Hernias aren't very dangerous or life-threatening, but they're an extremely common injury. Around 600,000 hernia surgeries are performed every year in the United States, according to the Asia Pacific Hernia Society. Whether you have surgery or not, the rehab process takes weeks. If you try to progress too quickly, you can injure yourself again.
Inguinal hernias are the most common form of hernia. They occur in the groin, and can be very painful. Usually the injury happens when you do heavy lifting or strenuous running. It occurs in the area where your lower abdominals and adductors connect, which is on the front of your pubic bone.
Inguinal hernias typically appear near the inguinal canal, which is a passage through the lower abdominal wall, explains the National Institute of Diabetes and Digestive and Kidney Diseases. Some people are born with weaknesses in this area, and some develop them through wear and tear.
Read more: Exercise and Inguinal Hernias
How Hernias Occur
A tear in your lower abdominal muscle wall, typically near the inguinal canal, opens up space for organ or fat tissue to poke through. Pressure from your abdomen forces this tissue through the tear. A sudden trauma like lifting a heavy weight can cause the tear, or the area can slowly wear down over time.
Certain sports, particularly hockey, can cause overuse injuries at the hip and groin that lead to a hernia. Heavy weightlifting can also cause tears because of the incredible amount of abdominal pressure that's created from doing a squat or deadlift motion.
When your ab muscles contract, they create more pressure in your abdomen. That's why you can get a hernia from an ab workout. Holding your breath when you do an exercise creates even more pressure.
Recovering From a Hernia
Depending on how severe your hernia is, you might need surgery. If it's not too severe, rest and a slow return to exercise is enough to let it heal. Either way, the recovery process can take weeks.
Part of the rehab process is slowly learning how to use your ab muscles again. When your abs contract, they squeeze the space in your abdominal cavity that houses your organs. This creates pressure, which can re-aggravate your hernia.
The key is to start with simple, benign core exercises for your hernia. Begin with exercises that help you stabilize your spine. Contracting the small muscles around your spine, like the transverse abdominis, won't cause a lot of pressure on your groin. Once you're comfortable with easier movements you can progress to more traditional ab exercises.
Josh Grahlman, owner of Clutch Physical Therapy in New York City, advises against using planking exercises early in the rehab process. While it might seem like a simple and nonthreatening ab exercises, it's probably too intense to do early on in your hernia rehab. Planks make your ab muscles work hard enough to re-aggravate your hernia.
Core Exercises for Hernias
Slowly build up strength in your transverse abdominis, starting with exercises like the dead bug.
To do a dead bug, lie on your back. Raise your arms up toward the ceiling with your elbows straight. Your legs should also be in the air with your knees and hips bent at 90 degrees. Reach your left arm back and right leg forward until your hand and heel touch the ground, then lift them back up.
Switch sides and reach out the other arm and leg. As you move your limbs, keep your lower back pressed against the ground. Be careful not to hold your breath, as this can increase abdominal pressure. Breathe in through your nose as your limbs go down, and out through your mouth as they rise up.
Once you've mastered the simple dead bug movement on your back, it's time to flip over to the all-fours position for an exercise called the bird dog. Start with your hands under your shoulders and knees under your hips. Your elbows should be straight. Look down at the ground so that your spine is straight.
Reach out your right arm and left leg until both limbs are fully extended. Keep your spine as straight as possible the entire time. As in the dead bug, breathe evenly the entire time. Exhale through your mouth as your limbs go up, and inhale through your nose as they come down. Move slowly and under control.
Once you can control your spine in dead bugs and bird dogs while breathing through the exercises, you can reintroduce the plank.
Read more: Exercising With a Hernia
On the ground, plant your elbows directly under your shoulders. Your forearms should be straight out in front of you. Hold your body up so that only your forearms and toes are on the ground. Try to stay in a straight line without letting your hips sag or stick up in the air.
An article from Mass General says you can begin incorporating a gentle curl-up into your routine at this time. Start slowly with this exercise, since it uses your more powerful abdominal muscles.
Lie on your back with your feet planted on the ground and knees up at 90 degrees. Your hands should be next to your butt. Gently reach your fingers forward on the ground and lift your shoulders, head and neck up with your arms. Breathe out as you come up, and then slowly lower yourself down while breathing in.
Other Helpful Exercises
Working your abs will help strengthen the area of the hernia in the abdominal wall to prevent another injury. However, there are other hernia prevention exercises you can do to stop it from happening again.
According to an article from DC Aligned, people who have hernias typically have tight hip flexors and weak glutes, which can be addressed with simple exercises.
To stretch your hip flexors, stand on one leg and grab that ankle, pulling it in toward your butt.
For your glutes, start with the hip bridge. Lie down on your lower back and plant your feet flat on the ground. Your knees should be bent with your hands by your glutes. Keeping your head on the ground, press your hips up in the air until there's a straight line from your knees to your shoulders. Hold for a few seconds and release, then repeat five to 10 times.
Recovery Time Frame
The amount of time it takes to recover from your hernia surgery or injury can be weeks to months. Generally, you can return to full activity at week six of recovery, according to Sportshernia.com. Some people recover faster, and some people might take longer.
Going through rehab is very important. A 2018 study published in Scientific Reports shows that going through rehab decreases the chance that you re-injure your hernia. If you have surgery, that means you can save another trip to the hospital by following your rehab protocol.
- Asia Pacific Hernia Society: Hernia Statistics
- DC Aligned: Exercises to Help Rehab for Hernias
- Sportshernia.com: Post-Operative Care and Rehabilitation
- Scientific Reports: Postoperative Rehabilitation May Reduce the Risk of Readmission After Groin Hernia Repair
- Mass General: Post-Operative Rehabilitation Guidelines Following Bilateral Sports Hernia Repair and Adductor Release
- National Institute of Diabetes and Digestive and Kidney Diseases: Inguinal Hernia