PT on the Net Research

Hernias and Weak Abs


I have a client with four or five incisional hernias from a large abdominal scar after an abdominal operation about 20 years ago. She is very cautious of doing any flexion work as she feels it puts extra pressure on the hernias. She has very weak abdominals as a result, and I am trying to strengthen them with leg work while in a supine position with head down and isometric exercises. Do you have any recommendations or suggestions regarding training with this client?


There are a lot of organs within the anterior aspect of the body that lay posterior to the inner unit (transverse abdominus, internal oblique, multifidus, deep erectors, pelvic floor muscles, diaphragm and external oblique, in which Vladimir Yanda describes as a functional inner unit muscle). Anytime there is inflammation in any of the organs, the muscles over them will be inhibited. This creates inner unit dysfunction, inner unit to outer unit synchronization, altered motor unit recruitment, instability in the low back, facet inflammation, SIJ dysfunctions and so forth. As well, anytime we have surgery and MDs cut through fascia and muscle, these muscles get sensorimotor amnesia.

To regain sensory motor unit synchronization, nutrition and lifestyle principles need to be in alignment. Here are some recommendations for you to get started. If you feel your client needs more, I would refer out.

There is a lot you can do with this client. Good luck, and I hope you found this response helpful. For more information, I would refer out to a CHEK, Poliquin or MAT Practitioner in your area.