Oblique muscle strains are one of the most common baseball injuries that do not involve the shoulder or elbow. They are also common to other sports that involve a high demand on trunk rotational control (golf, hockey, wrestling). These strains involve the deep fibers of the muscles of the trunk or torso that have to control the transfer of energy from the lower body to the upper body with both swinging and throwing. The trunk is the transition between the lower and upper halves of the body and it needs to maintain stability to allow for effective energy transfer between the two parts. The trunk muscles also have to control the rotation of the midsection that is so important particularly for hitting. The most common muscles involved are the internal and external obliques which are referred to as the deep abdominal muscles. They provide a much more important role in stabilization than the more superficial rectus abdominus muscles, which many people refer to as the six pack muscles.
Because baseball (and other rotational sports) typically involves a forceful and repetitive trunk twisting motion, these muscles are particularly susceptible to strains when overused or when not trained properly. There are a few key exercises to incorporate to ensure stability of these muscles to both train for rotation and also to resist rotation forces. When training to improve rotational control, exercises like ball throws or band rotations are key. These exercises should always go to both directions and a player should train at least as much to their non-hitting side as to their hitting side so that they are always training in both directions.
Exercises to avoid rotation (counter-rotation movements) are also critical to help with stability. Common exercises for these movements include planks and pallof presses pictured below.
For questions, feedback, or topic requests, please email SportsPT@inova.org.
Dr. Seth Blee
Seth is the Senior Director for Inova Physical Therapy Centers with oversight of 20 outpatient clinics in Northern Virginia. He graduated from Boston College's pre-medical program with a BS in philosophy. He then went on to physical therapy school and graduated with honors from Columbia University in New York with a Master’s of Science in Physical Therapy in 1998. Since graduating, Seth has worked with several different patient populations, but has focused the majority of his time in orthopedics and Sports. Seth is also certified in Sportsmetrics for injury prevention, trigger point dry needling, and Blood Flow Restriction therapy. Seth is a Certified Strength and Conditioning Specialist, which he integrates into his treatment of athletes of all ages. In addition to his clinical hours and his teaching and residency hours, Seth joined the medical staff of the Washington Nationals as their Lead Team Physical Therapist in 2016. He has also treated professional football, basketball, hockey, lacrosse, and Inova Physical Therapy Center- Sports Medicine Clinic soccer players and became the Team Physical Therapist for the NWSL (National Women’s Soccer League) Washington Spirit in 2020 as well. He has done multiple podcasts discussing rehab in professional sports and has been on ESPN as part of the E60 Project 11 program.