If the exercises cause pain, a further strength training program should be avoided and the doctor should be consulted. It is possible that the hernia has progressed so far that surgery is indispensable. It is also important to educate the patient about his or her behavior pattern. Too much pressing during bowel movement, sports with strong pulling of the abdominal muscles such as javelin throwing, handball, gymnastics, should be avoided.
Exercises
Physiotherapy is rarely prescribed for inguinal hernia. In the run-up to an operation, however, physiotherapy offers the possibility of reducing the discomfort in the groin area by means of targeted strength training. It is important that there are no fast, abrupt movements and no exercises where the pressure in the abdomen increases.
The inguinal ring is connected to the M. Obliquus externus and M. internus abdominis (oblique abdominal muscles) and the M. Rectus transversus (straight abdominal muscles). Careful abdominal muscle training can minimally improve the symptoms. The following exercises are gentle: Further gentle exercises can be found in the article Groin pain.
- Supine position: keep legs turned on, arms lying beside the body, palms up, press lower back on the pad to make the lower belly short, hold position for several seconds. Increase: Stretch legs alternately while maintaining the remaining tension
- Supine position: raise legs 90°, press hands against knees and build up tension from both sides
- Supine position: raise legs 90° and tilt them to the right and left as far as the oblique abdominal muscles can hold them
- Supine position: raise legs 90°, leave legs alternating to the floor and hold them shortly before putting them down, then change them again
Physiotherapy
Competitive athletes are more likely to undergo surgery, as the condition may worsen with each training session. After an operation, physiotherapy is possible as a prophylaxis in hospital. Thrombosis and pneumonia prophylaxis are especially important, because due to the operation in the abdomen, the straightening of the trunk and general movement is very painful.
Nevertheless, the patient has to stand up and walk to maintain circulation. Patients are usually allowed to leave the hospital after 2-3 days. From day to day, straightening up will also become easier.
After the acute phase has subsided, physiotherapy can be used to loosen the tense back muscles that have developed due to the undynamic walking. Scar mobilization ensures loose tissue and prevents the skin layers from sticking together. If the doctor gives his okay for strengthening exercises for the abdomen, these can also be included in the therapy.
It is important, however, that the suture or the net that was inserted is firmly seated and that the wound healing is over so that the pressure that arises during the exercises does not cause it to tear open again. It is also important to wait longer and start later. Exercises as mentioned above can be applied well and can be increased in the further course. Forearm support, side support, abdominal exercises with more movement and aids are exercises in the later phase. Carrying heavy loads should be avoided after a hernia and in general, a healthy body weight should be taken into account, especially if you are prone to connective tissue weakness.
All articles in this series: