When it comes to an inguinal hernia, exercises can help manage or even prevent the onset. Classified as a protrusion through the abdominal wall near the inguinal canal, or groin, an inguinal hernia is the most common. Affecting just over 60% of people, symptoms include pain and discomfort at the hernia site with bending, lifting, and coughing. In this article we break down the best exercises (recommended by physical therapists) to strengthen muscles that will help decrease and prevent symptoms.
Types of Exercises to Perform
An exercise program for an inguinal hernia will focus on two primary goals:
adequate trunk flexibility
good core strength
When the core is strong and can properly coordinate daily activities, it will minimize strain on surrounding tissues, like the groin. Unfortunately, poor trunk flexibility and weak abdominal muscles are common with an inactive lifestyle and being overweight; which often lead to the need for hernia surgery if not properly addressed.
These exercises can be beneficial for any of the types of hernia. However, for more specific recommendations, see our other hernia exercise resources linked here:
Below are six of the best stretches and exercises for both managing and preventing an inguinal hernia which focus on flexibility, core strength, and stability.
1. Hamstring Stretch
The hamstrings attach to the bottom of the pelvis. This commonly tight muscle group can throw off the mechanics in the entire core and put excessive strain on the pelvis, low back, and groin. Thus, a simple hamstring stretch can go a long way.
Start with both knees bent and wrap the band around the mid foot of the leg you wish to stretch
Then, extend the knee until straight, if tolerated
Finally, to deepen the stretch bring the entire leg up toward your chest
Hold for 30+ seconds for 2-3 sets on each leg
2. Side Lunge Groin Stretch
This exercise is a great strengthening and stretching combo for the groin. Start cautiously with a small range of motion to ensure your groin can tolerate this move before progressing.
In standing, bring the leg you want to stretch straight out to the side while keeping the knee straight
As you do this, you will shift most of your weight into the opposite leg - with the knee and hip bent - how deep you can go will depend in your strength, flexibility and comfort
Ensure your form is optimized with your butt back and get into a full sideways lunge position
Hold for 1-3 seconds
Then, move with care as you bring the straight leg back up to the starting position
Repeat on one side for 10-15 repetitions for 2-3 sets on each leg
If you're struggling with this stretch, you can also try a frog stretch (see the next exercise in the video) or a seated butterfly stretch as well.
3. Button Pull or TA activation
The transverse abdominis (TA) muscle, or lower abdominal muscle, is essentially your body’s own built in corset. Strengthening this muscle can help protect the groin and lower abdomen by providing great innate stability. This muscle commonly gets weak with inactivity, low back pain, and being overweight.
Lie on your back with both knees bent and feet flat on the floor
Place your hands inside your hip bones to monitor your muscle activation
Practice drawing the belly button toward your spine - you should feel your ab muscles tightening under your fingers and belly flatten
Start by holding the tightened muscles for 3-5 seconds while focusing on keeping the upper body relaxed and breathing normally (note: this is easier said than done)
Try 10-15 repetitions for 2-3 sets
Progress how long you can hold with time and then build to more dynamic moves- this is the most important stepping stone to other core strengthening exercises with proper form
4. Pillow Squeeze
This exercise works the hip adductors, the inner thigh muscles that attach directly to the groin. Thus, it’s important to always start gently.
Grab a pillow, large towel, or even a small ball that you can comfortably squeeze between your legs
Lie on your back with the knees bent and feet flat on the floor
Place the pillow between the knees
Engage the core first (as discussed in the TA exercise above)
Then, press the knees together as you squeeze the pillow, taking care not to strain other areas of your body
Hold for 5-10 seconds for 10-15 repetitions for 2-3 sets total
Don’t forget to breathe!
Progress your hold time and intensity of the squeeze as tolerated
This exercise is excellent for working the glutes, hamstrings and core all at once. Focus on keeping good form to boost your body’s overall core stability.
Lie on your back with the knees bent and feet flat on the floor
The heels should be 6-12 inches from the butt and directly under the knees- not too close or far away
Keep your weight balanced through your feet as you tighten the abs and lift your butt off the ground
Lift as high as you can without pain, strain, or arching of the low back
Hold for 3-5 seconds and then return to the starting position
Repeat for 10-15 repetitions for 2-3 sets total
To progress, increase the hold time or try a single leg bridge
6. Bent Knee Fallout
This is an exercise progression for the TA activation we went through above. The goal is to learn to coordinate using the core with more dynamic moves of the arms and legs, just like you would with normal daily activities.
Start in the same position on your back
Find a neutral spine (like explained above) and tighten the lower abs
Let one leg (not both) fall out to the side as you externally rotate the hip and you come onto the outside edge of your foot
Go as far as you can while you are still able to keep the spine in neutral without rotation
If you are having trouble with wobbling, then keep the motion smaller
Alternate between the legs until you have completed 10 repetitions on each side
Repeat for 2-3 sets total
Benefits of Exercises
Practicing safe stretching and strengthening for an inguinal hernia leads to a handful of benefits; including:
Better core coordination to minimize unnecessary strain
A great way to reduce the risk of a hernia (aka hernia prevention)
Increased blood flow to the groin area to help reduce swelling, redness and pain - this can be further addressed with other hernia treatment options
Reduced risk of a hernia progression or strangulated hernia
Excess stress on the abdominal cavity and groin can make your hernia much worse and exacerbate symptoms. If you’re not sure what you should be doing or voiding, it is always best to check in with your physical therapist for more personalized recommendations for core exercises. In general, here is what to avoid:
Situps or crunches
Valsalva maneuver (holding your breath and bearing down with a bowel movement or lifting) - due to the extra intra-abdominal pressure it creates
Straining with a bowel movement, particularly with constipation
Core focused moves with pilates and yoga (until ready)
High impact sports or other straining physical activity
Managing and preventing an inguinal hernia all begins with a better understanding of the underlying cause. Plus, learning how to minimize strain to the groin with an exercise routine and proper lifestyle choices. These exercises are a great addition to any home program and can yield great benefits for feeling your best without risking complications from your hernia. If you notice the bulge getting larger, you feel ill (fever or chills), or symptoms get progressively worse, make sure to get in touch with your doctor immediately for medical advice.
JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.
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