Hernia Prevention

[Scott.Acosta]

What would you say are the most effective ways to prevent hernias?

[Mark Rippetoe]

Choose your parents carefully.

[Pluripotent]

In general, people get hernias because they have fat abdomens and weak abdominal walls (or prior surgery which makes defects in the abdominal wall - after which they become fat and weak). So, likely the answer is to get strong and don't carry large amounts of abdominal fat. But I will admit that I am approaching this question as a physician, and as a physician, I see a large amount of fat people with weak abdominal walls. Perhaps the people on this forum with experience could relate how common hernias are in people who are strong and lifting heavy weights. I would suspect that the incidence is low, as long as they have proper form and are not lifting beyond their ability (which is likely how most hernias develop), but again, we generally don't see such people in the office...so...

And also, a fair number of hernias are a result of genetics...and most people who don't treat kids would probably be surprised at how common it is for kids to need hernia repairs (although often such hernias will resolve on their own as the kids get older.)

[Mark Rippetoe]

My sense is that hernias occur in lifters, like me, at about the same incidence as in the general population. Inguinal hernias are almost always due to genetic predisposition. Training may postpone the acute incident that makes a repair necessary, but if you have a hernia, you got it from your parents. Blame those assholes, not the barbell.

[Pluripotent]

I think this is correct, however I would only quibble a little bit. There are numerous types of hernias. Some of them are indeed genetic (for instance - you may be born with a tract leftover from when your balls dropped, the indirect inguinal hernia mentioned above, among others). For such types of hernias, there may indeed be little you can do to avoid the inevitable protrusion of you visceral contents at some inopportune time in your life. However, this does leave a fairly large incidence of hernias that are caused mostly by lifestyle choices, and in general, for such as those, the type of program presented here will probably be your best protection. And I'll bet that those are the types of hernias that strong individuals generally don't get.

But getting patients to lift is likely harder than getting them to stop smoking, and generally mall walking is the extent of the "exercise" which you can shame them into attempting. I've tried a few times. Typically I'll be sitting in front of an overweight chain smoker and they will tell me that they are getting plenty of exercise, cause they stack the storage room at Wal-Mart, or are walking "tons" around their neighborhood. But for some reason, they are still obese... Must be something in the water...

[Mark Rippetoe]

However, this does leave a fairly large incidence of hernias that are caused mostly by lifestyle choices, and in general, for such as those, the type of program presented here will probably be your best protection. And I'll bet that those are the types of hernias that strong individuals generally don't get.

My comments refer to inguinal hernias, because that is what is meant by the generic term "hernia" when posted on this board. There are other hernias, like mid-line hernias of the abdomen, and other weird, uncommon types that can be heavily predisposed, if not caused, by obesity, even in strong men. Obesity is not good.

[mkamaryn]

I've had an umbilical and a mid-line hernia. I'm not near obese, but not "cut" either. I was squatting 5x5 in the low 400's when I had my first (umbilical) hernia - so, pretty strong. There was no event that precipitated the first hernia signs (small bulge and pain) - so, I don't know what the cause was. Anyway, I know I'm just one data point - could be an outlier.

[Pluripotent]

Such a hernia is likely genetic, caused by congenital midline defects, which many people have without knowing it. As Rip said, it was probably going to declare itself eventually. Umbilical hernias in adults can also be caused (or worsened) by obesity and liver cirrhosis, among others. But since you say you aren't obese, and I'm assuming you haven't pickled your liver with alcohol.... but then this is merely a best guess.

[hreed]

It would be an interesting study to determine whether weightlifting alters the chance of one. Anyone know if data has been collected on the incident rate, besides approx 25% of males will have at least one? To be clear, I had inguinal hernia surgery yesterday so this subject hits pretty close right now. The rupture occurred while deadlifting 325 (and I weigh 175, up 20 lbs since starting a little over a year ago). The doctor smiled when I told him it occurred when deadlifting, followed by the question "Crossfit or Starting Strength?"

Now, in no way am I blaming lifting. My grandfather had one (inguinal) about 20 yrs ago, father had emergency surgery about 15 years ago when lifting an engine block and another a few years later, umbilical. Both barely tipped the scales at 150 in their primes, and while certainly active in blue collar professions, neither did any "training" besides the grandfather during two tours in Korea during the Conflict. Point being, in all likelihood I was getting one. Weightlifting simply is when if occurred.

The OP asked what can be done to prevent a hernia. How about wearing a belt? Making sure you keep the abs tight and contracted while under load? Potentially weighted ab work?

[risepmj]

I have had an umbilical hernia on the may to july.it has a tolerable pain and oviously poped up
with thumb nail size bulge.I was kept training with always belt over 135lbs.
but this time,i don't have a pain and no bulge.It is disappeared.
What mechanism makes my herinia to be disappeared?