Hernias: The Truth Behind the Bulge

Has anyone ever cautioned you against lifting something heavy — warning that you’re in danger of giving yourself a hernia? You may find yourself wondering what exactly that is and whether you’re really taking a risk with your weight-lifting heroics.

A hernia is a defect in the strong connective tissue beneath the muscles of your abdomen. It happens when increased abdominal pressure finds a weak spot and pushes internal organs or fat though the gap. The result is a protruding bulge under the skin that may be painful. And it’s certainly true that you can get one while lifting heavy objects. But also they are caused by abdominal strain, chronic coughing, obesity and pregnancy, among other things.

Where Hernias Show Up

About 75 percent of abdominal wall hernias occur in the groin (or lower abdomen). Other areas where they can emerge include the upper abdomen and belly button. The most common hernia types are:

• Inguinal (groin). The groin is a complex array of ligaments and muscles and is particularly susceptible to several types of hernias. The two most frequent are the direct and indirect inguinal hernias, which run above the inguinal ligament. Both are more common in men. Femoral hernias are more common in women. These run below the inguinal ligament along the upper thigh, and are often the result of pressure on the lower abdomen during pregnancy.

• Umbilical. An umbilical hernia, located near or through the belly button, is formed when part of the small intestine passes through the navel during fetal development. These are common in newborns, but can occur or enlarge at any age. 

• Ventral. A ventral (or incisional) hernia can happen anywhere on the abdomen at the site of a surgical scar.

How to Repair Them

Although some minor hernias can be manipulated back into place, they don’t heal on their own. Fortunately, there are several effective surgical treatments available to repair the damage. Among them are:

• Open repair involves inserting sterile mesh material through an incision and suturing it in place to strengthen the weakened area.

• Laparoscopic repair uses a small video camera as part of the surgery, creating smaller incisions and reduced scarring.

• Robotic repair improves on manual laparoscopic techniques, with more precise instrument control. 

Preventing a Hernia

Most people end up with hernias because of overexertion and pressure. However, it’s possible to have a genetic propensity for them because of inherited weakness in the connective tissue or muscle structure. To lower your risk, consider these strategies:

• Maintain a healthy weight.

• Exercise regularly to strengthen core muscles.

• Abstain from smoking.

• Use proper lifting form with heavy objects and ask for assistance when needed.