Re: Hernia and Weight Lifting

[Guest guest]

Dear Mangesh Sawant,

There are 2 varieties of Inguinal Hernia

1. Indirect hernia due to a preformed congenital sac

2. Direct hernia due to a biochemical disorder of the tissues usually

resulting from aging.

Either variety may definitely become aggravated or even triggered off by

intense lifting of heavy weights. I have seen patients who had what may be

called a sudden " rupture " in its truest sense.

Weight lifting with a hernia is dangerous and can precipitate

irreducibility and even strangulation that may lead to death if it is not

appropriately treated.

Fitting and wearing a hernia truss to keep a hernia inside is a very tricky

job even under normal circumstances. Improperly fitted and worn hernia

trusses are a common cause of the dangerous complications mentioned above.

No sane doctor would advise weight lifting with a hernia present (truss or

no truss).

Modern hernia surgery is both safe (done under local anesthesia) and an

ambulatory (you can walk home shortly after it is done without hospital

stay) procedure. Every patient should be encouraged to have it done by a

trained and qualified surgeon.

A person who lifts weights would be well advised to get it done by a

surgeon who has a special interest in hernia surgery as their results are

the best with the lowest recurrence rates (<2% Vs 6%-20%).

The use of a " Langot " to *prevent* hernia is traditional in India and does

provide support to the lower abdomen. Still, there is no scientific study I

know of that demonstrates its effectiveness.

If the " Langot " does not cause you discomfort or cramp your style there

seems no reason not to wear one especially if you are doing power lifting.

I have never worn one myself. But I train with weights only for fitness.

regards,

Dr. Shantanu Udhav Nagarkatti

Consultant Surgeon

Specialist in Major Ambulatory Surgery

(Herniology and Proctology)

Asst. Hon. Prof. of Surgery, K.J. Somaiya Medical College and Hospital

Hon. Prof. Mind-Body Medicine, BV Institute and BITS Pilani

Clinic: 4th Floor, 29, Bombay Mutual Terrace,

534 Sandhurst Bridge, Sardar Vallabha Bhai Patel Road

Opera House, Girgaum Chowpatty

Mumbai 400007, Maharashtra State, India

Tel: 3643546

+0000, you wrote:

>Date: Fri, 8 Mar 2002 16:26:58 -0800

> From: " bioforce " <bioforce.inc@...>

>Subject: Role of Supporter

>

>Mangesh Sawant wrote:

>

> He stopped me when i was doing full

>squats below parallel. First of all he thinks squats

>are always done to parallel or above parallel. He told

>me that if I squat below parallel, there is a great

>risk of hernia. To prevent that I must wear a very

>tight supporter. He recommended typical Indian

>supporter which is a loin-cloth (called LANGOT in

>hindi) that can be wore very tightly.

>

>Mel Siff wrote:

>

>[No amount of any loin-cloth support like that is going to prevent a

>hernia, which, by the way, seems to have a genetic link. Anyway, the risk

>of hernia is

>very slight indeed and I know of very few lifters who have ever suffered

>one as a result of even maximal lifting, even without wearing tight

>clothing of any form. If you wish to decrease the IAP (Intra Abominal

>Pressure),

>then all that you have to do is release some air carefully from one's

>lungs, but

>this, of course, can compromise trunk stability during heavy lifting. As

>for that

>instructor's unwarranted beliefs about full squats, it is impossible to do any

>serious Olympic lifting without doing full squats. ]

>

> Casler writes:

>

>Mangesh, generally what Mel has stated is true. An inguinal hernia is

>the result of the creation of intra-abdominal pressure beyond the limits

>of the containment tissue (inguinal rings and canal).

>

>This is " always " a risk we take when we lift, because the strength of

>the tissues involved can be affected by many things. Most who

>experience a hernia have a congenital weakness that has been exploited.

>You may have this weakness your whole life and never test it to the

>point that it " ruptures " or allows a portion of the abdominal contents

>to " push through " under pressure.

>

>Additionally as we age, these tissues age too and they weaken slightly

>which could also allow a previously used weight or load to cause a

>hernia. I have had personal experience with this and have to say that

>even improving the condition of the abdominal muscles allowing them to

>produce a greater " intra-abdominal pressure " could also put you at risk

>(as was the case with me)

>

>Please don't let me create undue anxiety, since it is an event that you

>cannot prepare for, or is there any way to determine this weakness or

>figure the actual IAP/containment ability ratio. It is not a definable

>condition that can be guarded against. Let me assure you a common

> " athletic supporter " (jock strap) used here in the States would have

>virtually NO effect at containing this event.

>

>I did manage to continue lifting (even with the hernia) and have

>squatted with well over 200 kilos for reps by using a specially modified

>hernia belt with some very serious " bindings " to apply pressure to

>contain the hernia even under considerable IAP.

>

>Additionally these squats were performed by balancing the bar on my

>traps/shoulders (no hand squats) and I applied " manual " pressure to the

>pads of the hernia belt during the whole lift. The side benefit of this

>is that applying such pressure causes the lats to contract with an

>additional stabilizing force to the spine.

>

>This practice " is not " recommended and could prove truly dangerous, I

>only mention it to explain that only performing a similar binding

>(uncomfortably tight) and applying manual external pressure, could you

>prevent this from happening " IF " you are susceptible to this weakness,

>which was determined as the testicles descended during you

>infancy/childhood and the inguinal rings and canal closed (or didn't

>sufficiently close in the unlucky case of hernia sufferers)

>

>You can no more predict this event than you can predict an arterial

>aneurysm.

>

>I hope this did not scare you, but the answer to your question is, as Mel

>has said, the Indian supporter might offer enough pressure to " slightly "

>provide support but it will not ultimately prevent the event if you

>reach the pressure/tissue strength limit.

>

>I might also point out that the construction of the supporter is such

>that it is generally " relaxed " when the hip is flexed (at the bottom of

>a full squat) and this is when the most support is needed.

>

>So. to actually answer your question; a supporter will likely not help

>and the intra-abdominal pressure for parallel squats is likely just as

>great or very close to that of full squats unless you bounce. I would

>suggest also that you, under no circumstances, attempt to " override "

>your natural tendency to create IAP when squatting. If you lean forward

>you will need to fight the leveraged forces on the anterior disc areas

>and this cannot be safely done without substantial IAP.

>

>Perhaps if you practice slow and safe progressions to insure adequate

>conditioning you may slightly reduce the possibility, but if you are

>unlucky enough to have the congenital weakness (or as Mel suggests it

>might even be genetic) if you lift heavy, you are playing the lottery

>for a chance to find it. Luckily the repair techniques make you

>generally " better than ever " .

>

>Regards,

>

> A. Casler

>

>TRI-VECTOR 3-D Force Systems

>Century City, CA

[Guest guest]

Re: Hernia and Weight Lifting

Dr. Shantanu Udhav Nagarkatti wrote:

Dear Mangesh Sawant,

There are 2 varieties of Inguinal Hernia

1. Indirect hernia due to a preformed congenital sac

2. Direct hernia due to a biochemical disorder of the tissues usually

resulting from aging.

Either variety may definitely become aggravated or even triggered off by

intense lifting of heavy weights. I have seen patients who had what may

be

called a sudden " rupture " in its truest sense.

Weight lifting with a hernia is dangerous and can precipitate

irreducibility and even strangulation that may lead to death if it is

not

appropriately treated.

Casler writes:

What Dr. Nagarkatti posts is very true and my previous post was not to

encourage anyone to perform " any " exercise with the condition. Since

almost all exercise involves a degree of IAP (intra-abdominal pressure)

you put yourself at serious risk of making the hernia worse. (even bench

presses and exercises you would think safe, are not to those already

suffering from a hernia)

Regards,

A. Casler

TRI-VECTOR 3-D Force Systems

Century City, CA

[Guest guest]

> Dr. Shantanu Udhav Nagarkatti wrote:

>

> There are 2 varieties of Inguinal Hernia

>

> 1. Indirect hernia due to a preformed congenital sac

>

> 2. Direct hernia due to a biochemical disorder of the tissues usually

> resulting from aging.

>

> Either variety may definitely become aggravated or even triggered off by

> intense lifting of heavy weights. I have seen patients who had what may

> be

> called a sudden " rupture " in its truest sense.

>

<< I myself have never suffer a hernia, however some of my friends

have, the hernia in nearly all cases was in the area where a weightlifting

belt buckles up. So it would seem to indicate that the unprotected area

around the buckle could be a weak point in belt wearing lifters.

I do not wear a belt and I train my lower back and abs with heavy

weights. Could that be why I have never suffered a hernia.>>

Iain Murray

Aberdeen, Scotland