If you have a hiatal hernia, you may question the conventional wisdom that exercise is good for you. When you have acute symptoms, exercise is probably the last thing on your mind. Perhaps you have found that certain types of exercise make your symptoms worse. And most people think of a hernia as something that happens when you strain or tear a muscle, so you may think exercise caused this in the first place. However, the relation between exercise and a hiatal hernia is not so simple. Chances are exercise did not directly cause the hernia, and the right kind of exercise might be just what the doctor ordered.
Hiatal Hernia
A sheet of muscle called the diaphragm separates your chest from your stomach. The diaphragm helps you breathe, but it also helps keep your stomach below your chest cavity, where it belongs. A hiatal hernia occurs when a tear occurs in the diaphragm, and the stomach protrudes through the opening. Unless the hiatal hernia is large, it can usually heal over time. Certain types of exercise can promote healing.
Causes
The specific causes of a hiatal hernia are not known, but exercise has not been identified as a cause. Risk factors for hiatal hernia have been identified, however, and include obesity, increasing age and smoking. To the extent that exercise promotes healthy weight and decreases the risk of obesity, it reduces your risk of developing a hiatal hernia.
Hiatal Hernia and GERD
Hiatal hernia does not directly cause pain, but it does contribute to a condition called gastroesophageal reflux disease, or GERD. GERD occurs when food and digestive juices from your stomach back up into the esophagus, which is the tube that leads from your mouth to your stomach. A muscle called the lower esophageal sphincter encircles the lower esophagus right above the entry to the stomach. This muscle relaxes to allow food into the stomach and tightens to close the esophagus to keep food and digestive juices in the stomach. Hiatal hernias appear to cause the lower esophageal sphincter to malfunction, allowing stomach contents to wash back up the esophagus, a condition referred to as acid reflux.
Symptoms
The most prominent symptoms of hiatal hernia are the symptoms you experience because of GERD, including heartburn, chest pain, the taste of stomach acid in your mouth and backwash or vomiting of stomach contents into the mouth. The pain can sometimes be intense and can significantly disrupt your daily life.
Exercise Benefits
Regular, short periods of moderate intensity exercise can reduce symptoms of GERD and improve hiatal hernias. Exercises and activities that help you lose weight, tighten your stomach muscles or strengthen your diaphragm can help prevent hiatal hernias and can promote healing of hiatal hernias. For example, yoga, deep breathing exercises and aerobic exercises that cause deep breathing strengthen your diaphragm. These activities also burn calories and assist in weight control.
Problem Exercises
Although exercise in general can promote healing of hiatal hernias, certain types of exercises and activities can make symptoms worse. Aerobic exercises that agitate the body, like vigorous running, can induce acid reflux, even in those who don't have problems with chronic heartburn, according to a July 26, 2010 article in "The New York Times." Exercises and activities in which you lay flat or place pressure on your stomach can also cause acid reflux. Doing bench presses, leg curls, leg lifts and surfing, for example, create abdominal pressure and position you so gravity helps move your stomach contents into your esophagus.
Solutions
First, avoid eating two hours before you exercise. Second, if you have a hiatal hernia, avoid the problem exercises. While your hernia is healing, ride a stationary bike, do yoga exercises and participate in gentler activities that don't agitate your stomach contents.
