Good core exercises after hernia surgery?

Any recommendations welcome.  Thanks.

It depends on what type of hernia you have.

 

For some types you may not need any exercises at all.  After 2 weeks you won't even realize you had a problem.

Hey Jim, best advice is to go back to your doc and ask for a prescription for a rehab program.  Having gone though a similar surgery, You will no doubt lose a great deal of strength just by being sedintary for a couple of weeks.  Depending on the extent of the tear and what was done i.e. mesh patch, open surgery, orthoscopic will have a lot to do with what the dr. feels is best. I can tell you that it's important to try to build that lower ab up to help it heal and for added protection.  Best of luck and don't overdo it!

Give it a chance to heal and you'll probably be good as new.

When I was a kid I had surgery to repair a hernia in my abdomen.  Dr said 6 weeks of easy does it.  5 days later I ripped it apart - just couldn't wait.  It has since healed nicely and the Dr did not have to go back in for the repair.  So my advice is to follow the recovery suggestions and then train hard.

And also what kind of surgery was used to repair the hernia. Can you give us any more details?

I had a hernia when I was 17 in my lower right abdomen that was aggravated by pole vaulting. The worst part of the recovery was the shaved hair growing back in...very uncomfortable! But things were back to normal within a few weeks. Just make sure to take it easy and follow doctor's orders!

I'd recommend, for the sake of avoiding future injuries, not doing the standard crunch/sit up routines. They can really put a lot of stress on your back and give you a herniated disk, which may be worse than a hernia. Try instead mountain climbers, planks, and plank variations with a Swiss ball. Do a Google search on "dynamic core exercises" and try some of those exercises out. Sounds like you already have the right idea, though, since you asked for good core exercises and not good ab exercises.

Best of luck with the healing!

Ah, true, I assumed this was a hernia at a young age...if that's the case, you'll be ambulatory within a few days, though it will be uncomfortable and a tad painful (they gave me some percocet for that...mmmm). If this is a hernia at a more "respectable" age, I'd do as Finndog says and ask your doctor for a rehab.

I think we might be able to help give you some more specific exercises once you're able to give us a few more details on your situation. Best of luck!

All of this sounds like sound advice. My wife had hernia surgery about 5 weeks ago. The hernia was probably caused by her trying to come back too quickly from a previous surgery, as it was in the same area. For now she is sticking with a stationary cycle, a Schwinn Airdyne that works both her upper and lower body. Next she's going to start with some light dumbell exercises, and hopefully we'll be able to get outside on the bikes soon, if it ever stops raining. But I think that easy does it is the best advice.

Oh year, I do a twice a week, hour long core class! I have lots of torturous, pain inducing ideas :

Thanks to all for your thoughts and advice.

Last Thursday (1 week ago) I had laparoscopic surgery for two "direct inguinal" hernia.  My primary care doctor found them last December during my annual physical, but said I could wait until after ski season  to get them fixed.  The operation went fine -- frankly I was more concerned about general anesthesia (which I've never had before) than the operation itself.  Since then, each day the pain is less and I can walk more erectly.  They prescribed Vicodan (sp?) for the pain, but so far I haven't taken any (wife thinks I'm nuts -- but that was the case before the operation too).  

I'm not supposed to do heavy lifting for another week.  Running is out of the question for at least the next few days.  In the mean time, I feel like my muscles are atrophying.  Assuming the healing continues over the weekend, I may get on the eliptical early next week -- albeit not at a "gut-busting" pace.

Yesterday afternoon, after I posted my question, it occured to me: why not ask my doctor?  She told me there is no specific core exercise that will reduce the likelihood of future hernias, and nor was it likely that the ones I had were due to under/over/incorrect exercise.  Apparently, hernias are caused by weakness and/or tears in the tissue under the muscle. She said the best thing was to get back into an exercise program gradually, but do get back into it.
      

Hey Jim, sounds good, did the dr use mesh to reinforce the area? I know you saw the other post.  Elypticals are great. her comment about the excercises is correct hoeevr the caveat is any excerciese done "correctly" is fine but any excercise done incorrectly will raise the risk of injury to anything!  As she said, the fitness level is not really connected, I had a direct and a sports hernia- where the muscle fibers don't heal and just keep tearing after partial healing. The "direct" hernia is where the intestines do not actually protrude or become estrangled by the tear.

Ok, you had one of the easier ones to fix.  Mine was fixed with the mesh that Finndog referred to.  Sounds like mine was a bit more serious than yours as it protruded 1/2 the size of a tennis ball and everybody was in favor of immediate surgery. 

I was walking around 2 days after surgery and walking w/o any pain in 5 days and working again (interior paint). I was skiing again 2 weeks later with doctors orders to try to ski smooth and no air time.

Unless there is some complications, I'd say in two weeks you won't even know you had a problem.  THAT 'S when you need to watch the way and amount of weight you lift and sudden moves laterally (basketball and tennis for example). 

Best of luck with it Jim.

Holy shit Louie! I wasn't able to ride in a car for two weeks let alone work!  It took a good 3 weeks to feel stable, we started rehab after 2 weeks but I has considerable pain for a while. Keep in mind it taks 3 weeks for soft tissue and muscle tissue to heal.....  GOOD advice on the lateral movements.

For those who don't recall, here's my surgery pics!!!!

I did have the mesh inserted.  The day after the operation I was walking short distances right away, but with pain.  Now, with each day walking gets easier, and I'm able to do more distance.  This morning for the first time I did my usual (pre-operative) 15-minute walk to the Metro stop near my house.  

Uncle Louie -- mine didn't protrude that much and I didn't feel them, so maybe healing will be as quick as it was for you.  Although I'm chomping at the bit, I will forego tennis, running, biking for another week at the least.

Finndog -- Sounds (and looks) like your hernia(s) were worse than mine; glad you've fully recovered.  I agree, exercise done wrong can hurt you; if not hernias, maybe something else. In part, it was that thought that motivated my OP.  I was concerned that maybe I had caused these, as just last August I started increasing the frequency and intensity of my core exercises. 

I'll keep you all posted.  Thanks.

I say yes on the biking next week as long as you aren't talking mountain biking......running the week after, though I'd avoid hard surfaces.......tennis the week after that.

If you tear it again....the recovery time will at least double.

Louie -- thanks.  My bike is a mountain bike, but I'll stay on paved trails for a while.  You're probably right re tennis.  It's a bummer though.  When we go on vacation in August, my wife is wants to play a lot of tennis, and she's playing every day now.  I guess the heightened possibility of humiliating defeat in a couple months is the price I've got to pay for full recovery.

BTW, your recovery sounds amazing -- but of course you were just a young guy of 50 at the time....     

Wow, a subject on Epic that I actually know something about.  Like anything, recovery from surgery is a Bell curve.  There are patients that take almost no pain medicine and those that are miserable for long periods of time.  I would say that the average patient can get back to light activity after 2 weeks and unrestricted activity after 4 weeks.  I usually tell my patients that after 2 weeks they can gradually increase their activity level as tolerated...let pain be your conscience.  I tend to be pretty conservative.  Many believe that with a laparoscopic repair that patients can do whatever they want (feel up to) as soon as they want. 

Utilize core strengthening exercises but there is no exercise that is going to prevent hernia formation.  Good luck with your recovery.

Dam, you guys did well!  Best wishes for a quick, painless and full recovery!  Ski season start in 43 days for me! :)
Edited by Finndog - 6/26/2009 at 07:28 pm GMT

pwderhound, are you the dr. I met on the plane to Steamboat?

Yes.  That is how I got started on Epic.  You told me about it and now I am a regular reader, sometime poster.  Perhaps our paths will cross in Steamboat this winter and we can make some turns together.

Pwdrhnd  --  Good advice.  Thanks. 

On another note, Pwdrhnd and Finndog: where do you guys stay at Steamboat? 

Hey, good speak with you! yes, gotta make some turns. I do remember skiing that day and running into you. It was a powder day I recall.

Jim, I have a condo at "Canyon Creek" its over by the HighMark and La Montana's Restaurant/Village Market.

Finn has his own condo in Steamboat and I have both a brother and a ski friend with places in Steamboat. 

Haven't been to the Boat yet, but it's on my shortlist for this coming Xmas break.  If we choose there, I may get back to you both to seek lodging advice.  If I remember correctly, another Epic member, gregmerz, is also a Steamboat regular.

thre are a few of us. Bumfreq too

Feeling good.  In the three weeks since the surgery, I've done a lot of walking and (after second week) a few times on the elipitical. Also did the weight stations, but at 1/2 to 2/3 my normal weights.  Went on my first run (2 miles) yesterday (I normally run about 3 miles).  The area of operation felt fine, but taking three weeks off from running took its toll -- I was dogging it the last half mile.

Had my post-op meeting with my surgeon last Friday.  He said I'm good to go.  Re weight training, he suggested less weight, more reps. In his view, that was a good general rule, even apart from recovery.  Any views on this?  Up til now my general rule has been: if I can't do 8 reps, decrease weight; if I can do more than 12 reps, increase weight. 

Good to hear it's healing quickly! You'll get your running back in no time.

Regarding the weights, when I used to use weights and machines I would follow your general guidelines. I'd up it a little more however. If you can't do 10 reps, decrease; if you can do more than 15, go ahead and increase a little bit. Anything more than 25 probably isn't doing much for muscle mass, but there's something you might want to think about here: what's your reason for weight training?

To elaborate, I'll explain why I've been weaning myself off of pure weight training in the past year. Weight training often focuses on slow, controlled movements that build muscle pretty quickly, but honestly, don't really translate into real-world movements. This is *obviously* dependent upon what kind of weight training you do. But you can make an exercise more difficult without increasing the weight by doing something as simple as standing on one leg while doing bicep curls. All of a sudden you're now engaging your core even more, and you're strengthening your balance while focusing on your biceps.

I still do some work with an EZ bar I have at home and a few dumbbells, but most of my "weight" training is now based on bodyweight exercises. Now, when I'm biking, climbing, or skiing, I feel like these exercises–that are not focused on slow, isolated movements–are aiding me in multiple ways.

I'd follow your doctor's orders for more reps, less weight. You'll start to feel your muscles getting leaner and they'll have more explosive power. Then do something as simple as lifting up your legs to a 90° angle while doing bench presses, and you'll be engaging and strengthening your core as well.

RFO -- thanks.  Pre-operation, I did vary my gym routine: after 25-30 minutes of cardio (eliptical or treadmill) I'd do the weight stations one day, and then the next time use dumbbells for 6 different exercises while standing on the flat side of a bosu.  Next week, I plan restart the bosu option -- I need to work back up to that, because I found it quite difficult (i.e., great exercise).  

In the summer, as much or more of my exercise is out of the gym: running, biking, tennis.  In the winter: skiing and some running, but relatively more gym time (not at a ski resort of course).  

My plan is to get back more into this variation in routine as I continue to recover.

You ask a good question: why do I do weight training?  When I was a kid, I did weights to bulk up.  Four decades later, I've given up on that goal.  Now I lift to keep my weight up, keep my overall muscle mass up so I have better metabolism, keep my upper torso (skeletal and muscles) strong for general health and to be able carry out the general duties of a dad: loading suitcases, lifting bikes onto the bike rack, carrying the sofa up a flight of stairs, etc.  

I've been hearing more about the "active fitness" that you describe and I'm interested in learning more about it.  Frankly, even though I've lifted weights for decades, I find it about as interesting as brushing my teeth.  You mentioned that you're doing more bodyweight exercises, which I gather involves more movement.  Is there a web-link that describes the types of exercises that you do?

Thanks very much.  

 

Jimski, your reasons for weight training almost exactly mirror mine! In college I was also trying to bulk up, and gained 25 pounds in one year, going from 165 to 190. Now, two years out of school, I exercise to get my happy endorphins, to be able to eat what I want (I love food), and to do similar "dad" duties. I won't be a father for a number of years yet, most likely, but it comes in super handy when my girlfriend wants to rearrange furniture in our living room, or carrying our bags on vacation .

When I started getting into bodyweight exercises about a year ago, I googled "bodyweight exercises" and just started flipping through all of the youtube vids and links that popped up. I already had most of the equipment necessary: my own body, a couple of stools to do dips on, and a couple of dumbbells and an EZ curl bar in case I wanted to change things up. For a pull-up bar (very necessary) I went to Bed, Bath, & Beyond and picked up an "Iron Gym" pull-up bar for $25 ($30 minus the 20% discount coupons they always send in the mail). It's rated for 300lb, but the metal will give a little bit anyway. Don't worry too much...I'm at 185lb now and since the initial "settling" of the metal bars it's been fantastic. If you have some strong piping near your house, you won't even need to buy a bar.

I started with the standard push-ups, pull-ups, curls, sit-ups, dips, etc., but those, honestly enough, can get just as boring as lifting weights. So then I saw two things that I thought would really make the exercise more dynamic. First, parkour, or free running. Do a quick google search on that and you'll find a bunch of sites and videos of guys/girls doing parkour exercises. Modify them for your own home, and all of a sudden you're combining running and lifting that doesn't get old. A lot of these exercises, even at the beginner intensity I do them at, are pretty difficult. I'm *still* trying to do a clean muscle-up!

That stuff led me to gymnastics. Dan Gill, one of the developers here, is actually an accomplished gymnast, and he's pointed me in the direction of a few places where I might take adult gymnastics courses. In the meantime, before I start, I'm trying to do some planche pushups, , over-the-head pushups, wing pushups, handstand pushups, and various L-leg dips or horizontal pull-ups/curls. (It's like doing a pull-up, but instead turn your body so that your back is parallel to the ground, rather than perpendicular. Start off with your feet tucked and get used to that position. As you get better, start extending your legs. Your abs will hate you!) 

This site seems to have a lot of gymastics exercises.
This one has some good ones, too.
Do a youtube search for prison workouts or ghetto workouts. Burpees seem like they'll kick my a$$!

In the past two months, I've stopped doing crunches and other ab-only exercises that flex your spine. First off, if you're working your stomach and not your back, you're creating an imbalanced core, and that could hurt you down the road. Secondly, that constant spine-flexing motion can eventually lead to a herniated disk . No thanks. Read this NYTimes post about it, and watch the video. Planks, dynamic planks, mountain climbers, all of those exercises will work your *entire * core, not just your abs. Much better.

Search for some plyometric exercises. My own favorite is the split squat jump (good for skiing, too!) Just start those slow, as plyometrics can be intense. Really good for explosive muscle power and cardio, too.

Once you amass an arsenal of your favorite exercises, start changing them up. Try the Tabata Protocol with a few of them (without weights). It's really intense, so start off doing a 20-second work/40 second rest ratio, and then start working down to the Protocol's 20:10 ratio. Another Times article discusses some studies that are finding that short bursts of super-intense excercise have just as much cardio-vascular benefit as endurance exercises (like running, biking, etc.), and will help you build muscle power as well. So when you only have 10 minutes instead of your usual 60 to work out, you can do an intense interval workout and still benefit.

By far the most helpful thing I found in working out, however, was finding a full-body sport. I am a HUGE advocat of rock climbing now, and whenever I go I find that my entire body has been used. Plus, it's a really cool feeling to use your own body to scale a vertical wall, and done correctly, climbing has made me feel more limber, more aware of my body position, and has made me stronger.

I'm sure you could find something similar to climbing that would get you really excited. You've mentioned that you play tennis, and I'm sure that's pretty intense for almost your entire body (except your non-racket arm ). Free running might do it for you, or gymnastics, or martial arts, or just tooling around with the bodyweight exercises you find might be enough. What I really like about these kinds of workouts is that once you've learned, or had a bit of training, these are all sports that you can advance in and practice on your own. I would be interested in hearing if you end up finding something that you enjoy!

I'll try and scrounge up some more links later on. I know I have a whole bunch of bookmarks for bodyweight excercise sites somewhere...

Hope that helps!