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Core Knowledge

Injury/Pain

The Simple Guide to Hernias

Overview

“Hernia is often an umbrella term used to describe strain in the abdominal muscles, but it often begins with trauma to the groin muscle group as well,” says Jennifer Lewis, PT, DPT, ATC, a physical therapist at Athletes’ Performance in Phoenix, Arizona.

The most common type of hernia (and the one discussed here) is an inguinal hernia, which develops in the groin. The condition is not normally dangerous at the moment, but eventually needs medical attention because it could lead to life-threatening complications. Even if surgery is needed to repair a hernia, it is a safe and relatively minor procedure that does not require a long period of recovery.

How It Happens

A hernia occurs when part of an internal organ, usually a section of intestine, pushes through a weak abdominal wall. Increased pressure can trigger the event, especially if there is a pre-existing weakness in the muscle wall. Strenuous exercise could cause a hernia (but rarely does), as could muscles weakened by the aging process. 

By the Numbers

5
Men are 5 times more likely to have an inguinal hernia than women

75
Percentage of all hernias that are inguinal hernias

10-15
Percentage of hernias that re-develop after surgery

Who’s At Risk

The injury is most commonly seen in hockey and soccer athletes due to the repetitive action of the hip joint. In the general population, those who have had one inguinal hernia are more likely to have another, and those with a family history are at higher risk. Men are more susceptible than women.

Symptoms

  • A bulge in the groin area
  • Possible pain or pulling sensation
  • More noticeable when a person coughs, strains, bends over or stands
  • A vague feeling of being full
  • In men, pain and/or swelling around the testicles in cases where the intestine protrudes into the scrotum
  • Rarely, severe pain (requiring immediate surgery) when the hernia cannot move back into the abdomen and blocks the blood supply

Initial Treatment

Treatment may not be necessary unless symptoms are present, but check with your doctor. A “wait and see” approach by your doctor is often recommended, but if the hernia interferes with sports participation, he or she could advise you to have the condition corrected. Get medical attention immediately if you experience significant pain.

Comeback Strategy

A hernia will not get better with time, but it may not get worse or require treatment for months or years. A study published in the Journal of the American Medical Association concluded that “watchful waiting is an acceptable option for men with minimally symptomatic inguinal hernias."

Prehab

Once cleared by your doctor, incorporate these prehab exercises into your recovery routine:

  1. Hip Rotation - External - Sidelying 
  2. Quadruped Posterior Rocking
  3. Pillar Bridge

How to Avoid This Injury

  • Maintain a weight that is appropriate for your height and frame.
  • Lift heavy objects by bending your hips and knees (think deadlift) as opposed to rounding your back at the waist, to prevent straining.
  • Eat foods high in fiber content to prevent constipation, which can cause straining and increase the risk of a hernia.

Movement Prep

Incorporate these exercises into your dynamic warm-up (a.k.a. movement prep) routine:

  1. Mini Band Straight Leg Lateral Walk
  2. Mini Band Bent Knee Lateral Walk
  3. Lateral Squats
  4. Drop Squats

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.


Tags: Pain, Rest, Torso, Upper Body, Injury Prevention, Injury, Prehab

References

  1. Jennifer Lewis, PT, DPT, ATC, Performance Physical Therapist, Athletes’ Performance, Phoenix, Arizona
  2. American College of Surgeons
  3. Journal of the American Medical Association
  4. University of Michigan Health System

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