I Have a Hernia! (NOW WHAT?)
Hernias are one of the most common injuries suffered by men, with over 25% of all men likely to suffer one in their lifetime. That said, when you consider the increased risk in populations who lift weights, the numbers become even more staggering. The question is, what happens if you get a hernia? A
So theoretically, you could be fine, you’re lifting and all of a sudden, bam, it comes out, ugh. oh, that looks like a pain in the balls.
What’s up guys, Jeff Cavaliere, athleanx. com. And Jesse Laico, altheanx. com. So today we’re talking about hernias.
And before you say, “Oh, I never had one, I have to worry about one. ” It’s actually one of the more common injuries, especially for those that like to pick things up and put them down. Like our question for today. This is an “Ask Jeff” video where you get your question featured and I answer it for you. Leave your question below.
Maybe you’ll appear in a future video like this one. So, we have from ALEXALMOST40, “Hey, Jeff, I just went to the doctor and it turns out I have an inguinal hernia. He said no heavy lifting. Are me and my gains screwed unless I have surgery? Thanks.
You’re the best. Jesse, you’re even bester. ” You like that one? ALEXALMOST40. Yeah, that sounds like the intelligence level of somebody that would like Jesse, actually.
That’s not very nice. I like Alex, but I’m just saying the use of the words Let’s talk about what this is, I can relate exactly to what Alex is talking about. Because I have had not one, but two hernias. Two hernias? Two hernias.
One of which I had repaired and one of which I live with to this day. So, the one I had repaired back in 2011, I had it for three years and at that point I finally started to get to the point where I was so uncomfortable that I had to go and get it repaired. Okay. We’ll talk about the options in terms of what repair looks like for those who have to go down that route. The other one that I had was in 2013, and ironically, I was filming an exercise that I recommend you not do, which I’ll get into in a second here, and of course, in filming the exercise not to do, I incurred my second hernia.
Ironically, the same thing that happened to me the first time that caused a hernia on the first day of doing that exercise. Is that why you have been demonstrating all the bad exercises? That is why Jesse demonstrates many exercises for me. So, what is a hernia and basically what causes it? Okay, so I got this right here.
So, what this is, is basically your intestines inside, your abdominal muscles on the outside. And what happens is you start to get a little breakdown in the outer abdominal wall and there are very thin muscles down here, we’re talking about inguinal hernias, down in the groin just to the right or left of your junk. That’s a weak spot. And a lot of times we are born with this weak spot that never actually fully closes. If we get any type of increase of international pressure, if we cough, if we sneeze, if we lift heavy, if we bear down and we push out, that can cause the inside to start pushing out against the outside.
And if we keep doing that, what happens is you’ll get this sort of gradual breakdown in the area. It’s not an incident that happens just like that. The actual tear you could feel as a one-off incident, but it was an accumulation of a lot of things that led up to it. So, if you look at this band here, it looks like it’s fine, it’s intact, it can actually function. But if I were to pull it and show you a little bit closer here, you can see that there’s a tear in that band.
Okay. So, that tear over time is going to eventually wind up breaking and snapping the band. You’ll feel the zipper like pain when that actually happens. But it’s an accumulation of those stresses, the increased IAP pushing against that that leads to that eventual breakdown. So, in my case, I actually felt this zipper like pain the moment I did that rep, but it was probably an accumulation of a gradual weakening of that tissue in that area over time.
Right. Very similar to what I talked about the pec tear that happens, we covered a few videos back. Though the pectoral happen on a single repetition, it was the accumulation of the breakdown of the tissue over time that led to that weakening in that spot that allowed it to break. So, who does it affect? 25% of the time men will have this happen to them in their lifetime.
That’s a lot. That’s a lot of inguinal hernias, it is actually one of the most popular repairs that we have surgically done every year. Women actually get it about 3% of the time. That’s it? But it’s still a lot.
Three out of every 100 women, it’s still a lot. It’s the fact that men are sort of predisposed by carrying a little extra anatomy down in that area. Unless you’re Jesse, you don’t have to worry about that as much. Whoa, whoa, whoa. I’m just saying.
Listen, so if you were to get one, what happens? Okay, so you’ve got two options always when you get a hernia. Number one, watchful waiting or surgical repair. Now, let’s go down the surgical repair, because again, I did that. You have two options in terms of surgical repair, and one of them is really not even that much of an option anymore.
And it’s the tension free or the tension of repair and what they do with the tension repair, is they actually suture the tissue, the whole and that our abdominal wall together. But what’s not so good about that is you’re basically holding it together with stitches so that if I were to increase the pressure on the abdominal wall from the inside out Then it causes the sutures to open up. Yeah, so it’s going to it’s going to pop that hole again. So, you have to really be careful about the type of pressure you’re developing from the inside out. However, they came out with the mesh repair and the mesh repair actually goes behind the hole.
So, this is the hole here. I put the mesh behind the hole like this from the inside out. So, the hole is actually never repaired. And what I do is I make sure the mesh is large enough to cover that hole. So even if the hole starts to get a little bit gradually bigger over time, they’re still being covered by the mesh and it doesn’t increase, there’s no tension on that repair.
I’m holding this in place, so actually, if I were to increase abdominal pressure from the inside out, I’m pushing the repair more into the abdominal the wall and actually causing more stability of the repair as opposed to less. So that would be the way you’d go. And that’s how I went and again, I haven’t had any issues with that repair now for 10 years, so that’s a good thing. Now we’ve got the other room, watchful waiting. You can train with a hernia.
Can you? Yes. Contrary to what people say, you have to just be careful that you do two things. Number one, I have now trained with my hernia for eight years. You have to be careful about the use of exercises that dramatically increase intra-abdominal pressure.
We’ll talk about that in a second. You also have to be careful not to utilize exercises that increase that inguinal vulnerability, I like to say. And let’s start with that one, because that’s the one I’ve covered before in videos and I mentioned earlier here talking about like a One Arm Row. Again, the tissues in this area of the groin are already thin and rather weak and sometimes already compromised genetically by the fact that that inguinal canal never fully closed. So, as you start to put yourself in a position like a One Arm Row, with one leg of one leg down on the bench, you’ve already got a lot of stress and tension in that area, especially for the leg that’s down on the ground that’s causing that stretch at the same time.
And then you go when you lift that heavy weight awkwardly, oftentimes that causes that area that’s already under tension that potentially could have already had a little bit of that breakdown to just simp