It’s one of the situations no one wants to be in—getting a hernia from lifting weights or being athletic is a horrible experience, requiring surgical repair. It’s a long road to recovery—one that’s trustworthy as long as you stick to the process and take your time through it. As far as experience goes, I’m someone who speaks from it. As a lifter and coach who’s undergone hernia surgery, I’ll tell you what you need to know if you’re in similar shoes.
What is a Hernia?
Truthfully, hernias can come in different forms. Umbilical hernias are typically located around the mid stomach region, and inguinal hernias are located in the lower pelvic region. In each case, the lining of the abdominal wall is compromised, allowing for tissue to “push through”. Depending on the severity and nature of the injury, this can be painful, and even require emergency surgery.
The urgency of the hernia really depends not only on its location, but also the tissue type that’s escaped. When the abdominal lining is torn, often a fatty tissue known as omentum is what causes the protrusion. Often this can create a bulge with minor pain/discomfort symptoms (as was the case with my inguinal hernia). That generally means you can still carefully function while you prepare for surgical repair in the coming weeks or even months. In other cases, organ tissue can begin to fall through, which sings a slightly different tune where comfort and time are concerned. In such a case, surgery typically needs to be arranged as soon as possible to return the organ (in the case of inguinal hernias, usually the intestine) back into place and repair the breach.
Regardless of the nature, surgery is the ultimate answer. And naturally, most people who undergo such a process and go under the knife, wonder if they’ll ever be able to return to the same level of capability they had before getting injured.
You can!
And that is good news indeed. I had my strongest PR’s in major lifts well after my surgery back in 2011, so it’s possible. If you’re recovering from a hernia surgery, these guidelines will send you along the right path to results without setbacks. On a similar note, many of these points can benefit a lifter who’s healthy and trying to avoid a hernia.
This was me cranking out reps with 505, about 4 years after hernia repair.
First things first – like many things, potential for getting a hernia from exercise is heightened depending on whether you’re genetically inclined to get one. Ask your parents if they’ve ever had any, and if yes, you’ll know that you’re probably more susceptible to one than the next guy is. With that said, training smart matters tenfold.
Everybody Breathe!
Like the subheading suggests, this one applies to both recovering hernia patients and healthy individuals who have never been injured. One major player in exercise that can be a huge cause of hernias is improper breathing techniques. Understand the importance of exhaling on the exertion phase of your lifts, remaining braced, creating intra-abdominal pressure, and limiting the amount of strain you place on areas like your pelvic floor. All exercise starts with good breathing. Practice it under light weight and get used to it. If you’ve been injured, it will only matter that much more.
Be Careful with Anti-Extension Work
It took me a long time before I could get back to exercises like ab wheel rollouts, hand walkouts, and barbell strict presses. The common thing among these movements is that of the anti-extension capacity of the abdominals that each exercise asks for. That places the abdominal tissue into a stretch that a strong contraction negates (in order to keep the spine neutral and intact).
Remember—you’ve been stitched up because your abdominal wall was torn open. With that in mind, you can easily reinjure yourself if you’re not careful. Start your abdominal work in a neutral position, and not an extended one. Work with short plank variations to start before pushing the envelope. If you’re healthy, pay special attention to your spine position during heavy overhead presses and rollouts. Just because it doesn’t “hurt” to fall into extension, don’t try to be a hero. Lower your load on presses (or range of motion on rollouts) and do what you can with your glutes and abs remaining engaged.
Moreover, bring more attention to the deepest abdominal tissue—the transverse abdominis (TVA). Simple vacuum exercises and hollow body hold/chop patterns can do well to target this muscle while still challenging anti-extension in a much more controlled fashion, due to the leg position keeping it from being overly aggressive on the repaired site.
Take a Closer Look at your Hip Complex
Don’t forget that many, many muscles cross through the core junction, and the hip joint is a complex one. The iliacus, psoas, TVA, rectus abdominus, and more muscles are all part of the region between the belly button and the upper thigh. When you’ve had a hernia repair, regardless of its location, plenty of scar tissue will be a by-product of the healing process, which will severely limit your range of motion to start. You’ll be limited in what you can do at the beginning, but creating more strength and flexibility within your bounds is key. Gentle stretching and rolling can do your body good, especially focusing on muscles that surround the site (think quads, glutes, IT band). You risk reinjury if you get right back into weight training without paying attention to your mobility and flexibility. Remember too – mobility comes from strength to achieve ranges of motion, so key activation work to the intrinsic muscles of the hip complex can go a long way.
Listen to the Doc
In conclusion, no one should want to go under the knife. And in the training community, everyone who does seems to want to set a world record for recovery time, and then post their braggadocio on social media with trite motivational quotes. Instead, let recovery be the name of the game and take the time you need to get better. In other words, don’t fall into the trap of trying to be a hero—especially if you’re a recreational lifter with a day job to focus on.