edinburgh: Churchill Livingstone, 2001.

Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Physical Rehabilitation. St. Louis: Mosby, 2002.

Starrett K, Cordoza G. Becoming a Supple Leopard: The Ultimate Guide to Resolving Pain, Preventing Injury, and Optimizing Athletic Performance. Las Vegas: Victory Belt Pub., 2013.

Weinstock D. NeuroKinetic Therapy: An Innovative Approach to Manual Muscle Testing. Berkeley, CA: North Atlantic, 2010.