Schedule an Appointment

Transverse abdominal muscle

In part three of our series on "core" trunk muscles and back pain we look at the muscle called the transversus abdominus. The transversus abdominus is the "cumberbun" muscle of the abdomen. It is the deepest of all the abdominal muscles and is oriented from side to side instead of the abdominal muscles we usually see that go from up to down. This muscle is considered one of the most important abdominal muscles to prevent back pain.

Here's why.

A group of physical therapists in Australia who study back pain found out that whenever we even think about moving our arm or leg muscles the transverse abdominus muscle contracts and steadies the lower back. The transverse abdominus contracts and steadies the spine by providing "squeezing support for the back. Much like you could squeeze one end of a tube of toothpaste and see the other end of the tube straighten out, the transverse abdominus squeezes the spine and abdomen and "pushes up" the trunk.These physical therapist researchers found out that in people who have back pain their transverse abdominus loses its ability to contract and take pressure off the spine. This is one big reason that the transversus abdominus muscle is important in treating back pain.

In this installment of our series, we shall look at the general overview of what the transverse abdominal muscle is, where it is located, what it does and how to exercise it effectively through a series of common workout methods.

Where Is the Transverse Abdominal Muscle Located?

The transverse abdominis is located in the abdomen immediately inside of the internal oblique muscle. It is one of the innermost muscles of the abdomen and it arises from the inguinal ligament, iliac crest, the inner surfaces of the lower six ribs and from the thoracolumbar fascia.

Basically, the transverse abdominal muscle starts at either side of your spine, wraps around your torso, connects to your ribcage and ends at the middle line of your abdomen.

The nerves connected to this muscle include the intercostal nerves, the iliohypogastric nerve and the ilioinguinal nerve.

What Does the Transversus Abdominis Muscle Do?

Along with other core muscles, the main roles of the transverse abdominis are to protect internal organs by holding them in place, and to support the torso by maintaining abdominal wall tension which stabilizes the spine and pelvis before any movement of the limbs can occur.

Let us take a closer look at some of these functions of the transverse abdominal muscle in the next section.

Functions of The Transverse Abdominal Muscle

Since the transverse abdominis is a part of the core, it has a lot of functions especially when it comes to functional movement. When it comes to body movement, the major functions of this abdominal muscle can be broken into two:

Static Core Functionality

This is the ability of the transversus abdominis and other core muscles in general to align your skeleton to resist a force that doesn’t change.

A good example of this is how this abdominal muscle helps to align your body when you’re doing plank exercises.

Dynamic Core Functionality

Unlike static core functionality, the dynamic core functionality of the transverse abdominis comes into play when your body is in movement and engages several parts such as tendons, ligaments and muscles to absorb resistance and adjust itself with relevance to your plane of motions.

A good example of this is how your posture constantly changes as you climb up a slope.

Other major functions of the transverse abdominal muscle include withholding bowel movements, facilitating contractions during labor and pushing during childbirth, and assisting with the Valsalva maneuver where your thorax tightens when you hold your breath to unconsciously help you carry out activities such as pushing and lifting.

What Exercises Work the Transversus Abdominis?

There are many effective ways to exercise your transversus abdominis and other core muscles in general. These include:

String Vacuum Exercise

The string vacuum exercise is a good way to develop your transverse abdominis. When using this method to exercise, a person sucks in their gut when performing tasks such as doing deadlifts, pull-ups and so on.

A popular variant of the vacuum exercise is using the string method. The string method works by tightly tying a piece of string around your torso right at the bellybutton level at three-quarters of your maximum vacuum capacity.

You then go about your day sucking in your abdomen and every time you relax, the string tightens around your stomach and reminds you that you need to maintain your vacuum.


The plank is a popular exercise that very many people use to build their core muscles in general. For this exercise, start by lying face down on the ground and then lifting yourself into the pushup position but using your forearms instead of your palms to support you.

Most people can do a minute of plank exercises while more active people can last for between two and four minutes.

Side Plank

Just as with the normal planking exercise, the side plank is also a popular exercise for core muscles. There are many variations of this exercise but the most common one involves getting into the pushup pose and then transferring your weight onto one arm while you turn your whole body to face the side and lift your other arm into the air.

You can switch arms every 30 seconds or so.

Dead Bug

This exercise starts with lying on your back with your arms and legs stretched out in the air. Bend your legs at the knees at a 90-degree angle and make your shins are as flat as possible and parallel to the floor.

Once you are in this pose, stretch your right leg slowly while dropping your left hand to the floor. Make sure your arms are straight. Bring both limbs back to the start position and repeat with the alternating limbs.

Boat/ Hollow-Body

This exercise starts with you lying flat on your back with your arms stretched over your head. From this rest position, slowly lift both your arms and legs up into a V position and hold for several seconds.

Slowly lower your arms and legs down to the resting position and repeat.

Toes to Bar

The toes to bar exercise is an advanced workout method for core muscles so don’t worry if you cannot do it properly from the get-go.

For this exercise, you’ll need to suspend yourself from a pull-up bar using both your hands. From this resting position, hold your feet together and bend your body only at the waist to bring your toes up to the bar.

Make sure that your knees are not bent when performing this exercise.

Leg Raise

The leg raise is one of the easiest and most common core muscle workout methods. When doing this exercise, start by lying down face-up on a flat surface. Place your arms on the floor straight down to your waist.

From this rest position, hold your legs together and slowly raise them up to form a 90-degree angle at your waist. Make sure that your legs are straight and not bending at the knees.

Squirm Heel Touches

For this exercise, you will need to start by lying flat on your back with your knees bent upwards and with your feet flat on the floor.

From this resting position, lift your shoulder blades and touch your right heel using your right hand. Go back to the resting position and then touch your left heel with your left hand.

This should be done in quick succession so that the right and left sides of your body simulate a see-saw effect.

Weight Twists

This is an advanced core workout exercise so don’t be discouraged if you can only do a few reps at the start.

For this workout, your starting position will be similar to the hollow-body exercise. Balance your body on your tail bone while keeping your legs straight in the air and crossed at the ankles.

While holding a suitable weight close to your chest, twist your torso at the waist and bring yourself down to the ground on one side. Once you’ve touched the ground, spring yourself back to the starting position and repeat with the other side.

Can Intense Exercise Injure the Transverse Abdominal Muscle?

  • Yes, you can injure, strain or cause complications to your entire core muscle system if you work them out too much.
  • Some of the complications that arise from straining your transversus abdominis and other core muscles in general are:
  • Being overly aware of your transverse abdominal muscle can cause the reduction of spontaneous movement or adjustment of the spine. This causes stiffness.
  • Working out your transverse abdominis too frequently can raise the base compression level between your lumbar vertebrae. This also causes stiffness.
  • Chiseled abs and a permanently vacuumed abdomen can impair the movement of the diaphragm and reduce breathing efficiency as a result.
  • The straining of the transverse abdominal muscle can cause lordosis.
  • Overworking the transversus abdominis can cause the pelvic floor to balloon and weaken. Abdominal strain can also be caused by other things such as not resting your core muscles after exercising them, not stretching, using improper techniques when doing tasks or playing sports that require jumping, running or swimming, sudden twisting and fast movement, and so on.


The transverse abdominal muscle is an integral part of your core. As we have seen throughout this article, the transversus abdominis has a variety of functions that are important in aiding movement and providing the necessary pressure to hold our internal organs and perform other tasks.

It is therefore important to make sure that we keep this muscle, and our cores in general, healthy and functional by exercising regularly.

However, you should remember that exercising too much can put a strain on your core muscles and cause complications such as stiffness and back pain.

Check out the next installment of this series to find out how you can combat and alleviate the symptoms of lower back pain.

The doctor may also suggest a numb block, a procedure that puts numbing medication on specific nerves at the back of your head. If the pain resides or completely goes away, then it's ruled out that nerve problems cause the headache. A numb block is not only a way of diagnosing the problem but can also be used to treat headaches. It's after analyzing the results of the tests that the doctor may prescribe an appropriate treatment plan, which may include

Physical Therapy

Together with a certified physical therapist, the doctor may recommend specific exercises that stretch and help the muscles relax. The therapy may include postural modifications, upper spine manipulation, and therapeutically exercise. The therapists may also recommend some activities

such as a SNAG (sustained natural apophyseal glide) that can be carried out at home to increase blood flow to the neck region and reduce stiffness.

You may also want to practice a good posture when sitting or carrying out tasks, use a neck brace when sleeping, and avoid any activity that worsens the pain. Also, avoiding propping your head too high when sleeping as it may strain the neck. Spinal manipulation, although quite effective, should only be carried out by an expert.


The doctor may recommend certain medications together with physical therapy. The first step should be to alleviate the pain by using prescribed pain medication such as aspirin, ibuprofen, muscle relaxers, and corticosteroid. Surgery is only recommended as a last resort. If all other treatment options have failed, and the pain is excruciating, surgery to release pinched nerves may help the muscles relax.

How to Prevent or Manage the Pain

A successful diagnosis pinpoints possible causes of headaches. For instance, the doctor can tell whether a bad posture while working is straining the neck muscles and advise better sitting and sleeping postures. Through the imaging tests, nerve and muscle degeneration may be detected and the appropriate cause of action recommended. These may include relaxation techniques such as meditation, exercise, and yoga. Relaxation increases blood flow to the muscles and nerves, which escalates the healing process.

Cold and hot treatments on the specific pain areas may help manage the pain and promote blood flow. Wrap ice cubes with a towel, then place on the neck as you gently massage the area for 20 minutes, then replace with a hot wrap for another 20 minutes. Repeat the process several times daily. Professional massage may also help, especially after a long day at work. When the pain results from degeneration of neck and spinal cord muscles, apart from taking pain medication, exercise, and a healthy lifestyle may help stop or slow down the process. Also, drink more water, eat more fruits and vegetables, and avoid unhealthy habits such as smoking and excessive alcohol consumption. Excessive alcohol consumption numbs or destroys spinal nerves which speed up the degeneration process. Osteoarthritis and muscle degeneration may not be preventable, but the pain is manageable through physical therapy and pain medication.

Cervicogenic headaches are treatable, but it all depends on the cause. It's essential to have a medical diagnosis when you have recurrent headaches. If not treated, the pain can get worse, or the neck condition deteriorates.

Chris Dollar, DPT, PT, FAAOMPT is a clinical specialist physical therapist and Coordinator of Clinical Education for OrthoCarolina. His area of practice focus is in the evaluation and treatment of spinal conditions.

Leave a Comment