Hernias and Diastasis Recti
Hernias are common with Diastasis Recti, not because diastasis causes hernias but because both issues occur due to a weak connective tissue.
Don't know if you have Diastasis Recti? Here is how you can self-assess:
What is a hernia?
A hernia is when a bit of your body that should be inside (like part of your intestine or bowel) actually pokes out through a weak spot in your abdominal wall.
You will see a bulge, or an outie belly button where you used to have an innie, or a thumb-shaped protrusion. It may feel tender to touch, or you may have no pain and just see a bulge when your strain, lift or cough.
There are different types of hernia but the one most likely to affect women during or after pregnancy is a hernia located at their belly button (an umbilical hernia). Like mine that you can see in the picture above.
What causes a hernia?
A hernia, along with diastasis recti or prolapse, is caused by excessive intra abdominal pressure. That’s extra pressure located inside your abdomen and pelvis.
Unless you reduce and realign that extra pressure that caused the problem, you may have a re-occurance of the hernia or another pressure related issues.
Increased abdominal pressure can be due to any straining (lifting, constipation, coughing etc), bad posture (hunched upper body, a pelvic tilt (both anterior and posterior), obesity, and multiple pregnancies.
Adjusting your whole body alignment and increasing your core strength allows your body to function optimally. This reduces the pressure and helps minimize the risk and effects of a hernia.
Can I exercise with a hernia?
Unless been told otherwise by your doctor - it is fine to do many exercises with a hernia BUT you want to avoid exerting pressure on the muscle around it.
So with an umbilical hernia crunches are a NO/NO even if you don’t have Diastasis Recti!
Those of you with Diastasis Recti (which if you are reading this you probably do) should already know not to do crunches or sit-ups, and are instead already doing diastasis safe core work like the FREE beginners program HERE, which is safe with a hernia.
General considerations with exercising with a hernia that you should take into account:
1) With weight lifting keep the weights light. If you find you are holding your breath they are too heavy - holding your breath is an indication that you are putting pressure on your abdominal wall.
Also make sure you are in correct posture with a neutral spine and not hunching.
2) Any movements causing your to bend backwards should be avoided (these should be avoided with Diastasis recti as well).
Back extensions or supermen is a move you may need to monitor if doing these to strengthen your back. If you keep the movement small you should be ok but monitor it.
3) STOP if you feel pain in that area OR you see if bulging out more
Non-surgical activities to help or prevent hernias
1) Fix your posture
You will find a number of posts and videos on this on my Facebook page – Core Fitness for Moms
If your body isn’t aligned, it is not holding your up properly and you are increasing the pressure on your abdomen.
2) Strengthen your core
Your core consists of your transverse abdominis, pelvic floor, back muscles and diaphragm.
These all work together to help your stand straight and be able to perform everyday movements safely.
The free beginners and intermediate programs found HERE give you a great foundation to start with.
- Doing core work that puts extra pressure on your abdominal wall such as crunches and sit-ups
- Doing everyday activities (such as lifting a washing basket or empting the dishwasher) in bad posture, always squat to pick something up no matter how heavy or light it is, see this article HERE for more information on this
- doing weight lifting if you are unable to activate your core correctly and maintain good posture for every rep of every set
Surgery to fix a hernia
You may need surgery to fix your hernia, though a doctor may not recommend it if your hernia is not causing your any pain or not getting any bigger.
This is a decision for you to make with your doctor.
BUT if you have not reduced your gap, gained a function, and fixed the underlying problem with your abdominal pressure you run the risk of the hernia recurring.
There are a few reason for this but let me just give you 2:
1) If you have not realigned yourself to reduce the pressure on the abdominal wall that pressure will be on the fix the surgery just did, pushing and pushing against it with the pressure building up behind the fix looking for a weaken spot to break through.
This may not be in the same place but another weaker spot.
2) If you haven’t regained a functional core and reduced your gap to a “normal” level then if you are open above or below the fix (say at your belly button) that gap will be pulling at the point of the fix giving the possibility of those stitches not staying.
OR making your belly misshapen because like a balloon if you squeeze the middle the pressure goes to either end.
Surgery to repair a hernia is common (I had my umbilical hernia repaired before I knew about diastasis recti and boy did they have a lot of issues with the gap and the repair!).
The surgeon basically pushes the protruding part back where it belongs and suture the muscles there or if it is very big they may place a piece of surgical mesh to reinforce the hole and prevent another herniation.
You can find many articles about it on the web or talk to your doctor/surgeon about it.
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