Can I still exercise with an Inguinal Hernia?

If you or someone you know have experienced a hernia, you may be unsure of what types of exercises you can do. So, what is a hernia? It occurs when an area of surrounding tissue or muscle is weakened, which causes a part of an organ or fatty tissue to congest through the fascia. There are 5 different areas hernias can occur: inguinal (inner groin), femoral (outer groin), umbilical (belly button), hiatal (upper stomach), and from surgery (incisional). The most common type of hernia is inguinal.

Inguinal hernias occur due to a section of the intestine or bladder protruding through the abdominal wall or inguinal canal. This is especially more common in men than women due to how testicles form from the inguinal canal which may create “gaps” in the abdominal wall. Hernias may first only present as a small bulge or protrusion which causes no pain. Although, as time progresses the hernia may increase in size due to vigorous exercise, heavy lifting or chronic coughing. The recommended form of exercise after surgery involves decreasing intra-abdominal pressure as explained by Simons and colleagues (2009).

Intra-abdominal pressure can be described as the amount of pressure in the abdominal cavity. It is important to have low intra-abdominal pressure-based exercises to decrease the risk of re-herniation and rupturing the artificial mesh (or stitches) holding the hernia in position. Exercises that have low intra-abdominal pressure include; aerobic activity (as recommended – mostly walking first 0-6 weeks), diaphragmatic breathing (6-8 weeks after surgery), body weight/ low weight functional strength training, and hydrotherapy. The optimal positioning of exercises for a hernia are sitting and standing, as lying positions increase intra-abdominal pressure. Exercises to avoid include core exercises (such as sit ups), swimming, Pilates, heavy lifting, and contact/high impact sports.

Before starting an exercise routine, it is important to consult your GP after hernia surgery. The main aim is optimal functioning while recovering from hernia surgery, such as the exercises mentioned above and maintaining aerobic fitness.

 

Emma Tutty
B.Sc. Exercise, Sports, & Rehab Science; Grad Dip. Exercise Physiology
Accredited Exercise Physiologist (AES, AEP) (ESSAM)

 

Reference

De Keulenaer, B. L., De Waele, J. J., Powel, B., & Malbrain, M. L. N. G. (2009). What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive end-expiratory pressure. Springer Link, 35 (6), 969-976.  https://link.springer.com/article/10.1007/s00134-009-1445-0

Simons, M. P., et al,. (2009). European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Springer Link, 13 (4), 343-403.  https://link.springer.com/article/10.1007/s10029-009-0529-7 (journal article)

https://www.crbard.com/en-us/Patients-Caregivers/Hernia/Hernia-Symptoms

Yegfitness.ca/tips-exercising-hernia/

https://www.msdmanuals.com/en-au/professional/gastrointestinal-disorders/acute-abdomen-and-surgical-gastroenterology/hernias-of-the-abdominal-wall