Exercises to prevent hernia

Contents

How to Prevent a Hernia

Preventing an Inguinal Hernia

Most hernias are inguinal hernias, in which a section of intestine pushes through muscle in your groin area at a location known as the inguinal canal.

Like all hernias, inguinal hernias develop due to a combination of muscle weakness and pressure inside the abdomen. (2)

There’s not a lot you can do to avoid the type of muscle weakness that lead to hernias, but there are steps you can take to reduce pressure in your abdomen.

Steps that may help prevent an inguinal hernia include the following:

Maintain a healthy body weight. When you’re overweight or obese, your abdominal wall is constantly under pressure from your extra body fat whenever you stand or move around. Losing weight is easier to recommend than to actually do, but talk to your doctor about developing an exercise and diet plan that works for you. (2,3)

Get enough of the right exercise. Being physically active in certain ways has been shown to help prevent hernias, but other types of exercise can put too much pressure on your abdomen.

Beneficial exercises may include:

  • Yoga
  • Pilates
  • Sit-ups or crunches
  • Light weights
  • Aerobic activities, like running or cycling

Activities to avoid include jumping exercises and squats, both of which can increase pressure on your abdominal wall. Fast movements can also lead to muscle tearing.

Any type of exercise than involves very high levels of exertion can also increase your hernia risk. (3)

Ask your doctor about any new type of exercise that you’re considering.

Incorporate high-fiber foods into your diet. Fiber-rich foods can support regular bowel movements and help prevent constipation, which can lead to straining that increases your hernia risk.

Foods that may help in this area include:

  • Fruits
  • Vegetables
  • Whole grains
  • Nuts and seeds
  • Legumes (dried beans and peas) (2)

If needed, take other steps to avoid constipation. Taking a fiber supplement or bulk-forming laxative, like a preparation containing psyllium, can help keep you regular and prevent straining during bowel movements.

If this doesn’t do the trick, you can try certain other laxatives, like mineral oil, milk of magnesia (magnesium hydroxide), or MiraLAX (polyethylene glycol).

Staying well-hydrated is also essential to avoiding constipation.

Since anesthesia and certain painkillers can cause constipation, it’s important to take extra steps to avoid constipation after any surgery — especially because surgery carries the risk of hernias at the incision site. (3)

Avoid heavy lifting, or do it carefully. If you have to lift a heavy object, bend down with your knees instead of your waist. Make your legs — rather than your torso — do most of the lifting effort.

And if an object is too heavy for you to lift comfortably, know your limits and don’t do it. (1,2)

Don’t smoke. Smoking can cause coughing, which can put pressure on your abdomen and lead to an inguinal hernia, or worsen symptoms in one that you already have. (2)

See a doctor when you have a persistent cough. Because coughing can lead to or aggravate a hernia, it’s important to get this symptom under control whenever you have an infection or another condition that causes it, including asthma.

Sneezing due to allergies can also increase abdominal pressure, so it’s important to control this symptom as well. (1,3)

Get treated if you have an enlarged prostate. Having an enlarged prostate can lead to straining during urination, which can increase pressure in your abdomen.

Signs of enlarged prostate may include waking up twice or more each night to urinate, straining to make your urine flow faster, and straining to empty your bladder at the end of urination. (3)

The 1 sign you probably have a hernia (and what to do next)

The most common types of hernia occur when weak spots in your abdominal wall rupture and allow internal organs, typically part of the bowel, to slip through. It sounds severe but in many cases there is little pain or the pain only occurs during strain.

How to tell you have a hernia

Even if a hernia doesn’t cause pain or discomfort, it almost certainly will cause a lump under your skin where the abdominal wall has torn. These can be hard to spot if they occur in the inguinal canal in the groin area, as most hernias do. The following steps will give some guidance if you suspect you have a hernia but cannot be relied upon for diagnosis. If you have concerns, see a GP.

  1. Feel for a lump or swelling around the pubic bone
  2. If you find a lump, make note of where it is and lie down
  3. Did the lump disappear or become smaller? If so, it may be a hernia
  4. Do you feel discomfort when coughing or lifting heavy objects? It’s almost certainly a hernia.

Hernias are commonly under-pronounced while lying down as there is less pressure on your abdominal wall from your internal organs. Even a lump that doesn’t reduce in size when you lie down could be a hernia, or it could be something else. Both are good reasons to speak to your doctor.

Hernias can cause sharp pain when your body is under strain. Acts like coughing, sneezing and lifting can pinch the organ trapped in the abdominal wall.

I think I might have a hernia. What happens next?

The simple answer is: tell your doctor as soon as possible, however, many people wait until they experience serious pain or discomfort, or the hernia has grown large. There are many reasons why this is a bad idea. Hernias never repair themselves and generally always get worse with time. The longer you wait, the less surgical options you will have to deal with it.

Detected early, hernias can be repaired using minimally invasive laparoscopic surgery. This is typically easier to recover from than open surgery and has less complications. Delaying treatment may mean open surgery is the only course of action.

There’s also a risk of the hernia becoming strangulated, where the blood supply to the trapped organ is cut off. This is rare, but can be life threatening and may require emergency surgery.

Unfortunately, early stage hernias are not a public health priority so dealing with it quickly might not just be up to you. Nuffield Health can diagnose and repair hernia’s quickly whether you’re privately insured or want to pay for yourself.

What about hernias you can’t see?

Hiatus hernias won’t produce any visible signs on your body but can be uncomfortable for those affected. They occur when part of the stomach pushes up through an opening in the diaphragm. It can lead to gastro-oesophageal reflux disease (GORD) which can cause symptoms like heartburn.

If a hiatus hernia is the cause of your GORD it can diagnosed with an x-ray or endoscopic investigations. Hiatus hernia is most commonly treated with medication or lifestyle changes and doesn’t usually require surgery.

Last updated Wednesday 27 November 2019

Enjoy the SilverSneakers store!

Plus, four exercises to build the strength you need to stay mobile, independent, and pain-free.

A weak core impacts everyday life more than you think. Even basic functional movements—like getting out of bed or walking to the car—start to feel challenging, if not impossible.

In other words, if you want to stay mobile and independent, you can’t ignore your core. And no, crunches won’t cut it.

Your core includes much more than your abs, says Michelle Barnett, D.P.T., a physical therapist at TRIA Orthopaedic Center in Bloomington, Minnesota.

It also includes the gluteal muscles (in the butt and hips), lats and traps (in the middle and upper back), and the multifidus and erector spinae muscles (around your spine). All these muscles, not your abs, are primarily responsible for keeping you upright and stable.

This is why poor balance is one of the more obvious signs your core is weak. What about the less obvious signs? Here are four to watch for—and what to do if you notice them.

Sign #1: You Rely on Your Arms to Get Out of a Chair or Bed

Try this 20-second fitness test: Sit down in your favorite chair, and get comfortable. Now stand up. Did you use your hands to help push yourself up? If so, it might mean your core strength is lacking.

“It takes a lot of abdominal strength, not only to sit up but to push yourself and roll onto your side,” Barnett says.

To transition from lying or sitting to standing, your abdominals and deep core muscles have to be able to brace, while your glutes have to be strong enough to propel you to your feet, she explains.

If you find you regularly rely on the strength of your hands and arms to push yourself out of your chair or bed, it’s time to add core-bracing and glute-strengthening exercises, like the ones below, to your fitness routine.

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Sign #2: Your Lower Back Arches While Standing or Walking

Have you ever caught yourself (or noticed someone else) standing or walking with your lower back arched and pelvis jutting forward? That’s your body’s way of telling you something’s off.

“Standing or walking with an overarched back could signal a couple of weaknesses,” says Brian Schwabe, D.P.T., C.S.C.S., a sports physical therapist. “First, your core lacks the stability and control to keep your spine in a good, neutral position, while tight hip flexors pull your pelvis forward.”

If your core is weak, your body compensates so other muscles will help hold you up, Schwabe says. Not surprisingly, this overarched position can lead to pain in your low back over time—which is why low back pain is another sign of a weak core.

Sign #3: You Sway as You Walk

Tilting or swaying side to side while walking is a telltale sign you’ve lost some core strength and stability, especially lateral (side) trunk stability, Schwabe says.

“Your core is supposed to resist against other movements and stabilize so your shoulders and hips can move around it,” he says. If your core muscles—in particular, your obliques, which run along the sides of your torso—aren’t strong enough to control your torso while walking, your pelvis ends up dropping side to side, resulting in a slight rocking motion.

Your walking pattern can reveal more than just weak core muscles. Check out our guide to what your gait says about how you’re aging.

Sign #4: You Hold Your Breath During Core Exercises

Your diaphragm—a large muscle between your chest and digestive organs—works closely with surrounding deep core muscles to control movement and breath. If you find yourself holding your breath during core exercises, like the ones below, you may lack the strength to control core function and breath simultaneously, Schwabe says.

As a result, you end up focusing on one task at a time—and it’s usually not breathing.

Why is that bad? “Holding your breath increases the abdominal pressure, and while that makes you feel like you’re more stable, you’re not actually engaging those abdominal muscles to create that stability,” Barnett says.

Do These 4 Essential Exercises to Strengthen Your Core

If you notice any of the signs above, or simply want to prevent them, try adding these exercises into your weekly routine. Perform one set of each exercise in order, resting 30 to 60 seconds between sets. For best results, do the full workout three days per week or more if you feel up to it.

Remember to stay active in other ways as well, like going for a walk or taking a SilverSneakers class. “Staying active in general is important because you’re going to be using all those core muscles when you do other activities,” Barnett says.

Exercise #1: Pelvic Tilt

Do 10 to 15 reps

Lying on your back, bend both knees and place feet flat on the floor hip-width apart. Flatten your lower back against the floor by tightening your abdominal muscles and bending your pelvis up slightly. Hold this position for five seconds, then release. That’s one rep. Perform 10 to 15 reps total.

Exercise #2: Bridge

Do 10 to 15 reps

Lie on your back with your knees bent, feet flat on the floor about hip-width apart, and heels a few inches away from your buttocks. Press your arms into the floor for support, and brace your core.

From here, squeeze your glutes to lift your hips up until your body forms a straight line from your knees to shoulders. Pause, then slowly lower your hips to return to starting position. That’s one rep. Do 10 to 15 reps total.

Exercise #3: Bodyweight Squat

Do 10 to 15 reps

Stand tall with your back facing a sturdy chair, feet hip-width apart and arms straight out in front of you for balance.

From here, push your hips back and bend your knees to lower until you touch the seat of the chair, keeping your chest lifted the entire time. As soon as you touch the seat, push through your heels to return to standing. That’s one rep. Do 10 to 15 reps total.

If you need to sit down at the bottom of the movement, feel free to do so, but try to stand back up without using your arms for help. Learn how to make the squat easier (or harder) for your needs in this guide.

Exercise #4: Clamshell

Do 10 to 15 reps per side

Lie on one side with your legs stacked and knees bent at a 45-degree angle.

From here, keeping your hips steady and your top foot down, lift only your top knee as high as you comfortably can. Your legs should mimic a clam opening. Pause, then slowly lower your knee to return to starting position. That’s one rep. Complete all reps, and then repeat on the opposite side.

Note: The exercises in this workout may be different or more advanced than those you’ll experience in a SilverSneakers class. Please consult your physician before beginning a physical activity program to make sure it’s safe for you.

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If someone asked you to point to your core—where would you point? Probably your belly where your abs are. But it turns out, core muscles actually run band to band (AKA from the tip-top of your ribs to the top of your hips) and all the way around all the way around. Yep, core got back.

“Your core technically includes your pelvic floor muscles, your internal and external obliques, rectus abdominis (and all the other superficial layers you think of when someone says six-pack, the erector spinae and multifidus (which are in the back), and all the deeper, smaller muscles in your trunk,” says Alena Luciani, MS, CSCS and founder of Training2xl. To put it one way: The core is more complex and complicated that my relationship with my ex, but unlike my ex, it’s a total #powerhouse.

Not only does the core protect the body and stabilize the spine and pelvis, powers your movement, and is the cornerstone of boss-babing the sh*t out of your workouts. So yeah, your core has to show up for you at all times. And if it doesn’t…or if it’s too weak? “The rest of your body and muscles have to compensate for it, which can cause a giant (and bad!) chain reaction,” explains Bethany Lyons, founder and CEO at Lyons Den Power Yoga.

It can be hard to know if your core is weak, because even visible six-pack-abs are not a sign that your core is strong. Lyons suggests two quick at-home tests to determine whether or not your core is weak. “You should be able to hold a hollow hold—your low back is pressed into floor, legs and arms hovering in the air, and core ignited—for at least 10 seconds. And you should be able to hold a plank for at least 50 seconds,” she says.

Beyond a decreased ability to do these OG ab-sculpting moves, having a weak core can result in a host of not-so-pleasant everyday symptoms. Keeping reading for five more signs your body is compensating for a weak core, plus how to deal.

Photo: Getty Images/Klaus Vedfelt

Clue 1: Your posture is sub-par

You know that the best way to sit at your desk isn’t all crunched or crouched over. But what if you can’t help it? Hunching over your desk can put strain and pressure on parts of your body that weren’t meant to support that position for long, which physical therapist Grayson Wickham, DPT, CSCS, founder of Movement Vault says includes your hip flexors, low back, pelvis, glutes, and shoulder girdle.

“Over time, sitting with poor posture can make your entire body to shift out of alignment, and eventually lead to overuse injury of the muscles that have to work even harder to compensate,” explains Katie Dunlop NCCPT certified personal trainer and founder of Love Sweat Fitness..

The fix: Practice sitting with your core engaged—belly button drawn back towards your spine—and shoulders pulled back, suggests Lyons. If you have a job that forces you to sit more days, you can try setting an “engaged core” timer, which’ll remind you of your goal.

Clue 2: Your lower back arches when you walk (AKA you have a pelvic tilt)

Have you ever noticed someone (or maybe you do it yourself) walking pelvis-first or with a super-arched lower back? Yep, a weak core could be the culprit here, too. Because carrying and delivering a baby can weaken the pelvic and abdominal muscles, this particular symptom is common in new moms.

“When your core is weak, sometimes the hip flexors or glutes may have to takeover, which long term could result in an anterior tilt of the pelvis—basically when the pelvis itself is pulled off balance,” explains Lyons. This pelvic tilt can also result in back, knee and hip pain or injury. “If you’re not bracing your core when walking, gravity can also pull our shoulders forward, which puts a ton of strain on your neck and upper back,” Luciani says. Instead, you want to walk with your chin in a more neutral position.

The fix: When you’re walking, Luciani suggests asking yourself: “Are my hips stacked beneath my shoulders?” To strengthen your core and make this stacked position possible, add pelvic tilts, leg extensions, single leg extensions, and glute bridges into your morning routine, suggests Wickham.

Clue 3: You have frequent lower back pain

If you’ve ever felt a tweak, pinch, or twinge when performing a day-to-day movement like transferring the laundry, tossing a ball to the dog, or taking something out of the oven (like these upgraded Ina Garten approved roasted carrots), weak core muscles could be to blame. When your core isn’t as strong as it needs to be, your lumbar spine can get all wonky, explains Wickham, which can put undue pressure on your vertebrae, discs, and the rest of the muscles that encase the spine.

The fix: Work specifically on strengthening your spine. “Strengthening the erector spinae— which runs from your neck to your lower back— can help reduce back pain by helping to encourage proper posture and form when performing exercises,” says Dunlop.

Clue 4: You feel weak when throwing or jumping

Ever feel weak when performing exercises like tossing a ball, throwing a punch, jumping up and down, or even doing something like a bicep curl? “Difficulty doing these things could mean your core isn’t trained properly,” explains Dunlop. That’s because our core muscles stabilize and send power and strength to other muscles. “If we aren’t strong throughout the midline, we throw out the chance that we’re going to be strong in arms, legs, shoulders, or ankles—called our distal parts,” explains Wickham.

The fix: Add compound exercises like the squat, deadlift, push-up, and lunge, which will tone and strengthen your extremities and core at the same time, suggests Luciani. “Even unweighted, these movements teach you how to brace your core, while using and strengthening your extremities.” #multitasking

Clue 5: You use objects and people around you as a “crutch”

If you frequently rely on the furniture or friends around you to get (and keep) you standing, it’s time to add some core bracing moves to your routine. “It surprises people how much core strength simply getting out of bed, a chair, or standing in line takes,” says Wickham.

The fix: Trying to sit down, get up, or stand without reaching for poles, pillars, tables, or your pals for help, will eventually help you strengthen the weak muscles, says Lyons. As with any other exercise, it’s get easier the more you do it.

If you noticed any of the 5 signs above— or simply want to prevent them, try these yoga moves which target your core. And if you’re a runner, start doing these 5 core-strengthening exercises.

Core conditioning — It’s not just about abs

Many of us have wished for flatter stomachs, a goal that seems more frustrating and elusive the older we get. You might have been tempted by infomercials for exercise devices or breathless magazine articles promising “flat abs” and tighter tummies “in just days.” Despite the hype, spot exercising abdominal muscles won’t get rid of fat. The only way to do that is to expend more calories than you take in. Working these muscles has its place, but the smart money these days is on strengthening a variety of trunk muscles, collectively known as “the core.”

Core conditioning improves posture, which contributes to a trimmer appearance (poor posture can give even a woman with well-toned abs a little “pot”). Moreover, developing core muscle strength can boost the effectiveness of workouts and reduce the risk of injuries that sideline our efforts to stay in shape.

Getting at the core

If you’ve ever had physical therapy to treat low back pain, you’re probably familiar with the concept of strengthening the core — the muscles in the abdomen, lower back, and pelvis that lie roughly between the rib cage and the hips. The strength and coordination of these muscles is important not only for sports and fitness routines but also for daily life — for example, reaching up to a shelf, lifting a child, or sponging a spot off the floor.

The current drive behind core conditioning comes in part from studies conducted in the 1990s showing that before they move an arm or leg, people with healthy backs (in contrast with those suffering from low back pain) automatically contract their core muscles, especially the transverse abdominal muscles, which wrap from the sides of the lower back around to the front. Experts concluded that well-coordinated core muscle use stabilizes the spine and helps create a firm base of support for virtually all movement. The role of the core is also central to the Pilates method, a series of exercises developed during World War I to help rehabilitate soldiers returning from the war. Its founder, Joseph Pilates, referred to the core as the “powerhouse.”

These days, patients who are receiving physical therapy for chronic low back pain or injury are told to contract their core muscles before performing prescribed exercises. And Pilates exercises are increasingly incorporated into health club workouts, along with other approaches that engage the core, such as fitness (stability) balls, yoga, and tai chi.

Exercises that strengthen abdominal and other core muscles should be part of an overall fitness plan that includes regular moderate-intensity aerobic exercise, such as brisk walking, 30 minutes per day, most days of the week. Guidelines also encourage us to get 20 to 30 minutes of strength training two to three times a week, and that might be a good time to fit in a few exercises designed to work the core.

Sample core exercises

To be safe and effective, core muscle strengthening exercises require proper alignment and progression from one type of exercise to another — adjusted to your body and fitness level. So you may want to ask a physical therapist or exercise professional for help in planning a program for you. (If you haven’t been physically active or have back problems or some other medical condition, consult a clinician before embarking on any fitness program.)

You’ll probably start by learning how to “draw in” — the first step in performing all core exercises and a basic tool you can use in almost any physical activity you perform (including walking). Here’s what you do: Sitting, standing, or lying on your back, gently but firmly tighten the abdominal muscles, drawing the navel in toward the small of the back. The tailbone should be slightly tucked. (Some trainers prefer to call it “bracing” the muscles, as if you were preparing to take a punch in the stomach.) Practice holding this position for 10 seconds at a time while breathing normally (that’s the hard part!). Once you get the hang of drawing in, you can start doing some core exercises, progressing from those you do on a stable surface (the floor or a mat) to those performed on an unstable surface, like a stability ball.

Below are just a few exercises that can help strengthen core muscles. If you decide to try any of them, go slowly, work at your own pace, and don’t keep doing anything that causes pain. Concentrate on performing the exercises correctly, not on the number of repetitions or how quickly you can do them. And don’t forget to breathe!

Reverse crunch

Lie with your back pressed to the ground, your hands at your sides, your knees bent, and your feet off the floor (ankles crossed) so that your knees create a 90-degree angle. Tighten your abdominal muscles, and raise your hips toward your rib cage, curling your tailbone off the floor (see illustration). Hold for a second or two; then slowly lower your hips to the starting position. Work up to 12 to 16 repetitions. Note: Use your hands at first to help stabilize yourself, but rely on them less as you get stronger.

Arm and leg raise

Lie on your stomach with your arms above your head. Tighten your stomach muscles; then lift your right arm and left leg (see illustration). Hold for five seconds. Lower, and rest a moment; then repeat with the left arm and right leg. Work toward eight to 12 repetitions on each side. Note: Avoid arching your back (keep your abdominal muscles engaged and your pelvis tucked). When you’re ready for more, try lifting the leg and arm on the same side.

Bicycle

Lie flat on the floor on your back. Place your fingertips at the back of your head. Tighten your abdominal muscles, bring your knees up to a 45-degree angle, and lift your shoulder blades off the ground. Turn your upper body to the left, bringing the right elbow toward the left knee and extending your right leg (see illustration). Switch sides, bringing the left elbow toward the right knee. Continue this pedaling motion, slowly, for a total of 12 to 16 repetitions. Rest and repeat. Note: Avoid pulling on the neck.

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Tips For Exercising With A Hernia

Doubling over in abdominal pain when you cough? Sensing a dragging, heavy feeling in your abdomen? Chances are you might have a hernia that requires medical attention. As per the Consumer Health Digest, it might affect people above fifty years of age.

What is a hernia?

A hernia is essentially the protrusion of an organ like the stomach or intestines through the wall of tissue meant to keep it in place. A range of hernias exist, however, the most common, called an inguinal hernia, will often result in a visible bulge in the lower abdomen, upper thigh, or groin. This lump may be able to be pushed back in and sustained with abdominal hernia belts however symptoms may accompany it including burning, aching, and pain at the site of the hernia as well as weakness, heaviness, and discomfort when bending over or coughing.

What causes a hernia?

Before attempting exercise with a hernia, it’s important to understand the risk factors which caused it in the first place. Most commonly, hernias result from a combination or weakened tissue in or around the abdomen and exertion, like with lifting something heavy or chronically coughing.
The strain on the abdomen from pulling or lifting heavy loads can tear vulnerable tissues and allow the intestines to pop through. Normally this might simply require time and monitoring to prevent further injury, however, in some cases the loop of intestines can get strangulated, cutting off blood flow and leading to permanent tissue damage. Exacerbating a hernia with strenuous exercises will do more harm than good and can result in life-threatening complications.

Can I exercise with a hernia?

Talk with your doctor about fitness and managing your hernia prior to attempting any exercise routine, however, know that a hernia doesn’t have to sideline any and all physical activity. Low-impact exercises that don’t require lifting weights and which don’t specifically engage the site of your hernia and surrounding muscles are a good idea.

Research conducted by Baylor University Medical Center at Dallas found that the patients who have access to an Elliptical Machine, Treadmill or Recumbent Bike have a faster recovery time. As many of the best elliptical under 500 dollars are quite available nowadays, patients can easily buy one for their home gym to reduce the recovery time.

Water-based activities like pool running or water aerobics are smart and weightless alternatives to high-impact running or soccer for example, while walking, dancing, or riding a recumbent bike can also provide a pain-free exercise experience to keep your health and fitness goals on track.

In addition to avoiding lifting weight, people with abdominal hernias should skip exercises which target strain to the abdomen, like crunches, some yoga positions, and HIIT (high intensity interval training). After your hernia is healed, you can work towards re-strengthening abdominal walls to prevent future hernias with core exercises, stretching, and weight-lifting.

What other considerations should I keep in mind?

Daily aerobic exercise plays a critical role in helping you keep off unwanted weight and lowering risk for ailments including high blood pressure, diabetes, and heart disease. Don’t let a hernia keep you from staying active and become your reason for gaining weight. The larger your waistline grows, the worse a hernia can grow, and the harder it will be for surgeons to successfully repair it. If surgical intervention is needed, you then run the risk of post-surgery dangers where some people have even received hernia mesh lawsuit settlements.

Sitting and standing positions during physical activity which relax the abdominal muscles are going to take it the easiest on an abdominal hernia. Bending, stooping, and hunching postures on the flipside can cause moderate to severe pain and potentially worsen an existing hernia.

Don’t ignore pain when it comes to exercising with a hernia. Sudden, sharp pain at the hernia site as well as radiating pain which comes and goes can indicate complications with your hernia like incarceration or strangulation. Select one of the many General Physicians in your area right away if you develop painful symptoms or see a dark discoloration of the hernia bulge.

Men develop abdominal hernias far more than women and most often when not in great shape and attempting to move, push, pull, or lift something heavy. If you like to lift weights but are afraid of developing a hernia, don’t fret. Lifting when done with proper technique can actually help strengthen abdominal walls to prevent hernias, as can dynamic warm-ups and knowing your limits to avoid injury. Sync up with a knowledgeable instructor or personal trainer to tackle the best technique and form for lifting weights that won’t result in a hernia.

How to Exercise With a Hernia

Exercising with a hernia isn’t always easy to do. Sometimes it’s not even a safe thing to do. Hernias are complicated things alone, never mind looking into exercising with one, but, here we are. Hernias can happen for a number of reasons and in a number of places. That makes it a little tricky to give you a definitive answer. Let’s look at why.

First things first; the cause and the place of your hernia need to be looked at, as well as the severity before you can exercise. It should go without saying, but please do talk to your doctor before you even try to exercise with a hernia. That’s just a side note. It’s also worth noting that they don’t get better without surgery. You will need it at some point. This is just how to keep fit in the meantime.

Hernia Location and What Exercise to Avoid

So first up, location. Where your hernia is has a significant impact on the exercises you can be doing. It’s mostly in your abdominal or groin region. A lot of that depends on your gender and how you got the hernia in the first place, but generally speaking, these are the most common. With that in mind, you need to avoid making it worse.

Ab exercises

In most cases, ab exercises are usually pretty hard to do and can be the riskiest when exercising with a hernia. It’s generally wise to give them a knock on the head for a while unless your doctor says otherwise. That’s point number 1.

As well as avoiding ab exercises specifically, it’s also essential to avoid overstretching too! Make sure that you aren’t doing ANYTHING that is going to cause excess stress on your abdomen. Anything at all that’s strenuous like yoga, for example, can be one of the worst ways to worsen your hernia, depending on where it is. Be careful before you do anything.

Heavy lifting exercises

Number 2 is to avoid heavy lifting. If you’re going to attempt to exercise with a hernia, you need to avoid putting yourself in even more risk. One of the easiest ways to develop a hernia in the first place is by overstraining. One of the easiest ways to do that? Lifting heavy things, especially with the wrong technique.

Until your doctor post-surgery gives you the green light, avoid doing heavy lifts both in your training and in everyday life. You don’t want to make things worse for yourself! Things like deadlifts, squats and bench presses are some of the biggest lifts and therefore probably should be avoided. Take it easy!

The conclusion

Basically, take it easy and get surgery. That’s the take away from all of this. If you truly want to keep exercising with a hernia, juts make sure you’re not doing anything strenuous. Keep breathing throughout your exercises too, as with weight training especially; it’s easy to hold your breath on a lift. That makes more pressure, and often a much worse hernia.

Talk to your doctor before you try anything to make sure you aren’t putting yourself at excess risk, and exercise lightly. Any exercise is fine really as long as you are not pushing yourself too hard.

Resources:

Before beginning any exercise or nutrition program, consult your physician, doctor or other professional. This is especially important for individuals over the age of 35 or persons with pre-existing health problems. Exercise.co.uk assumes no responsibility for personal injury or property damage sustained using our advice.

If you experience dizziness, nausea, chest pain, or any other abnormal symptoms, stop the workout at once and consult a physician or doctor immediately.

Activities to Avoid If You Have Had Hernia Surgery

A hernia is a defect in the musculature of the abdomen, a weakness or an actual opening, that can lead to a protrusion of the underlying abdominal wall. Severe cases can be seen and felt on the lower abdomen. These cases require immediate attention as they cause disruption of blood flow, which could lead to tissue death in the affected area. Even minor hernias cause pain in the abdomen when the muscle group is activated. Bending and lifting are common precipitators, but even coughing can cause acute pain. Surgical intervention is required and moderating physical activity during recovery is a must.

Is This an Emergency?

If you are experiencing serious medical symptoms, seek emergency treatment immediately.

Walking

One activity your doctor will encourage you to not avoid is walking. Patients spend only a couple hours in recovery following most hernia surgeries. You will be discharged as soon as you are awake and able to walk. While the rest of your first day will likely be spent resting, it is important to start walking on the next day after surgery, even briskly, but avoid walking up stairs or hills for the first several days.

Running

Avoid running for at least the first three days to a week, then begin with light jogging. Stick to the track and avoid up-and-down cross-country terrain that requires greater core muscle involvement.

Showering

It is important to keep the suture site clean and dry, but it should remain dressed for at least the first two days. Avoid showering during this period. On the third day, you can remove the dressing and take a shower. Pat the suture site dry afterward and avoid excessive rubbing with the towel. Get someone to support you if you need to step into and out of a bathtub. It’s better if you use a stand-up shower stall if it’s available.

Abdominal Exercises

Avoid exercise that stretches or pulls abdominal muscles for at least two weeks, then begin with light resistance training. You can resume core strength training after about four weeks. Work-related activities like heavy lifting should be considered core strength training and avoided for a similar period. No sex for two to three weeks, and if you’ve had incisional hernia repair, it is best to delay sex until the fourth week 2.

Sports

Your participation in non-contact sports like baseball, tennis and basketball can resume in six to eight weeks, but given the nature of sports and the possibility of accidental contact, it is always best to inform your doctor of your intentions. Contact sports like football or hockey should be avoided for at least 12 weeks. Laparoscopic repair leads to shorter recovery times, but check with your doctor before you resume unlimited activity.

The Wrap Up

A hernia is a defect in the musculature of the abdomen, a weakness or an actual opening, that can lead to a protrusion of the underlying abdominal wall. Severe cases can be seen and felt on the lower abdomen. Avoid showering during this period. Avoid exercise that stretches or pulls abdominal muscles for at least two weeks, then begin with light resistance training. Work-related activities like heavy lifting should be considered core strength training and avoided for a similar period. Your participation in non-contact sports like baseball, tennis and basketball can resume in six to eight weeks, but given the nature of sports and the possibility of accidental contact, it is always best to inform your doctor of your intentions.

Exercising with a hernia is often fine and even recommended, especially if you are overweight. Dr. Thembi Conner-Garcia, a physician at Heartland Community Clinic in Peoria, IL suggests, “Prior to exercising with a hernia, you need to consult with your doctor. Depending on the type, size and location of the hernia, restrictions will vary.”

Exercising With a Hernia

Many people choose to live with their hernia as long as it doesn’t pose any serious complications. Nonsurgical treatments and lifestyle changes have been shown to greatly reduce hernia discomfort, though they are only temporary solutions. Exercise can be helpful, oftentimes easing symptoms. It will help you burn calories and may reduce belly fat, which is beneficial to most hernias.

Exercise Modifications

Dr. Conner-Garcia explains, “For the most part, you can safely exercise with a hernia but some exercise modifications are usually needed.” Modify your existing workout by reducing impact, intensity and or duration. Engage in moderate exercise and choose activities that don’t put undue stress on your abdomen. Aerobic exercise will help you burn calories and manage your weight.

  • The stationary bike is a good choice. Opt for the recumbent bike. The sitting angle will prevent straining your abdomen and your core muscles will be supported. If you choose to use a spin bike or an outdoor bike, take it easy and remain in the seated position while you ride.
  • Swimming and water exercise are also safe ways to get your cardiovascular exercise in. These are no-impact workouts so the likelihood of straining yourself is particularly low. You want to be careful not to overdo it and avoid twisting motions that put pressure on your abdomen.
  • A walking program is another excellent choice. It’s low impact in nature, again helping to reduce the chance of strain on your abs. Walking also builds core strength, which is very helpful in the prevention of hernias.

A 2012 experimental study published in US National Library of Medicine National Institutes of Health found that certain yoga asanas were helpful in reversing inguinal hernias. Go for gentle yoga. Standing poses like the tree pose are good choices. Practicing deep abdominal breathing along with your yoga practice can also be helpful.

Exercises to Avoid

“In general, you should avoid exercises that require lifting a large amount of weight, excessive straining or anything that can increase your intra-abdominal pressure,” explains Dr. Conner-Garcia.

Exercises to avoid include:

  • Heavy weightlifting that causes you to strain or grunt
  • Any pushing activities that cause you to strain or grunt
  • Any pulling activities that cause you to strain or grunt
  • Ballistic activities like kicking or punching

Those who play sports like soccer, ice hockey, rugby, football, wrestling, field hockey, tennis, or run track most frequently get sports hernias. These sports involve ballistic or high impact movement and movement that requires a quick change of direction. These are activities that should be avoided when you have a hernia.

Post Surgery Exercise

If you opt to have surgery on your hernia, the American Council on Exercise (ACE) recommends that you allow about three weeks recovery time and engage in only light activity during this time. Wait until you hit the six week mark to start or resume strenuous exercise.

You definitely want to make core strengthening a priority during your workouts. Just be sure to do so slowly and gradually increase the intensity of exercise. Always monitor your body for signs of discomfort or changes in your incision. Also, if you experience pain, back off the exercise and note which exercise caused you pain so that you can avoid it and look for an alternative.

Keep in mind that your abdominal muscles will be sore after surgery but this will subside over time.

Core Strengthening

ACE recommends these modified exercises for strengthening your core:

  • Partial Crunch: Unlike traditional crunches, partial crunches don’t focus on how high you flex your torso; instead, think about how much you tighten your abdominal muscles. You should only flex your torso a few inches while tightening your muscles. Start with one set of 15 repetitions (holding for a second at the top of the movement before descending) and slowly work your way up to three sets of 15.
  • Prone Plank: Adopt the top of the push-up position and pull upward and inward with the abdominal muscles while holding the plank for up to 30 seconds. Work up to three sets of 30-second holds, resting for 30 seconds between sets.
  • Lean Back: Sit on the floor with your knees bent and both feet flat on the floor. Keeping your spine straight, slowly lean back until you feel your abdominal contracting to hold you in that inclined position (for most people this will be about 30 degrees of inclination). Hold the position for up to 30 seconds. Work up to three sets of 30-second holds, resting for 30 seconds between sets.

Exercise Safely

Be sure to follow your doctor’s guidelines for safe and effective exercise. If you’re new to exercise or unsure about the best exercise program, consult a physical therapist for guidance.

Be cautious, but don’t shy away from physical activity. If done correctly, exercise will help you cope with your hernia and prepare you for surgery if you have to have it. It should definitely be a part of your prevention plan post-surgery.

Getting a hernia from lifting weights or being athletic is a horrible experience. Hernia surgery involves a long road to recovery — one that’s effective as long as you stick to the process and take your time through it. As a lifter and coach who’s undergone hernia surgery, I’ll tell you what you need to know if you find yourself in similar shoes.

But First, What Is a Hernia?

Truthfully, hernias can come in different forms. Umbilical hernias are located around the midstomach region, and inguinal hernias are located in the lower pelvic region. In each case, the lining of the abdominal wall is compromised, allowing for tissue underneath to push through. Depending on the severity and nature of the injury, this can be painful and even require emergency surgery.

The urgency of the hernia really depends not only on its location but also the tissue type that’s escaped. When the abdominal lining is torn, often a fatty tissue known as the omentum is what causes the protrusion. Often, this can create a bulge with minimal pain symptoms (as was the case with my own inguinal hernia). This generally means you can still carefully function while you prepare for surgical repair in the coming weeks or months. In other cases, organ tissue can begin to fall through and surgery needs to be arranged as soon as possible to put the organ (in the case of inguinal hernias, usually the intestine) back into place.

Whatever the nature, surgery is the ultimate answer. Naturally, most people who go under the knife wonder whether they’ll ever be able to return to the same level of capability they had before getting injured.

You Can!

And that is good news. I had my strongest PRs in major lifts well after my surgery in 2011. If you’re recovering from hernia surgery, these guidelines will set you on the right path to positive results without setbacks. On a similar note, many of these points can benefit a lifter who’s healthy and trying to avoid a hernia.

Ask Your Parents

Like many aliments, potential for getting a hernia from exercise is heightened depending on whether you’re genetically inclined to get one. Ask your parents if they’ve ever had any, and if yes, you’ll know you’re probably more susceptible to one than the next guy is. With that said, training smart matters tenfold.

Everybody, Breathe!

Like the subheading suggests, this one applies to both recovering hernia patients and healthy individuals who have never been injured. Improper breathing technique is one major player in exercise that can be a huge cause of hernias. Understand the importance of exhaling on the exertion phase of your lifts, remaining braced, creating intra-abdominal pressure and limiting the amount of strain you place on areas like your pelvic floor. All exercise starts with good breathing. Practice it under light weight and get used to it. If you’ve been injured, it will only matter that much more.

Be Careful With Anti-Extension Work

It took me a long time before I could get back to exercises like ab wheel rollouts, hand walkouts and barbell strict presses. The common thing among these movements is the anti-extension capacity of the abdominals. They place the abdominal tissue into a stretch that a strong contraction negates (in order to keep the spine neutral and intact).

Remember, you’ve been stitched up because your abdominal wall was torn open. With that in mind, you can easily reinjure yourself if you’re not careful. Start your abdominal work in a neutral position and not an extended one. Work with short plank variations before pushing the envelope. If you’re healthy, pay special attention to your spine position during heavy overhead presses and rollouts. Just because it doesn’t “hurt” to fall into extension, don’t try to be a hero. Lower your load on presses (or range of motion on rollouts) and do what you can with your glutes and abs remaining engaged.

Take a Closer Look at Your Hip Complex

Don’t forget that many muscles cross through the core junction, and the hip joint is a complex one. The iliacus, psoas, transverse abdominal muscle, rectus abdominis and more are all part of the region between the bellybutton and the upper thigh. When you’ve had a hernia repair, regardless of its location, plenty of scar tissue will be a byproduct of the healing process, which will severely limit your range of motion to start. You’ll be limited in what you can do at the beginning, but creating more flexibility within your bounds is key.

Gentle stretching and rolling can do your body good, especially focusing on muscles that surround the site (think quads, glutes, IT band). You risk reinjury if you get right back into weight training without paying attention to your mobility and flexibility.

Listen to the Doc

In conclusion, no one wants to go under the knife. In the training community, everyone who does seems to want to set a world record for recovery time, and then post their exploits on social media with trite motivational quotes. Instead, let recovery be the name of the game and take the time you need to get better. No one’s trying to be a hero — especially not a recreational lifter with a day job.

Can Exercise Cause a Hernia?

People often ask if exercise can cause a hernia. A hernia may occur when certain activities increase pressure against the abdominal wall or against a muscle weakness in the abdominal wall. Certain strenuous physical activities and exercise, such as those that involve heavy lifting, pushing or pulling, can cause a hernia due to increased pressure within the abdomen. It most often occurs during sports or activity that requires sudden changes of direction or intense twisting movement.

A hernia in the groin is called an inguinal hernia and is considered the most common type of hernia caused by excess strain, as the groin is the weakest region of the abdomen. These hernias most commonly occur when you suddenly try to lift weights or push heavy objects beyond your strength, or indulge in a stringent exercise routine when you are out of shape or overweight. Weightlifters, body builders and manual laborers are also at a risk of developing a hernia, if they do not follow proper lifting techniques. Statistics show that a hernia occurs more commonly among helpers, equipment cleaners, handlers, and laborers, and is more common in men, especially due to overexertion in lifting (60%).

An umbilical hernia, or belly button hernia, is the second most common type of hernia that may be caused by strenuous activity. This type of hernia is also common in women after pregnancy.

A hernia can be avoided by:

  • Stretching or warming up before lifting a heavy object to avoid stretching a muscle
  • Using the right method for exercising and lifting weights:
  • Keeping your back straight and pushing from your leg muscles (as they are stronger than your back muscles) while lifting
  • Bending from your knees and not from your waist
  • Keeping the object close to your body
  • Gradually increasing weights while exercising
  • Supporting your back with a weight lifting belt, when lifting weights
  • Not overdoing exercises
  • Avoiding pulling or pushing exercises that force you to hold your breath
  • Being careful while performing curls, crunches, dead lifts or benching
  • Avoid lifting objects that are too heavy for you
  • Remembering to breathe correctly while exercising to stabilize your core

Talk with your doctor to learn more about the causes of a hernia and ways of preventing it.

Battling a Bulging Hernia

Don’t Ignore Your Groin Pain

Usually, the wall of the abdomen is strong. The muscles keep your intestine in place. But if there’s a weak spot, the intestine can push through and form a hernia. A person may be born with a weakness there, or the weakness may develop over time later in life.

“It’s like when you look at an old tire on a car and you see kind of a bulge on the sidewall of the tire. That’s because there’s a weakness in the wall of the tire. And the air is pushing the wall of the tire outward to create that bulge,” says Dr. Dana K. Andersen, an NIH hernia expert.

A hernia developing in the abdomen is extremely common. Babies, children, and adults get them. Most of the time, hernias are found in men over 40. Can lifting heavy objects give you a hernia? Maybe if you already have a weakness in the wall of your abdomen.

“The majority—three-quarters—of abdominal wall hernias are in the groin,” Andersen says. The groin region is the lower abdomen.

The first sign of a hernia is a small bulge from the lower abdomen. You may notice it only when you stand up, cough, jump, or strain. That’s because those activities increase the pressure within your abdomen. That increased pressure can make a part of your intestine pop out of an area of weakness. When you lie down, the bulge may go away.

If you think you may have a hernia, ask your doctor. A doctor can usually detect a hernia during a physical exam. Your doctor can rule out other conditions that cause bulges or lumps.

If the bulge is very soft, your doctor may be able to massage the intestine back into the abdomen. A small, soft hernia that does not cause pain may not need treatment right away. The doctor may suggest watching and waiting for changes, like pain, to develop. If a hernia is painful or large, your doctor may suggest you see a surgeon for advice. You may need surgery to repair the hernia.

If your doctor can’t massage the intestine back into the abdomen, that means it’s trapped. A trapped intestine is dangerous because its blood supply can be cut off or strangulated.“The rim of the defect is forming a sort of a noose around the abdominal contents,” Andersen explains. “If that noose is tight enough so that the loop of intestine can’t be eased back through the defect, then the concern is that the intestine itself could be injured by strangulation.”

A strangulated hernia can be very serious and even life threatening. Symptoms include severe pain that doesn’t go away, nausea, and vomiting.

Surgery is usually needed if the intestine is trapped—and emergency surgery if it’s strangulated. A hernia is one of the most common reasons for surgery in the United States. “It’s a successful and low-risk procedure done about 800,000 times a year in the United States,” Andersen says.

If you think you may have a hernia, talk with your doctor. And check out the tips in Wise Choices for how to keep a hernia from getting worse. Keep in mind that anyone with sudden pain in the groin should immediately seek medical help.

A hernia occurs when part of an internal organ or tissue protrudes through a weak area of muscle. Many hernias are in the lower abdomen and are especially common among men. In fact, about 25 percent of men will develop a hernia in their lifetimes, according to the National Institutes of Health.

A hernia can have many causes. We see congenital hernias, which include most of the groin hernias we see and which happen in both men and women. Prior surgery can also cause hernias, which are known as “incisional hernias.” One of the most common types of hernias are umbilical hernias, or hernias of the belly button, which most people know as “outies.”

Only a small percentage of hernias — about .3% — are actually dangerous. However, hernias are commonly operated on when they become painful. The most common symptoms are pain or pressure in the area of the hernia.

How Do We Fix Hernias?

Hernia repair is one of the most common surgical procedures performed in the U.S. with almost one million operations each year.

The surgery may be performed by laparoscope or by an open procedure, where the surgeon directly repairs the hernia through an incision in the abdominal wall. Surgeons also have the ability now to perform robotic or computer-assisted surgery.

Computer-Assisted Technology allows:

  • Wristed instrumentation (similar to having your hands in a small space)
  • 3D stabilized magnified view
  • Autonomous control for surgeon of three instruments and a camera
  • More ergonomic for surgeon

An open surgical technique is when a larger incision is made. This results in good muscle closure, but has a higher incidence of infection.

A laparoscopic technique uses a small incision into which the laparoscope is inserted. The instruments to repair the hernia are inserted through other small incisions in the lower abdomen. Mesh is then placed over the defect to reinforce the abdomen wall. This technique has smaller incidents of infection, but the muscle has a harder time closing the hernia defect.

The type of operation chosen by the surgeon depends upon many factors and is tailored to each specific patient.

Hernia Repair: How to Stop a Hernia from Popping Out?

Stop a Hernia from Popping Out

Normally, the wall of our abdomen is strong and its muscles hold our intestine in place. A hernia is formed when there is a weak spot through which the intestine can squeeze through. You might have been born with a weakness in that region, or the weakness might have developed over time later in your life.

Getting a hernia in the abdomen is quite common. Infants, children, and adults are found to be affected. Most often, males over 40 years are getting it.

One of the first signs of a hernia is a small bump from the lower abdomen. You can see it only while standing, coughing, jumping, or straining. It’s because these activities elevate the pressure without your abdominal region. That elevated pressure would make a part of the intestine to pop out of the area of weakness. You can often see that the bulge goes off when you lie down.

So, do you think you have a hernia? What can you do to stop it from popping out?

Read the following article to know how to deal with a hernia here:

How Can You Tell if You Have a Hernia?

If you suspect you have a hernia, talk to your doctor. If you don’t have any symptoms, your doctor may discover a bump in your abdomen or groin during a physical examination.

Most often, individuals with a hernia will see a lump or tenderness along with pressure/pain while bending, coughing, and straining. This lump may feel easier when he/she stands up. This denotes a reducible hernia. This type of hernia can be pushed back into your abdomen. To do this, your doctor may carry out a massage so as to put your intestine back into place.

To put it simply, a hernia, which is small and soft and that doesn’t cause a pain may not require any treatment right away.

Other symptoms of a hernia are:

  • A feeling of heaviness in your abdomen or groin
  • Pain and swelling in your scrotum (for males)
  • Pain during a bowel movement and/or urination
  • Pain while lifting or transporting something heavy
  • The pain felt later in the day, particularly if you are standing a lot

In children, you can will notice a bump when your baby cries, coughs, or strains during a bowel movement.

How Can You Treat Your Hernia at Home?

Generally, all cases of hernias are candidates for surgery. Unless you cannot have surgery due to other medical conditions or delayed, a surgical repair will be prescribed. If surgery isn’t possible or delayed, you can use a truss or an umbilical hernia belt to keep the bulge of your hernia in. These umbilical hernia belts will work for certain types of hernia by helping to keep your hernia from popping out.

In addition to wearing an umbilical hernia belt, you can also try to gently push your hernia into the abdomen. You might feel it easy to do while lying down.

While this is the case for the people who have a reducible hernia, there is another condition called irreducible hernia, meaning that it can’t be reduced. In some cases, the intestine can be trapped, which can be fatal as it will cut blood supply to the region. This is called strangulated hernia. This is the case of medical emergency and needs an emergency medical care.

Tips to Follow at Home:

  • If you have the problem of constipation and need to strain for bowel movements, start adding fiber to your diet so that you don’t have to strain.
  • If you have a cough, ask your physician to treat it so that you are not coughing, which causes the hernia to pop out.
  • Avoid doing any activities that can elevate abdominal pressure like heavy weight lifting.

How a Hernia is Medically Treated?

Are there any medications to treat a hernia?

No, there are no medications to treat the hernias directly. However, your doctor may prescribe medications in order to decrease the risk of worsening your hernia. These include stool softeners and cough medicines.

So, how do the physicians treat hernias?

If your hernia is small and without pain, you and your physician can decide to wait. On the other hand, if your hernia grows and causes pain, you may need surgery.

In general, treatment of your hernia would depend on whether it’s reducible or irreducible and potentially strangulated. In this, even the reducible hernias should be repaired in order to prevent the strangulation. Only if the patient has some other medical conditions that make the surgery impossible, the physician may not repair the hernia, instead, he/she will suggest the use of abdominal binders.

On the other hand, if you have an irreducible hernia, you will need emergency treatment due to the risk of strangulation. However, an attempt to push back the hernia will be made, with pain medications and muscle relaxation techniques. If this turns unsuccessful, emergency surgery will be prescribed.

What’s in the Strangulated Hernia Surgery?

As mentioned above, a strangulated hernia surgery is an emergency care. Here, the primary objective of the surgeon will be to decrease the hernia, meaning to release your entrapped bowel and restore it where it actually belongs within the abdominal cavity. And, this should be done before the tissue gets damaged permanently.

After this is done, the hernia has to be repaired right away, so as to prevent it from occurring again.

So, how do surgeons repair hernias?

Hernias are repaired using two types of surgeries:

Traditional Surgery: Here, the abdominal wall will be opened and the protruding tissue will be pushed back into the abdomen. Then, the abdominal wall will be sealed and the weak spot will be reinforced using a synthetic mesh.

Laparoscopy: This is a less-invasive method, which makes use of tiny-optic instruments to be sent into the abdomen via tiny openings. A camera will be sent through one opening, so as to guide the surgeons who are manipulating the devices in the other openings.

Once the hernia surgery is over, you can resume your regular day to day activities by following your physician’s advice and ability permits.

1..https://www.dailymail.co.uk/health/article-2513418/Ask-doctor-How-I-stop-hernia-popping-out.html

2..https://newsinhealth.nih.gov/2017/12/battling-bulging-hernia

3..https://www.emedicinehealth.com/hernia_faqs/article_em.htm#what_is_the_treatment_for_a_hernia

4..https://www.hernia.org/types/strangulated-hernia/

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