A hernia is a protrusion of the body's internal contents through their surrounding tissue walls. Hernias are named based on their anatomic location; for instance, an umbilical hernia is one that protrudes from your belly button. Elevated intra-abdominal pressures are often responsible for the formation and recurrence of various types of hernias. Weight training has been linked to significant increases in intra-abdominal pressure. Additionally, several factors, including position, breathing control, and body mass index, have been shown to contribute to hernia recurrence post-surgery.
Biology of Hernias
Abdominal wall hernias occur when the muscle, tendon, or fascia responsible for maintaining structural integrity of the abdomen are lost. Fascia is a type of connective tissue present throughout the body, which serves to stabilize the abdominal wall and contain your internal organs. The pathology of hernia formation lies in either surgical wound failure or an underlying connective tissue disease. If you have recently undergone hernia repair surgery, it is important to recognize your elevated risk of hernia recurrence during the period of incisional wound healing. Surgeons regularly use a mesh material to help close the wound and reduce the hernia, which often improves the functional outcome of the surgery.
Weight Lifting
Sudden dramatic increases in intra-abdominal pressure, such as physical straining and heavy lifting, cause a reflex contraction in the abdominal muscles, increasing the tension of the connective tissue overlying the abdominal wall. The combination of elevated pressure and stress increase the probability of hernia formation. If you have recently undergone hernia repair, heavy weight lifting will place strain on an already weakened abdominal wall; this type of activity is especially risky if the surgical wounds have not fully healed.
Risk Factors
The risk of hernia recurrence depends on several factors, including baseline intra-abdominal pressure and abdominal tissue strength. According to the 2005 article "Normal intra-abdominal pressure in healthy adults" from the "Journal of Surgical Research," individuals with a higher BMI, or body mass index, experience significantly elevated pressures on the abdominal wall at baseline compared to healthy patients. Other conditions that chronically elevate intra-abdominal pressures, including pregnancy, chronic cough, and liver disease, are known to increase the risk for hernia formation following surgery. Conditions and behaviors resulting in chronic muscle weakness, including smoking, malnutrition, and steroid therapy, also increase the risk of hernia recurrence.
Applications
The risk of weight training complications following hernia surgery can be reduced by using proper breath control during lifting, according to a 2004 article from the journal "Spine." The article, "The effects of breath control on intra-abdominal pressure during lifting tasks," demonstrated significantly elevated intra-abdominal pressures when the participants inhaled and then held their breath during weight lifting. This type of breath control was compared to natural breathing, exhalation followed by holding, and inhalation-exhalation breathing while lifting. The researchers concluded that proper breathing during weight lifting could help control intra-abdominal pressure elevations.
References
- "Surgery Clinic of North America": The Biology of Hernia Formation; MG Franz; February 2008
- "Spine": The Effects of breath control on intra-abdominal pressure during lifting tasks; M Hagins, et al; February 2004
- "Journal of Surgical Research": Normal Intraabdominal Pressure in Healthy Adults; WS Cobb, et al; December 2005
- "Intensive Care Medicine": What is normal intra-abdominal pressure and how is it affected by positioning, body mass and positive end expiratory pressure? BL De Keulenaer, et al; February 2009
- "Hernia": Lightweight mesh improves functional outcome in laparoscopic totally extra-peritoneal inguinal hernia repair; LR Khan, et al; February 2010
- "Tintinalli's Emergency Medicine: Hernias in Adults"; Donald Byars; 2010
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