Hernia from RDLs? WTF?

[johnwolfram]

Since it is apparently difficult to get decent injury advice from an actual physician, and since your books basically got me back into lifting, I thought I would ask you about this...

I was doing SLDLs about a month ago and I felt a twinge in my upper left abdomen, right below the sternum. It caused chest pain and referred back pain and got better after a few days. A couple weeks later I started up RDLs (50% deadlift max), and a couple workouts after that I felt a twinge in a similar spot. Again, I let it go for a couple weeks. I assumed that this was a sort of rib sprain that kept flaring up.

I renewed my gym membership Friday (July 1st), did my first normal SS workout (had been easing back into it previously) and had no issues. Monday (4th) the gym was closed so I used the standard bar I had at home to do RDLs so I at least could say I did something that day. First set I felt a painful twinge upper left abdomen and it was immediately tender if you pressed on that area (thought it went away after a couple hours)

I finished the other two sets and my pullups (STUPID) and then started icing my stomach. Immediately after this happened I started having acid reflux symptoms and have been since. I've also been having transient chest pain in the general area. I haven't been able to sleep normally since then because the damn pain seems to happen every time I try to sleep.

I went to a doc and he said he didn't feel any abnormality in the area. I told him about the twinge and the reflux and asked if it could be a hiatal hernia. He said that it is very unlikely I could have done that from lifting. I asked him that in case I did have one if it would be safe to continue lifting (i.e. would lifting make it bigger and increase the risk of strangulation) and he said that it wouldn't make it any worse. I thought this sounded like BS, how can increased abdominal pressure not make a hernia worse? I know hiatals are different than inguinal and abdominal ones (and surgery isn't done on them unless they're serious) but still.

I went in and did another SS workout yesterday and it didn't make it any worse, but damnit, I can't fucking sleep because of this. Also, I'd prefer not to start missing workouts but if I do have a hernia I don't want it to start hurting worse and I sure as hell don't want to have to leave the gym in an ambulance in the case it becomes strangulated. A similar thing happened two years ago and I didn't get to train for three months because that is how long it took to convince the doctor just to let me have a damn barium swallow and endoscopy done.

This shit is really pissing me off. I have been on the fucking novice program for 3 years and keep having to reset it because of shit like this. When I was in high school 5+ years ago I had form for shit, lifted every day and got injured once in two years. I love lifting and all, but 1) screw RDLs right now and 2) I can't afford to have a bunch of medial shit tested 10 times a year.

Anyway, what do you think? Ever heard of anything like this?

[Mark Rippetoe]

I have a hiatal hernia, and it has caused no problems while lifting. I don't think they occur with trauma anyway. But something occurred, it doesn't sound like a costal cartilage or a rib, and if I were you I'd get an upper GI consult this week.

[Gunnhild Bruno]

Do you have a history of esophageal spasms?

[warmachine7954]

My wife has a one of these and we have yet to have a Dr. help her any. She has terrible heart burn and acid reflux.

What do you do Mr. Ripptoe to get relief from this?

[Mark Rippetoe]

Stop eating gluten and stop taking NSAIDs. Worked for me.

[Gunnhild Bruno]

The first time I had a GERD-related esophageal spasm, I finally understood why people show up in emergency rooms thinking they are having heart attacks, only to be diagnosed with heartburn. “Heartburn” is really an inadequate word for this, as I’ve had run of the mill acid indigestion, and it does not feel the same. At all. Luckily for me, someone had described the symptoms to me before, so I didn’t go to the ER and undergo the humiliation of being told I “just” have heartburn.

Low carb eating works for me to control/stop it. I personally don’t see a connection to wheat specifically, although it seems entirely plausible that this would be the issue for some people. But if I eat a lot of starch and sugar for too long, such as when I am trying to put on mass, I start getting run of the mill heartburn and then inevitably end up having an esophageal crisis that not only comes with terrible abdominal and back pains but also makes me feel like someone is trying to pry my lower molars out of my jaw with a rusty knife.

Cutting out sugar and starch always fixes it. I take the opportunity to ditch some extra fluff.

[warmachine7954]

She doesn't take NSAID's but way to many starches.

[Mark Rippetoe]

First place to start. And it won't take but a few days to see the difference.

[Gunnhild Bruno]

FYI, johnwolfram, the reason I ask about esophageal spasms is that, a couple of times, I have triggered them with an overly vigorous sneeze. So I'm wondering whether the pattern of breathing/diaphragm movement when doing RDLs might trigger them for you.

This is provided that you have them in the first place, which we still do not know.

But I haven't triggered them with sneezing while eating low carb, so, if you're not eating low carb already, perhaps you'll be able to do RDLs if you do. Or just don't do RDLs. There are other assistance exercises for the back.

[Jonathon Sullivan]

The first time I had a GERD-related esophageal spasm, I finally understood why people show up in emergency rooms thinking they are having heart attacks, only to be diagnosed with heartburn.

You have touched upon a source of great pain, and revenue, in my life. It is so true.

Except--and I say this in all seriousness--it is a foolish emergency physician who sends a chest pain patient home with a diagnosis of "heartburn." That way lies only grief, and ruin.