Abdominal Exercise Following Abdominal Hernia Repair

It's important to exercise after hernia repair, with mesh or without. If you've had the problem for a while, your ability to perform physical activities might already be limited.

However, strengthening your abdominal muscles after hernia surgery needs to be done the right way to prevent further complications.

​Read more:​ How to Strengthen Your Muscles to Prevent a Hernia

Follow your surgeon's specific recovery instructions before performing core exercises after hernia surgery. In general, you will likely be up and walking around and doing light activities within the first two weeks after surgery. However, strenuous exercise and heavy lifting are typically delayed four to six weeks, according to NHS.

In addition to healing time, how soon you are able return to activity such as strengthening abdominal muscles after hernia surgery also depends on your level of postoperative pain, according to a September 2012 literature review published by ​British Columbia Medical Journal.​

While you can't jump right in to sit-ups after hernia repair, you can begin gently strengthening your abdominal muscles. If you experience pain with exercises, stop immediately and contact your surgeon.

​Move 1:​ ​Abdominal Draw-In​

Perform the abdominal draw-in exercise, as demonstrated by Princeton University Athletic Medicine, at less-than-full effort when starting out.

1. Lie on your back, on a firm surface. Bend your knees and place your feet flat on the ground.
2. Place your hands on your hips, resting your fingertips approximately 2 to 3 inches inside your hip bones.
3. Tighten your abs as if you are pulling your belly button down to your spine. Your lower back will flatten into the floor, and you should feel the muscles under your fingertips tighten.
4. Hold for two to three seconds; then relax. Repeat 10 times.

Progress your abdominal draw-in by adding arm and leg movements, once you can do three sets of 10 repetitions without difficulty. Here are some options:

• Draw one knee in toward your chest; then lower. Alternate sides.
• Draw both knees in toward your chest at the same time; then slowly lower. Do not allow your low back to arch — if it does, you aren't yet strong enough for this variation.
• Slide your heel along the ground until one leg is straight. Slowly slide your heel back up toward your buttocks until you reach the starting position.
• Drop both knees to one side as far as possible, without allowing your hips to leave the ground. Rotate the opposite direction.

​Move 2:​ ​Double-Leg Bridge​

While strengthening your abdominal muscles, also include your glutes and lower back muscles that work together with your abs to stabilize your core.

1. Lie on your back with your knees bent. Perform a pelvic tilt and maintain this contraction throughout the exercise.
2. Push down through your heels and squeeze your buttocks together to lift your hips off the floor, as high as possible, without pain. Do not allow your shoulder blades to come off the floor.
3. Hold for two to three seconds; then slowly lower back down. Perform 10 repetitions, working up to three sets in a row.

When this bridging exercise is no longer challenging, advance the double-leg bridge into the single-leg bridge. Straighten one leg and raise it up until the bottom of your foot is pointed toward the ceiling. Perform a bridge as previous, balancing on one leg only. Repeat five times on each side.

Other variations of the bridge include crossing your arms over your chest to decrease your base of support, marching your legs while in a bridge position and bridging with your feet on top of an exercise ball.

​Move 3:​ ​Forearm Planks​

Planks are effective for strengthening abdominal muscles after hernia surgery. This movement can be easily progressed as your ab strength improves.

1. Lie on your stomach on a firm surface. If this is uncomfortable, move into plank position from your hands and knees.
2. Bend your elbows and place your forearms on the floor underneath your shoulders.
3. Keeping your legs together, push down through the balls of your feet and lift your body up into a straight position from head to toe, supporting your upper body on your forearms.
4. Hold for 10 seconds, working up to one minute between rest breaks.

​Move 4:​ ​Side Plank​

The side plank emphasizes the oblique muscles — abdominal muscles that rotate and help stabilize your core.

1. Lie on your side with your legs stacked on top of each other. Prop your upper body up on your forearm.
2. Push down through your forearm and bottom foot to lift your torso off the ground until your body forms a straight line.
3. Hold for 10 seconds to one minute, and repeat on both sides.

​Move 5:​ ​Dead Bugs​

Despite its odd name, the dead bug exercise is an advanced abdominal strengthening exercise. Perform an abdominal draw-in and maintain a tight core during this exercise.

1. Lie on your back on a firm surface. Straighten your elbows and raise your arms, reaching your hands toward the ceiling.
2. Bend your knees and flex your hips to 90 degrees. Your shins should be parallel to the ground. This is the starting position.
3. Slowly lower one arm over your head while simultaneously lowering the opposite foot toward the floor. Keep your arm straight and knee bent.
4. Hold for one to two seconds; then return to the starting position. Repeat on the opposite side.

​Read more:​ Can I Exercise With a Hernia?

Not all abdominal strengthening exercises are appropriate after hernia repair. Avoid performing crunches or sit-ups lying over an exercise ball. This puts a significant amount of stretch on your recently repaired muscles.

Lifting heavy weights, even if you aren't directly targeting your abs, requires you to brace your core. Avoid barbell exercises until specifically cleared by your surgeon. Instead, use strength training machines that stabilize the weight for you, reducing pressure on your core muscles. Exercises that require significant pushing or pulling, such as using a row ergometer, should also be avoided until you are fully healed.

If you have any concerns about exercising after surgery, consult a physical therapist for an individualized exercise program. Physical therapy after hernia surgery focuses on pain management, progressive strengthening exercises and returning you to normal daily activities in the safest way possible.