A hiatal hernia is a common medical condition where a portion of the upper stomach pushes through a hiatus, or opening, in the diaphragm muscle and into the chest.
While it’s most common in older adults, age isn’t the only risk factor for a hiatal hernia. It can also be caused by strain on the diaphragm from prolonged heavy lifting and coughing, as well as from lifestyle factors like smoking.
Hiatal hernias do not usually cause symptoms. In some cases, though, hiatal hernias cause stomach acid to leak into the esophagus. This is called acid reflux or gastroesophageal reflux.
If you do have acid reflux because of a hiatal hernia, certain exercises can aggravate your symptoms.
There are two types of hiatal hernia:
- Sliding hernia – A sliding hernia happens when the top of the stomach and the lower part of the esophagus squeeze up into the space above the diaphragm. This is the most common type of hiatal hernia.
- Paraesophageal hernia – A paraesophageal hernia happens when the top of the stomach squeezes up into the space above the diaphragm. This is not very common, but it can be serious if the stomach folds up on itself. It can also cause bleeding from the stomach or trouble breathing.
Exercise is one way to manage many chronic health conditions, and losing weight can help minimize the symptoms of a hiatal hernia.
However, certain exercises can actually make your hiatal hernia worse by putting strain on the abdominal area or aggravating heartburn, chest pain, and other symptoms.
You don’t have to avoid exercise entirely, but you’ll want to focus on workouts that won’t aggravate your hernia. Talk to a doctor about the following exercise considerations before you get started.
Overall, you can work out if you have a hiatal hernia. Exercising can also help you lose weight, if needed, which may improve symptoms.
It is important to note that if you have been diagnosed with a hiatal hernia and are asymptomatic (i.e., not having symptoms), you do not need to worry about changing your exercise routine.
However, if you are experiencing acid reflux type symptoms due to a hernia, high intensity exercises may exacerbate your symptoms.
Until you determine your triggers, you may need to try different intensities of exercise to determine what aggravates your symptoms.
For example, if you run for 30 minutes and begin to experience heartburn, try instead a walk-run program for 30 to 45 minutes (run 2 minutes, then walk 2 minutes, etc.).
The following exercises are considered safe for a hiatal hernia:
- gentle or modified yoga, without inversions
If you look online for “natural” ways to treat a hiatal hernia, some websites tout diet along with specific exercises that are said to strengthen your abdominal area.
It’s debatable whether strengthening exercises can actually treat a hernia, or if they just minimize your symptoms. In any case, consider talking to a doctor about the following exercises.
Exercises to strengthen the diaphragm
Diaphragmatic breathing consists of deeper breathing techniques that help increase the efficiency of oxygen flow. Over time, these exercises may even help strengthen the diaphragm muscle. Here’s one method:
- Lie down or sit in a comfortable position, placing one hand on your belly and the other on your chest.
- Breathe in as deeply as you can until you can feel your stomach press against your hand.
- Hold, then exhale and feel your stomach move back away from your hand. Repeat for several breaths each day.
Yoga exercises for hiatal hernia
Gentle yoga exercises can help hiatal hernia in a few ways. First, the deep breathing techniques can strengthen your diaphragm. You’ll also see increased strength and flexibility overall. Some poses, such as Chair Pose, are thought to help strengthen the abdominal area without straining it.
Be sure to tell your yoga instructor about your condition so they can help modify the poses. You’ll want to avoid inversions that may worsen your symptoms. These may include Bridge and Forward Fold.
Exercises for weight loss
Losing weight may improve your symptoms of a hiatal hernia. Exercise, along with diet, can help create the calorie deficit needed to burn body fat. As you lose weight, you may notice your symptoms decrease over time.
It may be difficult to prevent a hiatal hernia, especially if you have risk factors or if you were born with a large opening in your diaphragm. Still, there are habits you can adopt to help minimize your symptoms, including:
- quitting smoking, with help from your doctor who can create a cessation plan that’s right for you
- not lying down after eating
- avoiding heartburn-triggering foods, such as onions, spices, tomatoes, and caffeine
- not wearing tight clothing and belts, which can make acid reflux worse
- elevating the head of your bed between 8 and 10 inches
While the symptoms of hiatal hernia can become a nuisance, this condition is extremely common. In fact, it’s estimated that about 60 percent of adults have hiatal hernias by age 60.
If you are experiencing acid reflux type symptoms because of a hiatal hernia, intense exercise may exacerbate symptoms. However, you shouldn’t rule out exercise entirely.
Some exercises — especially cardiovascular routines — can help you lose weight if needed and improve your symptoms. Others might help strengthen the diaphragm.
Talk to a doctor before you start these exercises, especially if you’re new to working out. They can also help you establish a routine with room for gradual improvements.