Therapeutic movements to prevent hernia formation and strengthen the abdominal muscles

Weakness and decreased tone of the abdominal muscles are the most common cause of hernias.
The abdominal muscles weaken due to a sedentary lifestyle, obesity, various diseases or anatomical features of the body.

The best way to restore them is therapeutic exercises. With its help, you can not only strengthen your abdominal muscles, but also get rid of the so-called tummy. Below is a set of exercises that is recommended for weakening muscle tone of the abdominals and pelvic floor. It is intended for those who, due to the nature of their work, have limited movements.

EXERCISE 1.

The starting position is the same, the legs are bent at the knee and hip joints, the heels are together and pressed to the buttocks, the arms are extended along the body (Fig. 1, a).

EXERCISE 2.

The starting position is the same, hands behind the head.

Tilt your legs to the left, trying to touch the floor with your left knee (Fig. 2), then do the same to the right. Repeat without stopping, without turning your head and shoulder girdle. Breathing is voluntary. Perform the exercise at an average pace 6–10 times in each direction.

EXERCISE 3.

The starting position is the same, the legs are bent at the knees and hip joints and pulled up to the buttocks.

Pull your right and left legs alternately towards your stomach (Fig. 3), trying to touch your chest with your knee. Breathing is voluntary. Repeat at an average pace 6-8 times.

EXERCISE 4.

The starting position is the same, legs together.

Bend and straighten your right and left legs alternately, as when riding a bicycle (Fig. 3). Breathing is voluntary. Perform for 1 minute at a slow pace.

EXERCISE 5.

Starting position: sitting, hands on hips.

Bend forward, sliding your hands along the front surface of your legs to your toes (Fig. 5), - exhale; return to the starting position - inhale. Repeat at a slow pace 2-4 times, trying to lift your chin when bending.

EXERCISE 6.

The starting position is the same, arms crossed on the chest, back straight (Fig. 6, a).

Turn your torso to the left while straightening your left arm (Fig. 6, b); return to the starting position. Repeat the same on the other side. Breathing is voluntary. Perform at an average pace 4 – 10 times in each direction.

EXERCISE 7.

The starting position is the same, arms extended forward.

Turn your torso to the left and touch your hands to the floor behind your buttocks (Fig. 7). Return to the starting position. Do the same with a right turn. Breathing is voluntary. Perform at an average pace 4 to 10 times in each direction.

EXERCISE 8.

The starting position is the same, legs wider than shoulders, arms raised up.

Squat low, spreading your knees wide (Fig. 8), and exhale. Return to the starting position – inhale. Repeat at a slow pace 4-6 times.

To prevent the formation and recurrence of an inguinal hernia, experts recommend strengthening the muscles of the abdominal wall through regular and meaningful training and limiting excessive physical activity. During pregnancy, women are advised to wear special bands to provide additional support to the abdominal muscles. Bandages are intended to prevent the development of hernias, and if they are present, to prevent an increase in the protrusion of the hernia and prevent strangulation. In the period after surgery, the bandage allows you to avoid muscle strain and reduce the load on the abdominal press, thereby significantly reducing the likelihood of complications and relapses. Wearing an inguinal bandage ensures uniform distribution of external load and intra-abdominal pressure on the operated area, reduces compression on the scar area, which promotes its rapid healing.

Treating a hernia with physical exercise: benefits and prohibitions on exercise

Intervertebral cartilaginous formations soften the pressure on the torso when walking. When the spinal nerves are pinched by the vertebrae, back pain occurs in the area

lower back, numbness in the upper and lower extremities.
This is due to the disc being damaged and moving out of its natural position. In this case, doctors diagnose “lumbar intervertebral hernia
”. After pain relief, the patient is prescribed spinal stretching and exercises to tone the back muscles.

How to complete: requirements for completing classes

The therapeutic and prophylactic complex of exercises, exercise intensity, and duration of exercise are developed by a physical therapy instructor.

To make the vertebrae feel “normal”, strengthen the muscles that support them:

Exercises for the back for a hernia are performed after pain relief, when the acute period has passed.
Movements are made at a slow pace, measuredly, without jerks or sharp turns. Calm, smooth poses will minimize tension in the fibers and eliminate muscle hypertonicity (strain).
Classes are conducted without weights - dumbbells, plates, or on special rehabilitation training devices that simulate loads.
During therapy, do not lift a load of more than three kilograms.

During the period of illness, you should eat right and adhere to moderate physical activity. Initially, the mobility of the legs is restored and the muscles are stretched. At this stage there should not be much strain on the lower back.

In the next stage, they begin to lift the body. The main thing is the gradual strengthening of parts of the musculoskeletal system and consistency of exercise. This is the only way the patient will get results. After a month of stable exercise, a person will feel relief. If you do not follow the rules and stop exercising, the pain syndrome will return, because... muscles weaken without training, and the hernia will remind itself again. Simple gymnastics, performed 3-4 times a week, should become part of life. Gymnastic exercises for a herniated spine are a guarantee of good health.

Exercises to Follow

Physical warm-up is performed according to sensations.

If a movement causes pain, it is not done. For convenience, place a 3-4 cm cushion under the lower back.

Body position is important in therapeutic interventions. The patient takes a horizontal position, lies on his side or stomach, and stands on all fours. In the starting positions, physical training takes place in a safe mode, because the lower back is protected from additional axial load, there is no pressure on the higher organs of the body.

Yoga classes will benefit a person. Asanas will help bring the body into balance. A simple technique of useful poses will relieve muscle tension (tension) and relax the musculoskeletal system.

Under the supervision of a rehabilitation trainer, they undergo therapeutic therapy. The effectiveness of muscle training is obvious .

Systematic classes:

reduce pressure on the hernia;
activate blood flow;
will remove inflammation in the problematic part of the spine;
restore the mobility of the spinal column;
strengthen your back;
will relieve pain.

What not to do with a hernia in the lumbar region

To avoid unpleasant consequences in case of intervertebral hernia, in order to protect the spine, follow the rules:

Large physical overloads and lifting heavy loads are contraindicated in cases of spinal pathology.
Before the massage procedure, consultation with the attending physician is necessary, because... not every massage is acceptable for a hernia, especially in the acute stage of the disease.
It is not advisable to steam or overheat the hernia during bath procedures.
Hypothermia will harm the body.
During treatment of the disease, avoid winter sports and any vigorous movement.
It is unacceptable to repair a hernia yourself.
Forced prolonged standing or sitting postures are also undesirable, so the static position of the body must be changed more often.

To prevent exacerbation of painful sensations, you should avoid drafts and close windows during exercise. Therefore, a mat is placed on the floor and they train in a light tracksuit.

Unacceptable types of physical activity

What not to do:

With sports cast iron equipment (weights, dumbbells); fitball on a gymnastic ball, lift or press a barbell, bend over with weights. Otherwise, the spinal and abdominal muscles will be overstrained, and the nerve processes in the lumbosacral joint will be compressed.
In order not to aggravate back pain, exercises on straight legs are contraindicated, otherwise the pressure on the intervertebral discs will increase.
A lumbar hernia occurs in the area above the pelvis - then twisting (swinging of the press) of the torso will complicate the course of the disease, because the extrusion (protrusion) moves and pinches the nerves of the spinal canal.
Exercises on the horizontal bar are strictly prohibited. When hanging vertically and pulling up on a bar, the load of body weight is placed on the spine. Since the ligamentous apparatus is weakened, the fibers of the ligaments are torn.
Doctors warn against swinging your legs, swinging your arms, lunging on one leg, bending your torso down and to the sides from a standing position, and rotating your waist.
Intervertebral discs absorb shocks and shocks, i.e. act as a shock absorber. Running, fast walking and jumping will reduce shock absorption and aggravate spinal deformity,

Physical exercises are not allowed to be carried out at an accelerated pace, accelerating the rhythm of movements; you should not increase the duration and number of approaches. Exercises should be dosed and within the patient’s strength.

Before starting training, consult a neurologist!
Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

Umbilical hernia in adults - symptoms and treatment

Treatment of umbilical hernia in adults is only surgical. Even an uncomplicated hernia is an indication for surgery [9]. It is impossible to cure a hernia with bandages; as a rule, they are used after surgery as part of rehabilitation.

Goals of surgical treatment:

Return the contents of the hernial sac to the abdominal cavity or remove it if the areas of the strangulated organs are no longer viable.
Restore the integrity of the abdominal wall in the area of the hernia defect, including using mesh prostheses. Such prostheses help to further strengthen the abdominal wall in the scar area. Connective tissue cells grow into the cells of the mesh and due to this, a dense scar “shell” is formed in the scar area, which prevents recurrence of the hernia.

The operation can be performed either open or laparoscopic. Both methods are equally effective, but after laparoscopy the pain syndrome is less pronounced and the patient’s rehabilitation is faster [1][9].

For small hernial protrusions (up to 1–2 cm), open surgery is often performed with local anesthesia. The surgeon makes an incision in the projection of the umbilical ring, places the organs and tissues from the hernial sac into the abdominal cavity and sutures the tissue to restore the integrity of the abdominal wall. Additionally, the weak area is strengthened with a mesh endoprosthesis. The mesh implant can be located preperitoneally (above the peritoneum), retromuscularly (behind the rectus abdominis muscles), supraponeurotically (between the aponeurosis and subcutaneous fatty tissue), or otherwise. The installation location depends on the technique. With open surgery with local anesthesia, the rehabilitation period is 1–2 weeks.

Laparoscopic surgery is considered a minimally invasive surgical procedure. It is performed using a video camera and special tools. The surgeon sees the surgical field on the monitor and controls all his actions during the operation. With laparoscopy, the period of hospital stay is reduced to 2–3 days.

For large hernias, most often only open surgery under endotracheal (general) anesthesia is possible. The surgeon makes a long incision in the abdomen, isolates the hernial sac, places the organs and tissues from the hernial sac into the abdominal cavity, removes the excess walls of the hernial sac and then sutures the tissues. If the hernial orifice is more than 2 cm, a mesh prosthesis is always installed. After such an operation, the patient remains in the department from 1–2 days to a week.

When operating on a strangulated hernia, the surgeon first carefully examines the contents of the hernial sac and determines its viability. If the contents of a strangulated hernia are reduced into the abdominal cavity before the doctor makes an incision, then it is necessary to examine the contents of the abdomen, find the strangulated organs and assess their condition. If the intestinal wall becomes necrotic or perforated (ruptured), the affected part of the organ is removed. After this, the surgeon sutures the hernial orifice. A mesh implant is not placed due to the high risk of wound suppuration and mesh rejection. It can be installed later, when the inflammation subsides or the hernia appears again.

When the contents of the hernia are suppurated (phlegmon of the hernial sac), an incision in the abdomen is usually made not above the hernia, but a little further. After this, the contents of the sac are isolated: the strangulated intestine is excised, the area of the hernial orifice is sutured from the side of the abdominal wall. At the next stage, the surgeon removes the hernial sac with its contents or opens the hernia and washes the cavity of pus and dead tissue. A mesh implant is not installed for this complication. It can be installed later, when the inflammation subsides or the hernia appears again.

If the strangulated hernia has repaired itself before the patient is taken to the operating room, it is necessary to monitor the patient for 24 hours to make sure that there is no necrosis of the strangulated organs and peritonitis. If the patient feels well and there are no signs of peritonitis, it is recommended to undergo elective surgery to remove the hernia.

Rehabilitation after hernia removal

In order for the patient to recover after surgery as quickly as possible, it is recommended that he:

do not lift weights exceeding 5 kg in the first 5–6 weeks after surgery;
gradually increase physical activity: 14 days after surgery, swimming, light jogging, walking, Nordic walking, cardio training without straining are allowed;
treat concomitant diseases, especially diabetes mellitus and chronic obstructive pulmonary disease;
wear a postoperative bandage for two months;
control weight.

Possible complications of operations

Complications can arise with any operation on the abdominal organs; this is due to the technique of execution [1][9]. Such complications include:

Injury to the intestinal wall during surgery. If such a complication occurs, the intestinal defect must be immediately sutured.
Bleeding in the postoperative period with the development of a hematoma of the surgical wound or inside the abdomen. It may be associated not only with a violation of the surgical technique, but also with a violation of the patient’s coagulation system, for example, with hemophilia. This complication does not always require a second operation: if there are no signs of ongoing bleeding (increasing hematoma, increasing pallor and general weakness, bleeding from the wound), you can evacuate the hematoma or perform a puncture of the abdominal cavity. If bleeding continues, the blood vessel is sutured or cauterized.
Seroma of a postoperative wound. This is an accumulation of serous fluid at the site of the removed hernial sac. It manifests itself as swelling and compaction in the wound area. If a seroma develops, the surgeon evacuates the fluid in the dressing room; repeated surgery is not required.
Suppuration of a postoperative wound. It manifests itself as redness in the wound area, throbbing pain in the wound, as well as an increase in body temperature. If suppuration occurs, it is necessary to remove pus from the wound and prescribe antibiotic therapy. It is often necessary to remove the mesh implant.
Chronic pain syndrome . It manifests itself in the fact that the patient has been bothered by pain in the area of the postoperative wound for a long time (more than two months). The cause of the complication is damage to the nerve structures during surgery. Chronic pain syndrome requires an integrated approach. Sometimes it is necessary to perform a second operation to free the nerve from the compressing tissue or remove the mesh implant [6].
Displacement of the mesh implant. The endoprosthesis may move if the mesh fixing material (suture material or clips of various modifications) comes off. In this case, the implant moves to the lower corner of the wound and folds, which often leads to recurrence of the hernia and the need for repeated surgery.
Recurrence of hernia. It occurs for various reasons: due to the characteristics of the patient’s connective tissue, suppuration of the implant, wound healing by secondary intention, or violation of the surgical technique. In case of relapse, the hernia is removed using a different method, i.e. if a relapse occurs after open surgical treatment, then it is recommended to perform a repeat operation using the laparoscopic method and vice versa.

Treatment of umbilical hernia in pregnant women

There are no generally accepted clinical recommendations for the treatment of hernias in pregnant women, but three key points can be identified:

strangulated hernias in pregnant women require emergency surgical treatment;
asymptomatic hernias up to 3 cm are recommended to be operated on after childbirth or in the second trimester of pregnancy;
preference is given to the laparoscopic method, but the decision on the volume of intervention should be made with the participation of an experienced obstetrician-gynecologist [14].

Patchwork technique

Wearing bandages can only delay, but not stop, the development of pathology. Therefore, treatment of a hernia is always surgical.

An outdated method is plastic surgery with local fabrics. The operation consists of stitching the edges of the “tear” together using the tension of the patient’s own tissues. Relapses of the disease in this case are up to 18%.

Plastic surgery using mesh polypropylene prostheses, similar to a patch, is a modern and much more effective way to treat hernias. There are practically no complications, since the synthetic material does not cause a rejection reaction. There are practically no relapses, since the prosthesis forms a frame in the leaky tissues of the abdominal wall that is much stronger than natural muscle tissue. Thus, this method is not only therapeutic, but also preventive. Thanks to its mesh structure, the polypropylene flap will soon be overgrown with the patient’s own cells, and after some time it will be impossible to distinguish it from native tissues.

During the rehabilitation period, the patient does not need to wear a bandage for six months, nor does he need to limit lifting weights for up to one and a half months, as is the case with traditional hernia operations.

Prevention of umbilical hernia

To prevent umbilical hernia in infants, remember to regularly place them tummy-down. In this position, the baby usually tries to turn around, crawl, and raise his head. All this contributes to the formation of a strong muscle frame.

In addition, children need to regularly massage their tummy, pressing lightly on it and moving their fingers around the navel clockwise. Another way: place your thumb and index finger 1.5 cm from the navel and squeeze it into the skin fold 10 times. Repeat the same manipulation, placing your fingers above and below the umbilical fossa.

Make sure your child has regular bowel movements without constipation. Do not leave the baby to cry for a long time - this will greatly strain the abdominal muscles.

In adults, preventive measures include:

Wearing a bandage during exercise, in the postoperative period, during pregnancy;
Body weight control;
Prevention of constipation;
Timely treatment of cough in respiratory diseases;
Limiting lifting of heavy objects;
Daily walking for at least 2 hours;
Regular physical training.

For umbilical hernia in childhood, exercise therapy is the main treatment method to avoid surgical intervention. However, the role of gymnastics in adults should not be underestimated. It helps, if necessary, to delay surgery and prevent re-formation of the hernia after it has been sutured.