hernias

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[Melissa Fischer]

I read about all kinds of injuries from aikido. Are we all too centered to get hernias? Has anyone ever had one and lived to tell the story? They seem to be faily common in other athletic fields, what about ours?

[Edward]

I've got one for the last 17 years or so. It's in the abdominal muscles area and fairly common in athletics. I got it however from seriously trying to push a truck weighing several tons :)

I did no surgery at the advice of my doctor, just let it heal naturally and I can say it is 95% ok. I practice aikido and kendo 7 days a week, and all what I feel is a mild discomfort after some of these aikido sessions during which we are asked to throw 2 resisting partners.

But I also feel regular pain from those dislocated thumb joints which never healed and from my severely damaged knees from too much kneeling throws in my previous judo training. So the hernia is obviously the least of my worries.

[Unregistered]

I've had an mild umbilical hernia (around my belly button) for almost three years. I got it doing yard work, not in aikido. My physician told me that it would never completely heal, so that eventually I will probably need to have it repaired. He also said that there is no urgent need to get it fixed until I am ready or it gets worse. The only time it has bothered me in aikido was when I came down hard on it with my belt knot in a seminar, but that only lasted a couple days (really just a bruise). I know a few other members of our dojo who have also had hernias, but they were never caused by aikido.

[akiy]

This thread has been moved from the Anonymous forum to the Training forum.

Please note that the Anonymous forum is intended for "delicate" subject matters for which people have a need or want to keep their identities from being revealed. I encourage people to keep this in mind before starting a thread in the Anonymous forum.

-- Jun

[BC]

Jun:

I think that hernias could definitely be considered a somewhat "deilcate" matter, as they can occur in "delicate" location of the body. Some people can be quite embarassed to talk about having them. Just my two cents.

[Melissa Fischer]

Thanks for the feedback. Has anyone ever had one repaired? How did that go?

[Kevin Wilbanks]

I have a friend who just had a double hernia repair. They put in two fairly large patches of some kind of kevlar sheeting I think. He couldn't do anything for about 2 months, and said it was very painful. Everyone I know who has had the surgery says it was a very painful and depressing experience. OTOH, the doctors tell his that now he is pretty much impervious to further inguinal hernia problems.

To some extent, one can be predisposed to hernia just by bad luck of genetics or developmental happenstance. However, I think there is a lot you can do to prevent them. Foremost is to undertake a sensible, gradual strength training regimen and keep it for life. Exercises like squats, lunges, and deadlifts, and other big movements where one must use the valsalva manouver are key. The other precaution is pretty obvious, and becomes less of a restriction if you follow the former: don't attempt to lift things that are beyond your capabilities, especially if you are unsure of safe heavy lifting biomechanics. If you train deadlifts and squats, your capabilities will be substantial, your knowledge of proper lifting form will be deeply ingrained in your body, and you'll have a very good idea of what your limits are.

[Anat Amitay]

hi there,

about hernia, I don't have one but I did learn about them, so here are just a few things of advice:

Hernia's are more common in men than women (it has to do with the development as a fetus). There are different types of hernia, in the area of the umbilicus, in the lower stomach... some forms are congenital and there are people who are more prone to getting one, if they don't take care- genes...

Yet there are many ways to prevent or minimize the chances of getting one-

bending should be done by flexing the knees and not the back. lifting heavy things should be done in a correct form- the heavy thing close to the body, knees bent, and contracting the pelvis muscles and the lower stomach (transverse abdominis)without holding your breath. these muscles specificaly are important for both men and women to work on for many reasons but also for the health of the back (spine) and reducing risks of hernia.

as for how to train them- you can ask instructors in gyms or a physiotherapist. if you want more information, i'll be happy to help out.

enjoy training!

Anat

[Kevin Wilbanks]

bending should be done by flexing the knees and not the back. lifting heavy things should be done in a correct form- the heavy thing close to the body, knees bent, and contracting the pelvis muscles and the lower stomach (transverse abdominis)without holding your breath. these muscles specificaly are important for both men and women to work on for many reasons but also for the health of the back (spine) and reducing risks of hernia.
I'm sorry, but this advice about consciously contracting the TVA (transverse abdominis) needs to be corrected. This idea has become popular among many faddists and fitness gurus, but it is not proper, safe lifting advice - there is no evidence to prove this method is safer, and both the body's instinctual behavior and the entire history of sporting contradicts it.

Holding the breath or strictly limiting the rate of exhale along with pushing down with diaphragm to increase intra-abdominal pressure is essential for the stabilization and protection of the lower back during heavy lifts - called the Valsalva Manouver. Not holding the breath, contracting instead of expanding the gut, or doing anything conscious about the behavior of your TVA muscles is a good way to screw up proper lifting form and seriously injure your back.

Ask any competitive powerlifter or weightlifter about the importance of the valsalva manouver in doing circa-maximal lifts. The function of back protective belts like lifting belts and the ones you see delivery drivers wear is precisely to have something to push out against to assist in increasing intra-abdominal pressure.

The behavior of the TVA and breath holding patterns are something that most people do properly on an instinctive basis - like blinking and swallowing. These habits should generally not be messed with without good reason. If you are so hernia-prone that you cannot naturally increase intra-abdominal pressure to assist with strenuous lifts without something popping out, than your situation is pathological, and you need medical care.

[Avery Jenkins]

The function of back protective belts like lifting belts and the ones you see delivery drivers wear is precisely to have something to push out against to assist in increasing intra-abdominal pressure.
As an interesting side note to Kevin's comments, only a few years ago, the recommendation for anyone lifting on the job was to wear the back brace. The theory was that this would reduce back injuries.

The most recent research shows, however, that constant use of the back belts actually increased injuries. Not due to any inherent problem with the belts, but because employees were wearing them all the time, thus weaking their abdominal muscles (the belt doing all the work for them), leaving the person actually more prone to injury than before.

Frankly, I think a big chunk of the low back injuries can be traced back to weight. Americans have a big time issue with obesity -- it's currently our number one health problem -- and weight coupled with inactivity is the number one cause of low back problems that I see.

Avery

[Kevin Wilbanks]

I generally agree. Although I would probably identify poor postural habits, especially sitting in chairs and bending/lifting technique as the primary culprit in the back problem epidemic.

Re: belts. I think they are a bad idea for regular use, because they can become a crutch, as you said - I also don't think we should be wearing shoes with funny supports and lumps in them, but that's another tale. As a general principle, I think it is best to do things au naturale, letting the body's inherent mechanisms adapt to doing things without excessive micromanagement or technological assistance.

For ordinary training in lifts where a belt can possibly be of use, I favor not using one, and letting one's body do the work. However, for maximal powerlifting attemps and such they can be a prudent added safety measure - it's an individual choice. One thing to note, though, there is no reason at all for the belt to be wider in back than in front, as its purpose is as a strap to help increase IAP, not provide mechanical support for the back.

Those work belts are actually a somewhat different animal, as many appear to be wide and stiff enough that they are intended to act as a truss. With employees wearing them all the time, what I often see would preclude the development of dependency on the belt: usually they have them on improperly and become used to wearing them in a useless fashion anyway. Setting up courses and other procedures to foster and maintain proper lifting technique would be a more sound policy, but not as cheap and easy as handing out belts.