Anthony, 60, who worked as a lawn mower contractor, decided in March 2008 that it was time to get back in shape. He renewed his subscription to the gym and started again with weights. Shortly after attempting to lift 220 pounds (100 kg) for the first time in 15 years, he developed pain in his right groin, which was diagnosed as an inguinal hernia. Anthony’s doctor booked him in for hernia repair surgery, which was to take place in September.
While awaiting surgery, Anthony consulted a homeopath and an osteopath. The osteopath gave Anthony simple exercises to strengthen his transverse abdominal muscles.
Anthony gave up all other forms of exercise, quit his lawn mowing job, and avoided stretching and lifting anything heavier than 4 to 6 pounds for about three months. He ordered a hernia support garment since he had a guarantee to maintain the hernia during all activities.
When the hernia first appeared, it would come out 10 times a day, just from walking or standing in the shower. This stopped when Anthony started wearing the hernia brace. In May it recurred when he tried to do some push-ups without wearing the hernia brace, so he went back to using it for a couple of hours a day.
By June, the hernia seemed to be under control, and Anthony felt confident enough to start doing some light aerobics and strength training at home. He also started working on his tractor, which involved some effort. When he did these activities, Anthony wore his hernia brace, which he found gave him a sense of security and took much of the worry out of his daily activities.
By September, the hernia had improved so much that Anthony postponed surgery for three months. To check that the hernia was really gone, an ultrasound was done. This showed that there was nothing left but a small enlargement of the deep end of the inguinal canal. The doctor asked him to try as hard as he could; this forced only a small amount of fat into the deep end, but not the intestine, and there was no bulge.
Roy, aged 58 in 2005, worked as a window cleaner and was also an Ironman athlete. The Ironman Triathlon is one of a series of long-distance races organized by the World Triathlon Corporation, consisting of a 2.4-mile swim, 112-mile bike ride and a 26.2-mile run. This grueling event requires months of intensive training and an extraordinary degree of fitness.
Roy had taken part in ten Ironman triathlons, but was sadly unable to do more as he had developed a small inguinal hernia. Roy knew two people who were still suffering from complications years after hernia surgery, so he decided not to have the surgery.
However, in January 2006, Roy met Craig, who had cured himself of his own hernia through diet, herbs, Pilates exercises and also by wearing a hernia support garment. Roy was eager to see if he could replicate Craig’s success, so in mid-January he began attending Pilates classes with Craig and began wearing the hernia brace.
Roy kept a journal to monitor his progress. After one month, he reported that he felt fitter, healthier, and more toned in his lower abdomen and pelvic area. He decided to run the Dover Half Marathon on February 19 and completed it in 1 hour 35 minutes, his best time in several years. Roy was so encouraged that he was eager to start training for another Ironman Triathlon.
Swimming is part of the Ironman program, but Roy’s hernia had so far caused him discomfort during swimming, a “pulling” sensation in his groin area. By the end of February, he felt confident enough to swim a fairly hard 2,000 meters while wearing his hernia brace. He was surprised to find that there was no discomfort at all.
So in March, Roy began a grueling 16-week training program in preparation for the Quelle Challenge Triathlon on July 2, 2006. He had to rack up 15-20 hours of training per week. As Roy was approaching 60 years of age and hadn’t done an Ironman in two years, he wasn’t sure he could do this training without aggravating his hernia, but he had largely forgotten about that now, as the bulge was not appearing longer. To be safe, he kept up his Pilates exercises and used his hernia brace.
The Ironman is the largest mass participation triathlon on the planet: 2.4-mile swim, 112-mile bike, 26.2-mile run. When the day came, Roy started at 7:20 am. Here is the report from him:
“The swim was comfortable, but slow. I had a good bike, I was taking it easy and I was ready for the marathon. I ran 4,456 meters. Total time: 13 h 2 min. I finished 1,656 out of about 4,000 participants, 26 in my group of No I don’t think I would have been able to get through the training successfully without the help of my Pilates exercises and wearing my hernia brace (although it was impractical to wear it on race day) ten previous Ironmen and didn’t seem to suffer any ill effects.”
In September 2008, Roy reported that he had not worn his hernia brace for some time, was still very active, and had no sign of a hernia. He is considered fully cured.
A question mark over surgery
Researchers from the US, UK, Sweden, and other countries have measured the rate of long-term complications after hernia repair surgery. It’s not good news. For example, Loos and her colleagues in the Netherlands found that of 1,766 men followed for three years using a questionnaire, 40.2 percent still suffered some degree of pain and 1.9 percent experienced severe pain. One fifth of the patients felt that their work or leisure activities were affected.
Some surgeons are very concerned that patients are routinely sent for this surgery even though their hernia may be quite small and painless. The early surgery policy is intended to prevent a hernia from progressing and avoid the risk of “strangulation,” an emergency situation. But now it has been shown that strangulation is not very common. Many surgeons now follow a policy of “watchful waiting” (monitoring) for a hernia rather than offering immediate surgery. In the UK, elective hernia repair surgery has been reclassified as ‘low priority’ by a growing number of regional health policy makers.
What do men like Anthony and Roy who have healed their own groin hernias have in common? On websites dedicated to non-surgical alternatives, the most frequently successful alternative system seems to be an exercise program like Pilates to strengthen the abdominal area. Next in importance is the use of a hernia support garment to keep the hernia “in.” This is crucial. If the hernia is allowed to remain protruding, it will prevent the gap in the abdominal wall from healing.
Today, most physicians and surgeons do not prescribe trusses and some strongly advise against them. Even today, some trusses use metal springs to apply pressure to the hernia, through a pad that can be quite hard and put pressure on the hernia. This bulge can cause scar tissue to form around the edges of the hernia, preventing them from coming together and healing. To keep the hernia in, the pad must remain in contact with it at all times and during all activities. Most trusses cannot follow the movement of the body and therefore do not.
A hernia brace should fit snugly, be comfortable, keep the hernia in at all times, and have no springs or pads that protrude inward. It must have a guarantee to keep a hernia in the muzzle, even during sports and heavy manual labor, and it must have a money-back guarantee. Also be careful with hernia brackets with metal components, as they can set off alarms at airports. The best type of hernia support consists of an elastic belt with stiff, flat pads that slide together in such a way that the area of the hernia is supported at all times.
Healing your own inguinal hernia is not such a new idea. After all, a famous 19th-century German clinic known as the Bilz Clinic considered hernia cures common and recommended simple exercises, mineral baths, and conscientious use of a truss or hernia support until the hernia healed.