Hernia Prevention

[Raymond]

Thanks Good intentions for the information, and your input as well. Also thanks to Mark T and William Bryant for their great input as well.

Mechanically I would like to know what happens in the internal abdomen when someone runs. Are the intestines slammed up forcefully against the inguinal canal? It would be nice if there were a branch of science which studied the mechanical engineering of the internal body and tissue fibers. under various conditions.

[Good intentions]

I think that lifting belts are more for the back and to help maintain form. Not preventing hernias.

Have you ever thought about the design of the typical “jock strap”. Aka athletics supporter. They have some of the elements of a truss, with the wide band across the area of the inguinal canal. It might be that the design is a result of trial and hernia but I’m pretty sure that the purpose is hernia avoidance. p.s. be careful searching for “jock strap” on the internet. Use the term “athletic supporter” instead.

I think that wearing a truss or at least a supporter is not a bad idea in the months after hernia repair surgery. Unfortunately, as I’ve noted before, surgeons today do not really think much about the healing process. They put the mesh in, wait the two to three weeks, and set their patients free. If they do think about healing time, they seem to use the typical “percentage of final strength” curves that you can find here and there, and apparently assume that 80% or whatever at some short time frame is close enough. The goal is to get people back to work as quickly as possible. If a recurrence happens they’ll just start over.

Here’s a paper from 2020 that is pretty good. I see that the authors still think of the mesh as maintaining its physical properties after the pores are filled with new tissue. They don’t seem to understand how fiber-reinforced composites work. It doesn’t have the properties of human tissue or mesh after “incorporation”.

Anyway, this might give some ideas. I pulled out a small part about tissue strength but the whole thing is worth reading. Fixation might be more important than it’s thought if the whole healing process is considered.

https://www.sciencedirect.com/science/article/pii/S2666138120300025

Engineered Regeneration
Volume 1, 2020, Pages 19-33
Engineered Regeneration
Hernia Mesh and Hernia Repair: A Review
Carmine Wang See, Tiffany Kim, Donghui Zhu

“…
4.2. Mesh Reinforcement in Tissue
The purpose of using a mesh is to provide a platform for native tissue to colonize through fibrotic reactions in the tissue [52,53]. A strong mesh aponeurosis scar tissue (MAST) complex reinforces the weakened abdominal tissue when implanted. MAST formation happens when connective tissue is deposited onto the mesh pores and filament (Fig. 5) [38,44]. The newly formed MAST tissue takes about 6 months to attain 70-80% of mechanical strength of native tissue [44].
…”

[MarkT]

Is there any evidence that lifting belts (or other ‘protective’ gear/clothing) help prevent primary hernias or recurrences though?

I did a very quick search on lifting belts and located several studies that found their use increases intra-abdominal and intra-thoracic pressure at certain points during certain lifting exercises, may provide a performance-enhancing benefit allowing subjects to lift more weight, and may provide a modest reduction in stress on spinal discs. I did not find anything that suggested a preventative effect for primary hernias or recurrences though.

I know that some medical device sites, and even some hernia surgeons’ sites, suggest that ‘protective clothing’, such as belts and trusses, may not merely help manage hernia symptoms, but may actually help prevent hernias and recurrences…but is this evidence-based advice?

[Raymond]

Thanks Mark. I love to jog, and sometimes pick up the pace for my runs which usually do not exceed 8 miles, and on average are around 4 miles; 5 times per week. So that should give you some context. Mechanically I don’t know what kind of pressure that places on a surgically repaired hernia.

However if Lifting belts help prevent hernias, then I would think that adaptive equipment like tighter spandex type shorts could help support the abdominal wall around where the surgery occurs. Functional abdominal support and hernia prevention is my preference rather than strictly comfort.
If someone were to invent such a short, I would think that it would be in great demand. It would cut down on more revision surgeries I would hope, don’t you think?

[MarkT]

I think those clothing recommendations are more for comfort than anything, and I highly doubt they serve to prevent recurrence.

Generally speaking, you should not be able to damage an inguinal hernia repair with normal activity after surgery and resumption of light to moderate physical exercise is essentially based upon a patient’s pain tolerance during recovery.

Atypical repair cases or resuming more intense activities (e.g., returning to sports, weight lifting, etc.) should probably be discussed with your surgeon. There are a wide variety of recommendations out there on whether (and to what extent) activities of various kinds should be restricted.

[William Bryant]

https://www.herniapants.com/hernia-underwear.html

Orione in grey I went for

[William Bryant]

You can buy hernia pants which are similar. I wore them to one consultation and the surgeon said they’d be really good for after surgery.