Pre hernia surgery

Medical Q&A [Moderated]
1

Hey folks,

My GP just told me I have a hernia (above my belly button) and recommended surgery. I have a consult this week. Surgery will be out some time.

it’s not entirely asymptomatic (kinda awkward and uncomfortable), but not painful.

I found the pod episode on this topic to be super helpful, but wonder if there are general rehab recommendations post op ? I am just seeing a lot of general recommendations about ab and core work.

Second question—are there ways to best prepare for the surgery? I’m trying to remain active without causing additional harm.

Thanks y’all!

2

I’m not sure what you are getting at regarding “general rehab recommendations”. As you are cleared for activity I would gradually return to your habitual training over time, firstly by reducing absolute intensity/loads.

There is nothing specific you need to do to prepare for the surgery; as someone who (presumably) habitually trains I am sure you are well ahead of the majority of your peers in terms of health coming into this procedure.

3

A video that may be of interest:

4

Thanks Jordan. I guess my question is are there any specific exercises that will help healing and/or preventing reoccurring?

5

Unfortunately, no. The (exercise) world is your oyster :slight_smile:

6

Thanks Jordan. Lots of stuff online about strengthening core and bracing. That’s not legit?

7

As these are not contributing factors to developing, preventing, or managing an umbilical (or other) hernia, they are not uniquely useful.

There isn’t a weird trick or something that you’re missing here, promise!

8

Thanks Jordan! I want you to know that this video really helped me. I was feeling pretty despondent about the idea of a surgery and now I’m confident I can come back stronger. Thank you.

9

Jordan—do you have the citations referenced here?

10

They are linked in the video caption on the YouTube page.

11

Thanks. If I’m reading this right we use the “acute injury” article to say that it’s not a single lift (like a single deadlift) and the Danish study to show that work-related mechanical lifting doesn’t seem to equate to more hernias. However, does that enable us to say that over time, repeated lifting of weights (not work stuff) is not a risk factor for hernias?

12

However, does that enable us to say that over time, repeated lifting of weights (not work stuff) is not a risk factor for hernias?

I don’t think this has been directly studied, though it has not been reported in the great many of exercise intervention studies that report injuries, reasons for low adherence in individuals, and so on. Case reports on this are also not impressive. So, I’d be on board with saying that resistance training is not a risk factor for developing a new hernia, though nearly any strenuous task can make an existing hernia known to the individual.

13

thanks Jordan. Surgery went well, but getting pretty inconsistent messages on return to activity. “Listen to your body” is it really effective tool for me— I’ll push myself pretty hard, regardless.

they said nothing more than 20 pounds for the first two weeks. Then told me limit abdominal pressure until no pain. Then said no bending, twisting, etc.

I’ve tried to steal some light band work, really low weight stuff, and nothing dynamic. There is pain, of course.

I know this is tough based on your responses, but is there a good way to navigate this? My postop with the PA in two weeks, and I’m guessing they’ll just look at the wounds, but I’m hopeful to get back on it in the gym following week.

thank you so much this has been really helpful. And really the only helpful thing pre-and post surgery.

14

I can’t really give you advice that contradicts your surgeon’s and feel comfortable with the medicolegal exposure, but as mentioned in the video and podcast- there should not really be any post-op activity restrictions.

While I don’t think this would be PR time for me, I would still be in the gym doing something- likely a bit lighter than normal due to residual discomfort. The 20lb recommendation is 100% fabricated nonsense.

15

Thanks Jordan. I’m back in there for sure,
just navigating pain and uncomfortably but managing it! Not impressed with all the guidance, or lack thereof, from them.

is it unlikely to reinjure once surgically repaired?

16

Repaired hernias are unlikely to re-herniate if repaired properly, but sometimes sh*t happens, unfortunately.

17

thanks Jordan. All I needed was “unlikely.” I’ve not been doing anything too strenuous, but still getting some light weights and PT in. I WISH someone would have sat down and said “oh you want to be active, here’s some things to do,” instead of just no info than “no twisting, stretching, etc.,” and “nothing over 20#,” which makes you feel like you are going to re-herniate.

is there a reason they don’t say that? Just for my education

18

They don’t know what movements, loads, etc. increase the risk of repair failure and feel like they have to say something. It’s all made up. Again, the current guidelines recommend against movement restrictions. Whether or not advising people to do whatever they want post op results in more, less, or the same complication rate as the standard of care now is unknown, but hernia repairs are really successful and I don’t see this changing for the worse if the post op instructions encouraged exercise…even hard exercise.

19

thanks! Given the Danish study does standing a lot or loaded walking (rucking) increas risk?

20

We don’t really know anything regarding complications or re-herniation risk from that data. I think you’re highly likely to be fine regardless of what you do, but as always, you should consult with your doctor. For more specifics relating to your case and what you should do, a consultation may be beneficial.