# Concerning proper breathing to manage a hiatal and other hernias

**URL:** <https://forum.barbellmedicine.com/t/concerning-proper-breathing-to-manage-a-hiatal-and-other-hernias/19230>\
**Category:** Medical Q&A \[Moderated\]\
**Created:** [November 20, 2025, 8:07pm UTC](https://forum.barbellmedicine.com/t/concerning-proper-breathing-to-manage-a-hiatal-and-other-hernias/19230 "2025-11-20T20:07:55Z")\
**Posts on this page:** 1\
**Page:** 1

<div class="post-metadata">

**Author:** ![DavidACM22](https://avatars.discourse-cdn.com/v4/letter/d/977dab/32.png) [@DavidACM22](https://forum.barbellmedicine.com/u/DavidACM22)\
**Post date:** [November 20, 2025, 8:07pm UTC](https://forum.barbellmedicine.com/t/concerning-proper-breathing-to-manage-a-hiatal-and-other-hernias/19230/1 "2025-11-20T20:07:55Z")

</div>

Hello everyone,

I wanted to seek some advice on how best to breathe/brace whilst managing hiatal and other hernias too.

I am a 31 year old male. I have been training for around 3 years now. I have a diagnosed umbilical hernia which I intend to have repaired at some point next year. However, I also possess a hiatal hernia (HH) which I have had since around 18 years old. I last had it checked in 2017 when it was around 5cm in size. I generally just get mild symptoms from the HH, including some random volume reflux, post nasal drip, sometimes some slight burning in my stomach, and aching pains around the HH site and sometimes chest.

I did some research on whether it is medically advisable to even lift heavy weights with a HH, whether doing so could worsen the HH (such as it’s size) etc. and was met with a significant negative response in my searches.

However, I did come across this post on this forum:

> [@My hiatal hernia has gotten bigger, should I stop lifting?](https://forum.barbellmedicine.com/t/my-hiatal-hernia-has-gotten-bigger-should-i-stop-lifting/13070):
>
> I’ve suffered from GERD all my adult life, but I’ve always managed to control it with PPI medication. Six years ago I went to gastroscopy and I was diagnosed with a small (\<1cm) hiatal hernia. About two years after this I started lifting weights (got started with Starting Strength, after that I’ve done various programs, including some of yours). Now last week I got another gastroscopy and it turned out that my hiatal hernia had gotten larger and was now about 2-3cm. My doctor wouldn’t directly …

In this post, **[ecophotog](https://forum.barbellmedicine.com/u/ecophotog)** kindly responded, advising that intra-thoracic and abdominal pressure was unlikely to cause worsening of a HH due to the opposing pressures it presents inside the cavaties during weightlifting. This appears to be in contrast to all the other advice online, which advises to breathe in on the eccentric and out on the concentric to avoid the intra pressures and their apparent worsening of a HH. However, based on **[ecophotog](https://forum.barbellmedicine.com/u/ecophotog)’s** knowledge and experience, would this breathe in and out technique rather than continous bracing during each rep not risk losing the opposing pressure in the thorraic region and thus risk worsening a HH? An example I can think of is any abdominal exercise where your abs are pushing up into the chest/HH area as you reach the end of the concentric, or even something like a lat pulldown where form may decay slightly, and one crunches one’s core, pushing up into the chest area without the opposing thoracic pressure.

Due to this confusion, I wanted to see what your guys’ thoughts were on the proper breathing/bracing technique to manage such hernias, alongside your thoughts on whether weightlifting does indeed worsen HHs.

Best,

David.