A sheet of internal muscles called the diaphragm extends along the bottom of the rib cage and separates your chest from your stomach. The diaphragm participates in breathing, of course, but it also helps in the elimination of body waste and helps prevent stomach acid from backing up in your esophagus. A hiatal hernia occurs when the diaphragm weakens or tears at the esophageal hiatus -- the hole in the diaphragm that allows your esophagus to empty into the stomach. When this occurs, part of the stomach protrudes through the tear. Usually, hiatal hernias can heal without surgical intervention. Exercises and stretches that strengthen the diaphragm can reduce the risk of hiatal hernia and certain exercises may relieve some of the symptoms.
Those who have hiatal hernia symptoms usually present with gastroesophageal reflux disease, or GERD. Symptoms of GERD include heartburn, belching, belching, difficulty swallowing, vomiting of food into the mouth and pain in the stomach or chest. Hiatal hernia heightens the risk of GERD by disrupting the muscles that wrap around the base of the esophagus, where the food enters the stomach. When this esophageal sphincter doesn't work properly, the contents of the stomach can flow back up the esophagus into the throat and mouth.
Treatment and Prevention
Stretching should be one component of a comprehensive treatment and prevention program. Physical conditioning, including stretching and strengthening the diaphragm and moderate-intensity aerobic exercise, can reduce symptoms of GERD. Consult with your doctor before beginning new exercise routines. Ask about medical treatments, as well as exercises and stretches that can help with hiatal hernia.
The sliding hiatal hernia, the most common type, occurs when portions of the stomach slide in and out of the hiatus. When the stomach is herniating into the hiatus, the esophageal sphincter can't close properly. Certain stretches can promote the movement of the stomach back down the esophageal hiatus. Stretch with one arm placed up to a ledge or bar, grab on and allow your body to hang and stretch. Let your body hang loosely and stretch your torso as much as possible. Repeat this several times a day to encourage protruded portions of your stomach to slide back into your abdominal cavity.
Stretching exercises loosen and strengthen abdominal and supportive muscles. Stretches that may help, include standing side bends, bending forward at your waist while standing and hip-extension stretches. Do not overstretch. Overstretching or stretching for too long can decrease the effectiveness of strength training by 4 to 28 percent and can also limit flexibility, reports exercise researcher, Len Kravitz, Ph.D. from the University of New Mexico. Limit stretching to 30 to 120 seconds to enhance strength and flexibility.
Deep breathing stretches and strengthens your diaphragm. Practice diaphragmatic breathing several times a day. Lie flat on your back, with your knees slightly bent. Place one hand on your chest and one on your stomach. Breathe in deeply through your nose using your diaphragm. You should see the hand on your stomach move upward as you inhale, but the hand on your chest should remain still. Exhale deeply, tightening your stomach muscles and keeping the hand on your chest still. Repeat four times.
Yoga promotes deep breathing, strength and flexibility and encourages blood flow to promote healing. Avoid postures that put pressure on your abdomen, such as the cobra, bow and bridge. Focus on gentle stretching stances such as yogic sit-ups, in which you lie on your back, hands behind your head and knees bent, and lift your head off the floor. Do standing poses like the tree pose. Consult with a trained yoga instructor to get guidance on poses that can help with hiatal hernia.
Is This an Emergency?
- Dr. Ben Kim: Hiatal Hernia Treatment
- Drugs.com: Hiatal Hernia
- Health Library: Hiatal Hernia
- National Digestive Diseases Information Clearing House: Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)
- National Institutes of Health: Hiatal Hernia
- Sports Hernia: Sports Hernia Rehabilitation Program
- “The New York Times”: The Claim: Exercise Can Worsen Chronic Heartburn
- University of New Mexico: Stretching: A research Retrospective
- "Yoga Journal": Hernia Help