How Can Physical Therapy Help With My Abdominal Pain?

Written by:
Dr. Ashlea Lytle
February 26, 2020

There can be many reasons why someone has abdominal pain. Internal organs, such as your small intestine, colon, stomach, liver, gallbladder, pancreas, uterus or ovaries, could be causing your symptoms. Or, the abdominal pain could be from a musculoskeletal condition, such as a nerve impingement from the spine, visceral fascial adhesions, strained muscles, or a dysfunctional pelvic floor. Seeing a physical therapist who specializes in pelvic floor therapy can help determine if your pain is musculoskeletal in nature or if you need to be referred to a different specialist like a gastroenterologist.

For the purpose of today's blog article, I'm going to focus on abdominal pain associated with a musculoskeletal problem and how a physical therapist can help.

When someone has abdominal pain arising from the spine, it can present just like appendicitis, GERD pain, kidney pain, or other visceral organ referral pain patterns. “Both non-musculoskeletal pain and spinal referred pain can be diffuse and aching in nature. Both can cause autonomic symptoms such as sweating, nausea and tachycardia” (Harding, 2007). The difference between non-musculoskeletal and spinal pain is usually movement. A qualified physical therapist will assess the movement of your spine and the segmental mobility of your spine to see if there is an association to your abdominal pain.

Abdominal pain can also be coming from the fascia surrounding the visceral organs. Fascia is a connective tissue that exists throughout the whole body surrounding our bones, ligaments, muscles, tendons, nerves, veins, arteries, and internal organs. “The fascia becomes an organ that can affect an individual’s health” (Bordoni, 2014). A physical therapist who performs visceral myofascial manipulation can help soften and relax the adhesions and restrictions of the viscera. Organs that I commonly treat are the bladder, small intestine, colon, kidneys, urethra, ureters, liver and diaphragm.

You could also strain a muscle of the abdominal region causing abdominal pain. This is often from participating in a strenuous physical activity (e.g., working out, playing sports, sexual intercourse, etc.) that exceeds what your abdominal muscles can handle. Those muscles include the rectus abdominis, external obliques, internal obliques and transversus abdominis. A physical therapist performs muscle tests and palpates the abdominal region to help differentiate and diagnose the muscle strain. If they're a good PT, they should also go beyond the abs to better understand WHY your muscles got strained in the first place. This can help prevent recurrence. Was it simply from being deconditioned or trying a new activity? Or maybe it was from underlying weakness or tightness elsewhere in the body (pelvis, hips, lower back, etc.) that set your abdominals up for injury? This is often where that fascia (connecting everything to each other) comes back into play.

A dysfunctional pelvic floor can also contribute to abdominal pain. The pelvic floor is made up of muscles and fascia that form a sling spanning across the bottom of your pelvis. It consists of 14 muscles in people with female genitalia, and 12 muscles in people with male genitalia. All of these muscles, in combination with other “core” muscles, must be functioning properly to ensure a healthy pelvis for sports and everyday life. Clinically, I have seen the obturator internus muscle refer to the lower quadrant of the abdominal region. A pelvic physical therapist would evaluate the function and mobility of your pelvic floor muscles. This is done by either a vaginal or rectal muscle exam.

Having a physical therapist go beyond the abdominal pain and look at your whole body is key to determining the true source of your condition. At Activcore, our physical therapists are trained to assess the spine and fascial mobility, overall muscle strength and stability, and pelvic floor function to help get to the root cause of your abdominal pain.

You can learn more about this topic by visiting our Pelvic Health page.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

Need help? We're here for you. Contact us today to request an appointment. Also check out our Telehealth offerings to get help from the comfort of your home.


  1. Bordoni B, Zanier E (2014). Clinical and symptomatological reflections: the fascial system.  Journal of Multidisciplinary Healthcare. (7): 401–411.
  2. Harding G, Yelland M (2007).  Back, chest, and abdominal pain.  Australian Family Physician. 36(6):  422-429.
  3. Suleiman S, Johnston D (2001). The Abdominal Wall:  An Overlooked Source of Pain. American Family Physician. 64(3): 431-439.

Dr. Ashlea Lytle

VP Colorado Region | Physical Therapist
Ashlea Lytle is a Doctor of Physical Therapy (DPT) who has been practicing for over a decade in the Denver area. She specializes in orthopedics and pelvic health for adults and kids. She primarily works at Activcore in Castle Rock, Colorado.


How Can Physical Therapy Help My Child with Bedwetting and Daytime Incontinence

Are your kids still having accidents at night? Are they peeing their pants at school? Do they feel embarrassed? Are they missing out on social activities? Urinary incontinence could be normal for their age but there does come a time when children should be dry during both the day and night.


How Can Physical Therapy Help With My Abdominal Pain?

There can be many reasons why someone has abdominal pain. Internal organs, such as your small intestine, colon, stomach, liver, gallbladder, pancreas, uterus or ovaries, could be causing your symptoms.


Mechanics For Vaginal Delivery: Is There A Right Way To Push?

I recently gave birth to my 1st child and was blown away that no one actually prepared me for the 2nd stage of labor, aka pushing phase, 10 cm dilation to birth. My husband and I went to several classes to prepare us for our newborn. During these classes they discussed the stages of labor, what tools they could use during labor, reasons for a c-section, joys and challenges of pregnancy, and how to breathe during the first stage of labor to make it through contractions. When I actually went through my 2nd stage of labor, I realized no one ever discussed how to push and breathe during this phase.


How Can A Belly Massage Help My Constipated Child? Learn the "I Love You" Technique.

Since the COVID-19 pandemic hit in March, I have had more time to practice and critique my I Love You (ILU) massage technique on my 16-month old son, who has been dealing with constipation since he started eating solid foods. I have found there are a few things you really need to do when doing the ILU massage. But before we dive deep into the mechanics, how does the ILU massage technique work?


How Does Squatting on the Toilet Help with Constipation?

Have you ever heard of the Squatty Potty? Advertised as the Original Bathroom Toilet Stool, the Squatty Potty was invented in 2010 by the Edwards family. After dealing with constipation themselves, they were told to try squatting to pass their bowels. This gave them the idea of the Squatty Potty. Now you are probably wondering: why would squatting help with passing stools? Let’s get an understanding of how digestion and bowel mechanics work.


Why Do I Have Troubles Holding in My Stool? I Had No Idea PT Can Help With This!

Do you leak stool with walking, running, or other physical activities? Do you have urgency of your stool and can’t make it to the toilet in time? Do you have to wear disposable underwear because you leak fecal matter?‍ As a pelvic health physical therapist, I see this quite a bit in my practice and everyone always asks the single question: “Why?!!!”


How Can Fiber Help With Constipation?

I’m sure there are a lot of people who can relate to the feeling of constipation. Tummy distended and full; pain in the stomach; a sensation you cannot completely empty your rectum; back pain –– all are symptoms of constipation. We probably have been told to increase our fiber intake and doing so will help loosen our stools. While this is true, there are several things you should know about what type of fiber and how much you should be consuming if you’re trying to improve constipation. 


Treating Constipation with Laxatives: Dependency & Safety in Adults & Children

Ever since I have been treating constipation and bowel dysfunction as a pelvic health physical therapist, I’ve had many clients ask if the laxative they are taking is safe and if they should continue using it, or if they can start their child on a laxative such as Miralax. Many of my clients are afraid they might become dependent and will always have to be on it for their bowels to function. Or they have been told to stop taking it because it is not safe. To have a better understanding of the risk of dependency on a laxative and its safety, let’s first discuss what it actually is, how it works, its side effects, precautions, why you would use it, and the current research on kids taking it.


Best Treatment Options for Diastasis Recti

Have you been told you have a diastasis recti? Have you tried some DIY treatments but haven't been able to improve it? As a pelvic health physical therapist, there are several professional treatment options that I recommend: physical therapy, laser therapy, functional neurology, gut health, hypnosis, and/or abdominoplasty surgery (if necessary).


From Groin Groans to Pelvic Pleasantries: How Pelvic Floor PT Steals the Show

Picture this: a clandestine world of pelvic pain, shrouded in secrecy and often deemed the domain of women. But wait, men also find themselves entangled in this web of discomfort. It's time to bust open the pelvic pain myth and bring pelvic floor physical therapy to the center stage! So grab your seat and get ready for a hilarious journey as we unravel the comic complexities of male pelvic pain and discover how pelvic floor PT can save the day.


A Comprehensive Approach to Managing TMJ Dysfunction

I wrote this blog after hosting a Zoom call with various practitioners in the Denver area. The topic of discussion was how to manage TMJ Dysfunction. By combining some of the strategies listed below, you can take significant steps towards alleviating TMJ/TMD symptoms and regaining comfort in your daily life.


Balloon Training for Fecal Incontinence: A Breath of Fresh Air

Fecal incontinence is often considered a taboo topic, even though it is a condition that affects millions of people worldwide. This topic can be a source of embarrassment, social isolation, and decreased quality of life. But fear not. For in this blog, we are going to explore the concept of balloon training for fecal incontinence and sprinkle in a little humor, because sometimes laughter really is the best medicine.