I am a 52-year-old man and have been going to the gym for eight months now. I’m doing well and have lost a stone and a half, but I have an inguinal hernia. What activities can I still do and what should I avoid?
Inguinal hernia is fairly common among men, more so as you age. Because of a specific weakness in the abdominal wall, there is a tendency in men for the large intestine to bulge through the connective tissue and form a small sac in the groin. When you lie down, you can sometimes coax the bulge back but it won’t stay there unless the abdominal lining is repaired. While the hernia is not harmful in itself, it can get progressively more painful, and if the intestinal bulge becomes trapped (“strangulated”), it may rapidly become a life-threatening condition.
It sounds as though you are pretty sure of your diagnosis, but it is worth pointing out that many injuries can cause groin symptoms, including back and hip problems. A hernia diagnosis should be made or confirmed by a specialist.
As things stand, the only treatment is a surgical repair of the weak tissue. Until then, you will need to take care with a number of activities, including exercise. Any actions that sharply increase internal pressure in the abdomen (anything where you are bracing or holding your breath to push or pull a heavy load) risks worsening the hernia. Lifting boxes or cases, moving heavy furniture or even straining on the loo are all best avoided.
In the gym you need to keep away from weight training. If you are careful – best to work this out with the help of an experienced gym instructor – you can continue doing light weight-training for muscular endurance, but not heavy weights.
You should also steer well clear of many stomach exercises. Push ups, curl ups or crunches — or anything else that involves bending forwards for abs strengthening – are unsuitable. So, for instance, are those exercises where you lift and lower both legs while you are lying on your back.
This can be a bit frustrating, not least because abdominal muscular weakness is often a factor in developing a hernia in the first place – unfortunately it’s too late to start correcting that problem once the hernia has already appeared.
It’s a different story after an operation. Once the specialist gives you the all-clear for strength training – anything from a couple of days to several weeks, depending on you and the type of op you had – you should make abdominal or core strengthening a priority. As with all new exercises, go gently at first, so you don’t end up re-injuring yourself.
It’s really good that you’ve lost some weight, as this alone takes pressure off your hernia. Keep up the good work by continuing your cardiovascular workouts: treadmill walking or jogs, cycling (sitting-down bike is best) and cross trainer are all fine. Swimming or running in the pool are good, as the water will support your body and you’ll be able to push yourself a bit harder without worry.