I have a client who has had recent surgery for an inguinal herniation. I would like some advice on exercises and stretches I can do to rehabilitate him.
Thank you for your question and client concern. Inguinal hernias are protrusions of the abdominal cavity contents through an area of the abdominal wall. There are two types of inguinal hernia, direct and indirect. An indirect hernia is said to be congenital (from birth) whereas a direct hernia is acquired. Congenital hernias occur when the inguinal canal entrance fails to close normally before birth. An acquired hernia occurs when a part of the large intestine protrudes through a weakened area of muscles in the abdominal wall/groin. The weakening results from a variety of factors including a sedentary lifestyle. I would start by asking your client if his doctor mentioned the type of hernia he had. If it is a direct or acquired hernia, it means there is a weakening of the lower abdominal wall. Therefore, the following points are vital to his success:
- Be sure his body weight is within normal range. If he exhibits a “pot bellied” syndrome, the likelihood of reoccurrence increases.
- Reduce abdominal pressure by avoiding constipation and the build up of excess body fluids. This is achieved by adopting an individualized nutrition program.
- Teach your client how to functionally lift. Avoid weights that are too heavy and build up abdominal pressure. Watch him lift, and don’t let him hold his breath while lifting.
- Strengthen his abdominal wall FUNCTIONALLY. Due to the complexity of these exercises, I would recommend purchasing Gary Gray’s DVD Abdominals v2.2, which will give you hundreds of abdominal movements to enhance your client’s abdominal wall function.
- Stay away from isolated exercises, which place too much stress throughout the abdominal wall!
In closing, if you apply a functional approach, the stress will stimulate and NOT aggravate.