Follow this cycling Physical Therapist's approach to safely and effectively cycling with a hernia.
Turn your head and cough! When I was a middle school student, the word “Hernia” made me run for the locker room door. Back then, exercise was bad, and cycling with a hernia was out of the question. As time passed, I became tolerant of those gym class physicals, but not the cycling with a hernia part.
The more we know, the better we do. Now hernias are a fact of life for many and a health condition that, when identified and treated early, is something to live with without incident. That goes for exercise too. The only thing worse than cycling with a hernia for the avid rider is not cycling with one.
Cycling With a Hernia
Researchers suggest that 27 percent of males and 3 percent of females will suffer a hernia during their lives. The incidence that you or one of your mates is cycling with a hernia is relatively likely.
Most hernias aren’t necessarily dangerous. Cycling with a hernia is safe if you’re aware and intelligent about how you approach your riding. However, a hernia will not improve on its own and can become a life-threatening condition if not handled appropriately.
What is a Hernia?
The wall of our abdomen consists of multiple layers of connective tissue, muscle, and skin. They create a strong barrier preventing the contents of our gut, like our intestines and other organs, from exiting our bodies.
Most hernias occur within the abdominal cavity between the chest and the hips. When a weakness develops in the abdominal wall, the contents protrude, causing a hernia.
Several types can affect riders when cycling with a hernia. According to the Mayo Clinic, inguinal hernias are the most common and affect more men than women.
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The inguinal canal is a passageway for reproductive structures and vessels prone to weakness. When a portion of the intestine or fatty tissue pokes out into the groin above the thigh, it creates an inguinal hernia.
Femoral, umbilical, diaphragmatic, epigastric, incisional, and hiatal hernias are less common. When cycling with a hernia, the term Sports Hernia may come to mind.
A sports hernia isn’t technically a hernia, but the signs and symptoms are similar. Sports hernias occur when the trauma of contact or repetitive explosive sports causes a tear in the tendons that attach to the pelvis.
Symptoms and Diagnosis of Cycling With a Hernia
You will see the signs well before cycling with a hernia. There will be a bulge near your pubic bone in the case of an inguinal hernia. You may experience burning and pain when bending over, coughing, and straining to lift or have a bowel movement as the bulge becomes more pronounced.
Men occasionally suffer testicular pain and swelling if the protrusion descends into the scrotum. When touching the area of the hernia, there will be tenderness and a feeling of weakness in the abdominal wall.
Cycling With a Hernia Self-Test
If you suspect you may have a hernia, follow these steps.
- Check for a bulge in the abdomen near the pubic bone when you are bent forward with your hands on the handlebars.
- If you detect a lump, place your hand on it while dismounting from the bike and lie down.
- You may have a hernia if the bulge disappears from under your fingers.
- A hernia is very likely if you experience discomfort when coughing and straining and the area pops out.
If your self-test is positive, contact your physician immediately. Cycling with a hernia is not an emergency, but if left unchecked, it can be. Your healthcare professional will perform a physical exam, and soft-tissue imaging, like a CT scan, will give a definitive diagnosis.
What to Watch Out For When Cycling With a Hernia
Occasionally, an untreated or progressively worsening hernia will develop complications and become a medical emergency.
If the portion of the intestine protruding through the abdominal wall or into the inguinal canal gets blocked, it creates an obstruction. If it gets trapped and cuts off the blood supply, strangulation occurs, and tissue death will result without immediate surgery.
Severe stomach pain, nausea, vomiting, and extreme tenderness in the abdomen or groin are signs that you shouldn’t neglect. If the hernia bulge turns red, purple, or dark, or you cannot have a bowel movement or pass gas, call for help.
A routine hernia that doesn’t improve or your doctor feels is at risk for complications may require non-emergent elective surgery. Your doctor will discuss the post-surgical recovery and when you can get back in the saddle. Most surgeons suggest waiting six weeks and easing into it.
Causes of Cycling With a Hernia
The good news is that cycling will not cause a hernia most of the time. Except, of course, in extreme cases, if a rider exerts tremendous effort and holds their breath while straining. Or when the trauma of an all-out sprint of an out-of-the-saddle hill climb damages the abdominal wall.
In most cases, hernias (inguinal and femoral) are the result of a congenital (present since birth) weakness of the muscles and tissue of the abdomen. However, risk factors include aging and the repetitive stress of excessive physical exertion, obesity, pregnancy, constipation, and coughing.
Can You Cycle With a Hernia?
The short answer is, “Yes, you can!” If your doctor gives you the okay, of course. Low-impact activities like cycling, walking, and swimming is safe bets. That is, if you’re wise in your approach.
Be careful to limit the traumatic stress of out-of-control sprinting. Never hold your breath while performing strenuous efforts. Be sure to watch your form when climbing out of the saddle. Stop cycling with a hernia if you experience pain. You’ll want to re-assess the situation.
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What You Can Do To Help Cycling With a Hernia
Exercise is essential to treatment, recovery, and daily life when suffering from a hernia. Core strength is vital for every athlete, especially when cycling with a hernia.
Here are a few core strengthening exercises you can do. Follow this Dead Bug Exercise Series for safe and effective core strengthening.
A Few Tips to Make Cycling With a Hernia Safe and Effective
- A proper bike fit by a certified professional is essential. If you’re in a stretched-out position, or the handlebars are low, your trunk will be bent too much, placing excessive pressure on the hernia region.
- A comfortable, padded saddle will reduce pressure on the affected region.
- Wear tight cycling shorts to reinforce your abdominal wall and create a barrier like wearing a hernia belt (a device designed to act as a reinforcing barrier for the abdominal wall).
- Don’t ever hold your breath.
- Take frequent off-the-bike breaks if the hernia area becomes irritated or uncomfortable.
- Stop immediately if the pain goes from achy to sharp or becomes unusually intense while cycling with a hernia.
- Contact a healthcare professional immediately if your symptoms persist or worsen.
Conclusion—Cycling With a Hernia
Maintaining the enjoyment of cycling with a hernia is not only possible, but it’s also probable. You can reduce pressure on the hernia region by making a few simple adjustments to your bike positioning and riding style.
Add some core exercises to your training regimen and watch for the signs of complications. You will be cycling with a hernia without worry.
Does cycling with a hernia have you worried?
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Semi-retired as owner and director of his private Orthopedic Physical Therapy practice after over 20 years, Chris is blessed with the freedom to pursue his passion for virtual cycling and writing. On a continual quest to give back to his bike for all the rewarding experiences and relationships it has provided him, he created a non-profit. Chris is committed to helping others with his bike through its work and the pages of his site.
In the summer of 2022, he rode 3,900 miles from San Francisco to New York to support the charity he founded, TheDIRTDadFund. His “Gain Cave” resides on the North Fork of Long Island, where he lives with his beautiful wife and is proud of his two independent children.
You will read him promoting his passion on the pages of Cycling Weekly, Cycling News, road.cc, Zwift Insider, Endurance.biz, and Bicycling. Chris is co-host of The Virtual Velo Podcast, too!
