It might seem like nothing, but hernias can be dangerous if you don't take care of them. They're nothing like broken bones or sprained ligaments, and you probably don't need to rush to the emergency room, but you shouldn't push too hard at the gym if you have a hernia.
Different Types of Hernias
When an organ or another tissue in the body pushes through the wall of a muscle or something else meant to contain it, you have a hernia, according to the Cleveland Clinic. That's a broad definition, but there are many different forms of hernias.
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The most common forms are inguinal, femoral, umbilical and hiatal. They all occur in or around the abdomen. Inguinal hernias are in the groin, near the inguinal canal, which is a passage through the lower abdominal wall. They are more common in men because the spermatic duct runs through the inguinal canal.
Femoral hernias occur at the top of the inner thigh and are less common than inguinal hernias. Occurring in or around the belly button, umbilical hernias are common in children. An estimated one in six children develop an umbilical hernia, according to the Cleveland Clinic. It's also possible to have multiple umbilical hernias.
Read more: Can You Exercise with an Umbilical Hernia?
Hiatal hernias aren't easy to feel and are impossible to see. It happens when part of the stomach pushes through the diaphragm and up into the chest cavity. It's not entirely clear what causes them, but aging and weakening of the diaphragm may play a role.
How to Spot a Hernia
With so many different types of hernias, it's hard to say exactly how your workouts should change. If you think you have this condition, it's best to consult a medical professional. Symptoms depend on the type of hernia you have.
If you feel a bump in your groin or the upper, inner part of your thigh, you could have an inguinal or femoral hernia. These may or may not be painful. The bump will be more pronounced if you cough or strain.
For an umbilical hernia, you'll notice a bump in or around your belly button. Sometimes, bumps appear in different parts of your abdomen. As soon as you feel or see a bump, you should consult a medical professional.
Options for Treatment
In some cases, treatment may not be necessary and you can live with the hernia. However, hernias never truly go away on their own. If you want to fix this problem, surgery is necessary.
Since the major forms of hernias occur in or around the abdomen, there are some general recommendations you can follow whether you're recovering from surgery or trying to avoid it as long as possible.
Exercise With Caution
You use your abdominal muscles all day, every day. They help you breathe, speak, walk and do many exercises in the gym. It's nearly pointless to recommend not using your abdomen. Instead, you should take precautions to avoid exacerbating your hernia.
If nothing else, make sure you avoid lifting heavy weights. Heavy squats, deadlifts or even pullups cause pressure to build up in the abdomen, especially when you hold your breath.
Don't Hold Your Breath
Known as the valsalva maneuver, holding your breath while lifting weights builds up pressure in your abdomen. There are some benefits associated with it, such as increasing the stability of your spine. If you have a hernia, it's best to avoid building up pressure in the abdomen as it may force your organs or tissue further through the abdominal wall.
You don't need to lift heavy weights to build up pressure in your abdomen. Holding your breath while doing something as simple as a plank can cause your abdominal pressure to rise. If you have a hernia, you should focus on your breathing during exercise.
Read more: Exercise and Inguinal Hernias
Use Proper Breathing Technique
Breathing technique should be the same for most exercises. You should breathe in during the relaxed or negative portion of the exercise and breathe out during the concentric portion of the movement.
As an example, you'd breathe in as you descend into a pushup and breathe out as you push yourself up. You can also count each repetition to stay in a consistent rhythm.
Avoid These Exercises
Any activity causing strain or discomfort in the area of your hernia should be avoided, according to a 2017 article in the Journal of the American Medical Association. That can mean anything from lifting weights to running. For many exercises, you'll have to be the judge.
It's best to avoid movements that work the muscles surrounding your hernia because you run the risk of making things worse. For example, if you have an abdominal hernia, you should avoid direct abdominal exercises. Crunches, planks and twisting motions are risky.
For inguinal or femoral hernias, you should avoid leg exercises that use the hip flexors or adductor muscles. Sprinting and agile athletic movements involve both muscle groups. In the weight room, many lower-body exercises use both muscle groups, so it's best to stay light on your those workouts.
Things to Watch For
If you decide to delay surgery and continue to work out, keep in mind that hernias don't improve with time. Generally, they'll get worse since the opening in your abdominal wall is already weakened. An article from MedlinePlus advises that you should monitor the hernia for symptoms like:
- Pain in the affected area
- Redness or other discoloration of the hernia
- Nausea, vomiting and fever
- Inability to push the contents of the hernia back into the abdomen
Strangulation and Incarceration
These symptoms may indicate that your hernia has worsened and you may have strangulation or incarceration. When you can no longer push the contents of the hernia back into your abdominal wall, you have incarceration, where the organs or fatty tissue are trapped. This can either cause infection or lead to strangulation.
If your intestines poke through the abdominal wall and are cut off from circulation, the tissue can die. This is called strangulation and it's very serious. It may even require emergency surgery. Continuing to exercise with a hernia can lead to either incarceration or strangulation, so it's important to be careful.
- National Institute of Diabetes and Digestive and Kidney Diseases: What Is an Inguinal Hernia?
- Cleveland Clinic: Hernia
- Cleveland Clinic: Umbilical Hernia Treatment for Children
- The Journal of Strength and Conditioning Research: The Valsalva Maneuver: Its Effect on Intra-Abdominal Pressure and Safety Issues During Resistance Exercise
- JAMA Network: Groin Hernia
- MedlinePlus: Hernia
- Cleveland Clinic: Inguinal Hernia
- NHS: Femoral Hernia Repair
- Summit Medical Group: Proper Breathing During Exercise
- NHS: Umbilical Hernia Repair