Working Out With A Hernia: Is It Safe? + 6 Exercises For Hernias

It is a common fear among many people who exercise: everything in your workout is going fine, and then suddenly, you feel a sharp pain in your abdomen and groin.

You may peek under your shirt or waistband and discover an unfamiliar bulge protruding from your abdomen; this is a dreaded hernia.

Although hernias can be caused by doing everyday activities like carrying groceries, sneezing, or coughing, they can also occur while playing sports, running, lifting weights, or doing some other form of exercise.

But, whether you got a hernia squatting 200 pounds or during a coughing fit due to a respiratory infection, can you work out with a hernia? Is working out with a hernia safe?

Furthermore, are there exercises for hernias that can help heal the tissue or improve your recovery after surgery?

In this article, we will discuss exercising with a hernia and the best exercises to do when you have a hernia.

More specifically, we will discuss: 

• Can Exercise Cause a Hernia?

• Working Out With A Hernia

• Can You Run With a Hernia?

• 6 Exercises for Hernias

Let’s get started!

Can Exercise Cause a Hernia?

Hernias are caused when the muscle, fascia, and other connective tissue that forms the abdominal wall becomes weakened, allowing the intestinal tissue to protrude or bulge through the weak area.

This weakness can be caused by the overstretching of the abdomen because of obesity or excess body fat, or poor posture.

Exercise can cause hernias.

Exerting yourself during exercise increases intra-abdominal pressure. This can provide enough force to push the intestines through a hole or weak spot in the abdominal wall.

Hernias can also occur due to the trauma of athletic activities, in which case they are referred to as sports hernias. 

Rather than being due to structural weakness in your tissue, sports hernias are tears that occur because of high-velocity twisting or turning as you run, kick a ball, play sports, or work out.

Working Out With a Hernia

Depending on the location and severity of your hernia, as well as your overall health and body weight, it may be possible to continue working out with a hernia, although some modifications to your exercise routine may be necessary.

One of the primary concerns of working out with a hernia is exacerbating the injury by increasing intra-abdominal pressure.

Any type of exercise has the ability to increase the pressure in the abdominal cavity, but the more vigorous and forceful your exertion, the greater the rise in pressure.

This can cause the hernia to bulge out and potentially cut off circulation to abdominal and pelvic organs such as the bowel.

Exercises that are contraindicated with a hernia include intense abdominal exercises that can activate the superficial and upper abdominal muscles, such as the rectus abdominis and external obliques.

Tensing these muscles can cause a dramatic increase in intra-abdominal pressure, which can increase the severity of a hernia, if not cause strangulation.

The following are examples of exercises to avoid when working out with a hernia:

• Full sit-ups

• Crunches 

• Ab exercises against resistance (cable crunches, crunches on a weight machine)

• Roll-outs with an ab wheel

• V-ups, Russian twist, or other ab exercises where both arms and legs are raised

• Planks

In addition to ab exercises that squeeze the upper abs, it’s also important to avoid strength training exercises that require you to perform the Valsalva maneuver. 

This involves inhaling and then holding your breath.

The Valsalva maneuver causes a dramatic increase in intra-abdominal pressure and must be avoided at all costs when exercising with a hernia or after hernia surgery.

This may mean that you cannot perform squats, cleans and presses, deadlifts, etc.

Furthermore, in general, any heavy lifting is contraindicated with a hernia and while you are recovering from hernia surgery.

You should not perform strength training exercises with a hernia unless you’ve been specifically cleared to do so by your doctor or physical therapist.

Can You Run With a Hernia?

Most doctors advise against running with a hernia, particularly a femoral or inguinal hernia because running can increase the risk of strangulation and cause further intestines protrusion.

You should refrain from running for 7 to 10 days after a hernia to allow the tissues to heal.

After that point, it may be possible to resume running if the hernia has resolved. Otherwise, you are likely a surgical candidate.

After laparoscopic hernia surgery, you can usually resume light exercise 1-2 weeks after your procedure. 

Running after hernia surgery is typically not advisable until at least two weeks postoperatively.

6 Exercises for Hernias

The good news is that not every type of exercise is unsafe with a hernia, and certain exercises can help prevent and heal hernias.

Evidence suggests that patients with abdominal hernias who perform certain core exercises prior to surgery have fewer postoperative complications and improved recovery times. 

Additionally, preoperative exercises that support weight loss can be helpful for patients who are overweight or obese that will be undergoing a surgical hernia repair.

The most effective core exercises for hernias strengthen the deep core muscles, namely the transversus abdominis and pelvic floor muscles.

The transversus abdominis lies underneath the superficial abdominal muscles such as the rectus abdominis (“six-pack” abs muscle) and obliques. This muscle wraps around the trunk in a 360° configuration, encircling the entire lower abdominal cavity and waist.

The transversus abdominis connects to the spine with strong connective tissue, forming a corset of support to the belly and lower back. However, this muscle can become overstretched and functionally weak with poor posture and excess weight.

As it over-stretches, thins and weakens, this deep core muscle becomes unable to properly support the trunk and retain the intestines.

When the pressure in the abdominal cavity increases suddenly or dramatically, intestinal tissue can force its way through holes or weak areas in the muscle and overlying connective tissue.

The resultant bulge or out pouch is a hernia.

For this reason, the best exercises to prevent hernias strengthen and restore function to the transversus abdominis muscle. 

Additionally, if you have a hernia and are awaiting surgery, these hernia exercises may hasten recovery and your return to exercise after hernia surgery.

Here are some examples of exercises that can help you prevent hernias:

#1: Side-Lying Tummy Tucks

1. Lie on your side with both knees slightly bent, maintaining the natural curvature of the lower spine.
2. Take the hand on the arm that’s on top and place it on your belly just below your belly button.
3. Use your lower abdominal muscles to try to draw in your belly button towards your spine, pulling your lower abdomen inward as far as you can while keeping your upper abdomen relaxed. Make sure you are breathing evenly and normally throughout this exercise.
4. Hold the abdominal squeeze for up to 10 seconds (while breathing) and then relax and release.
5. Perform 10 to 15 reps.

#2: Sitting or Standing Abdominal Squeezes

1. Sit or stand upright with good posture, lifting your chest and pressing it somewhat outwards.
2. Imagine that a helium balloon is adhered to the top of your head, pulling your head’s crown and lengthening your spine towards the sky.
3. Put one hand on your lower abdomen, just below your belly button. 
4. Using your deep core muscles, draw in your lower abs as if adhering your belly button to your spine. Keep your upper abdomen relaxed.
5. Hold the abdominal squeeze for up to 10 seconds (while breathing) and then relax and release.
6. Perform 10 to 15 reps.

#3: Pillow Squeezes

1. Lie on your back with your knees bent and feet flat on the floor. Place a pillow between your knees.
2. Take a deep inhale. As you exhale, use your deep core muscles, pelvic floor muscles, and inner thigh muscles to gently squeeze the pillow with both knees.
3. Exhale slowly as you do this so that you can prolong the length of the squeeze. 
4. When it is time to inhale, relax the squeeze before squeezing again on the exhale.
5. Complete 20 repetitions or more daily.

#4: Bridges

1. Lie on your back with your arms at your side, knees bent, feet flat on the floor, and a pillow between your knees.
2. Squeeze your glutes and deep abdominal muscles to lift your hips up off the floor until they are in a straight line from your knees to your shoulders.
3. Hold for one full breath and then relax.
4. Complete 20 reps.

#5: Walking

Gentle walking should be a safe way of working out with a hernia. While walking, ensure you breathe evenly and calmly.

#6: Indoor Cycling

Stationary biking, or riding an indoor cycle, should be a safe type of exercise to perform with a hernia.

Check with your doctor for any questions about working out with a hernia. And remember, always listen to your body and give it the time it needs to heal.

If you are interested in reading more information specifically about running and hernias, check out our article: Running With A Hernia: Is It Safe? + Six Tips For Running After A Hernia.