What are Hernias? An Overview
A hernia is a condition where an organ or tissue pushes through a weak spot or opening in the surrounding muscle or connective tissue. The most common type of hernia involves the abdomen, although they can also occur in the groin, diaphragm, and other areas of the body.
Causes:
Hernias can develop for various reasons, typically involving increased pressure within the abdomen or other areas, combined with a weakness in the surrounding muscles or tissues. Common causes include:
Straining during heavy lifting: Improper lifting techniques or lifting heavy weights can increase intra-abdominal pressure.
Chronic coughing or sneezing: Conditions like asthma or chronic obstructive pulmonary disease (COPD) can lead to prolonged coughing, which may contribute to a hernia.
Obesity: Being overweight puts additional pressure on muscles and tissues, increasing the risk of hernia formation.
Pregnancy: The growing uterus can put pressure on the abdominal wall.
Age and muscle weakening: As we age, muscles naturally weaken, which can contribute to hernias.
Genetics: Some people may have a hereditary weakness in the muscle walls that predispose them to hernias.
Symptoms:
Common symptoms of a hernia may include:
Visible bulge: A noticeable lump or bulge in the affected area, particularly when standing, coughing, or straining.
Pain or discomfort: Pain or a feeling of heaviness, especially when lifting, coughing, or during physical activity. It can range from mild to severe.
Pressure or a dragging sensation: Some individuals report a sensation of pressure in the affected area.
Acid reflux or difficulty swallowing: If the hernia is in the diaphragm area (like a hiatal hernia), it can cause digestive issues.
Redness or swelling: In some cases, the hernia may become inflamed or irritated.
Treatment from a Physiotherapist:
Physiotherapy is a conservative treatment approach that can assist with managing symptoms and improving function, especially in mild cases or in the pre/post-surgical phase. The aim is to reduce symptoms, prevent worsening of the hernia, and enhance recovery.
Core strengthening: Focus on strengthening the deep abdominal muscles (such as the transversus abdominis) and the pelvic floor. A strong core provides more support to the abdominal wall, potentially alleviating pressure.
Postural education: Physiotherapists can teach techniques to improve posture, reducing strain on the abdominal wall.
Breathing exercises: Proper diaphragmatic breathing and techniques to manage intra-abdominal pressure are essential to avoid further aggravation of the hernia.
Pelvic floor exercises: In cases of groin or pelvic hernias, strengthening the pelvic floor muscles can help provide support to the surrounding structures.
Manual therapy: Gentle mobilisation of the surrounding muscles and tissues can assist in pain relief and improve function.
Activity modification: Guidance on avoiding activities that could worsen the hernia (e.g., heavy lifting or strenuous exercise) is crucial. A physiotherapist will provide advice on how to manage physical tasks more safely.
Surgical Consideration:
While physiotherapy can manage symptoms and improve strength, surgery is often required to repair a hernia. Physiotherapy may be recommended both before and after surgery to improve recovery, minimise complications, and speed up rehabilitation. Pre-surgery physiotherapy can help the body be in the best condition for healing, while post-surgery physiotherapy can assist in regaining strength and movement.
It’s important to consult with a healthcare provider, such as a physiotherapist, doctor, or surgeon, to determine the appropriate course of action based on the type and severity of the hernia.