Postpartum Umbilical Hernia | When Your Body Just Can’t Take the Pressure

Umbilical hernia after pregnancy, or postpartum hernia, is related to the discussion on diastasis recti. As is Prolapse. Let me explain. And at the bottom of this post there are links to get the right help.

Hernia, diastasis recti and prolapse are all caused by the same problem: Excessive intra-abdominal pressure, meaning too much pressure inside your abdomen and/or pelvis.

This pressure has buit up inside your body and has nowhere to go but outwards and downwards and so eventually something has to give. I have discussed diastasis recti at length on this blog and pelvic organ prolapse is discussed here but today, let’s talk hernia.

WHAT IS A HERNIA?

A hernia is when a bit of your body that should be inside (like part of your intestine or bowel) actually pokes out through a weak spot in your abdominal wall. You will see a bulge, or an outie belly button, or a thumb-shaped protrusion. It may feel tender to touch, you may be able to gently push it back in sometimes and you will be more aware of it when you strain (lifting something heavy, or coughing or sneezing).

There are different types of hernia but the one most likely to affect women during or after pregnancy is an umbilical hernia ie located at or near your belly button (umbilicus). An incisional hernia is another type of hernia which can sometimes occur after surgery of the abdomen (such as c-section).

Umbilical hernia is the one most associated with the pregnancy or postpartum period and it’s the one I’m going to talk about here.

It will look and feel like: an outie belly button or protrusion, a soft bulge or a swelling, possibly with a dark tint to the skin in the area.

WHAT CAUSES A HERNIA?

A hernia, along with diastasis recti or prolapse, is caused by excessive intra abdominal pressure. That’s pressure inside your abdomen and pelvis, that is pushing away – out and down. In the case of umbilical hernia, it pushes so hard that part of an organ or other tissue actually pushes right through the abdominal wall at the weakest point (at or near your belly button).

This is the important bit. See I will come onto the ‘What You Can do About It’ in a moment, but unless you change the direction and force of the intra abdominal pressure that caused the problem in the first place, you may be heading for a recurrence of the hernia, or  some other pressure related condition.

There are some factors which can make the pressure inside your abdomen high: multiple pregnancies (both in terms of more than one baby and more than one pregnancy!) especially if closely spaced. Obesity can be a contributing factor, as can any straining, such as heavy lifting, or violent or prolonged coughing.

But having more than a couple of babies, or moving heavy furniture around don’t cause hernia on their own. Your body is perfectly capable of doing those things, if your core is working right.

Whole body alignment, meaning the way you carry your body every day, as well as the strength (or lack of strength) of your core muscles: the ones that support your entire abdominal and pelvic region… these are what you need to address to minimise the risk and the effects of hernia. These muscles need to be not just ‘strong’, but functioning optimally, to keep everything in. They also need to be aligned correctly so that the pressure inside your abdomen is drawing and holding you in, not pushing it all away.

Your core muscles consist of your Transverse Abdominis muscle (your deepest abdominal muscle), the Multifidus muscles of your spine, your diaphragm (separates your lungs and the organs of your chest cavity from all the stomach bits and enables you to breathe), and your pelvic floor. Their job is to contain that entire abdominal and pelvic cavity, and to regulate pressure within it, comfortably and without strain.

HOW DO YOU FIX A HERNIA?

Well, you may need to have surgery, and whether or not this is advisable or the best course of action for your particular circumstance is obviously a matter for you and your doctor.
Doctors won’t always advise surgery to fix a hernia and sometimes they may suggest you leave it alone. Surgery is likely to be recommended if the hernia is causing pain or distress or is getting bigger.

Surgery to repair hernia is common, whereby your surgeon will effectively push the offending protruding part back where it belongs then sew up the hole. (Technical terms, obviously). Some procedures use a surgical mesh to reinforce the abdominal wall. There are many good online medical resources, some of which I’ve listed below.

NON-SURGICAL TECHNIQUES + EXERCISES TO RELIEVE OR PREVENT HERNIA

1. The first thing you can do to relieve the pressure inside your abdomen is to stand right. You see, if you tuck your backside underneath you, or walk in high-heeled shoes all the time which thrusts your pelvis out in front and strains your hip flexors and knees, if you bend your knees all the time when you stand or stick your chest out or your chin up… your body isn’t in a straight line and its not holding itself up properly. What that means for your midsection, is that you’re increasing the pressure within your abdomen. Learn more about how to stand right here and for a more scientific explanation of the biomecahnics, see  the ‘Under Pressure’ links below.

2. Next you need to find, train and then strengthen your core muscles, which include your pelvic floor. You can read more about doing the right ab exercises here and a summary of the key ‘Core’ facts here.

3. You need to stop doing some things: certain exercises that strain and exert pressure on your abs and pelvic floor like sit ups or crunches; and you need to not only learn to do the right ab exercises, but also how to use your core effectively and optimally during every workout or movement. It’s no good carefully doing your breathing exercises and finding your transverse muscle, and then straining your way through a bootcamp session or a breath-holding kettle bell swinging routine without your core active, stable and supporting you.

4. You need to be aware of how your body is positioned and working (don’t worry – you won’t always have to think so hard about it) when you pick up your baby or toddler, when you haul a heavy basket of laundry or when you shut the car door with a karate kick whilst holding an infant seat and finding the keys in your pocket… Your core needs to be trained how to work right the whole time. Don’t panic – It will learn, it’s  just forgotten and you need to re-teach and re-align yourself to work right and relieve the pressure. “Lift yourself  [belly button to spine on an exhale, pelvic floor lifted, with no butt tucking or shoulder tensing] before you lift your baby” is a great mantra to live by.

5. This will help too ;)  MuTu Focus: the Essential Foundations of a Flatter Post Baby Tummy focuses exclusively on strengthening and realigning your core and whole body posture to reduce this pressure, as well as relieve back pain, flatten your tummy and tone your pelvic floor You can follow the entire 8 week program online or on DVD.

FURTHER RESOURCES + LINKS

 

WHEN TO SEEK SPECIALIST PERSONAL HELP – MORE INFORMATION ON CONSULTING WITH A WOMEN’S A HEALTH PHYSIOTHERAPIST

Great information in this article ‘What is Pelvic Health Physiotherapy?’ from Pelvic Guru 

… and also from Tracy Sher at the Pelvic Guru, The Ultimate Pelvic Anatomy Resource! Links, articles and videos – this post has EVERYTHING and is kept updated – an amazing resource.

Downloadable (free) PDF information leaflets and very helpful diagrams available from the International Urogynecological Association (IUGA) (click ‘Patient Leaflets’)

The Association of Chartered Physiotherapists in Women’s Health (ACPWH)

‘Under Pressure’ on Katy Bowman’s blog at Aligned and Well

The NHS on hernia

WebMD on umbilical hernia in adults

Health Central on umbilical hernia repair in adults

The FDA announcement on surgical mesh

Medical papers / more technical:

NCBI / PubMed on umbilical hernia repair

  • Nicky

    I found this website really helpful and appreciated the further reading on the topic.
    Thanks. I’m only 7 weeks post partum and having my suspected hernia checked this week. My tummy is normally my pride and joy and I want to do everything I can to make it look better now. I feel a lot more confident that something can be done through the right exercise. Thanks again!!

    • http://mutusystem.com/ Wendy Powell

      I’m glad it helped Nicky :)

  • lu

    It has been over 2 yrs since I had my baby. Can I still “get fixed” with your program?. I have a mild prolapse and horrible posture….not what I used to be. Will my organs go back in place now after so long?

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  • michelle

    I have all three issues listed in this article. Took a lot of doctors,3 years and feeling “crazy” to get some answers. First time I’ve seen anything written will all of these put together. Thank you.
    I have been running before,during & after my two girls were born. Stopped any ab work and boot camp like stuff to have have anymore damage done.
    abs are very weak now and lower back pain at times,I would like to start this new class called Pure Barre that is low impact,core work and stretching (all which I NEED) Your thoughts?
    I thought that if I at least made the muscles strong it could “hold” what “things” it is holding in better,lol.
    Not sure why pregnancies (had it with first then C-section with 2nd) caused this. Not overweight,workout…bad luck I guess! But got two healthy babies ;)
    Thanks for any info.

    • http://mutusystem.com/ Wendy Powell

      I’m so happy you found the information helpful. Our programs incorporate the workouts your need, but always with your core weakness + instability in mind – they are safe + effective – you can see how to choose the right one here http://mutusystem.com/download-the-mutu-system-coaching-programme.html

    • val

      Sorry to butt in on your question as to why a c section and normal pregnancy would cause this – a hormone is released during pregnancy and birth that relaxes the ligaments and tendons throughout the body. So, when the tendons are weak and the muscles aren’t up to par after birth, this tends to cause a jumble for the organs. I’m not sure if Mrs. Powell suggests this in her program ( I’m going to try the program out after I talk with my doc) but the addition of collagen type 1&3 and glucosamine with chondroiton would help to restrengthen ligaments and tendons along with proper exercise. Wish I had followed my own advice, but I didn’t want to take any supplements for fear of what it may do to my breast milk.

  • Gecko

    Hi, I have two children and was completely fed up and depressed that I still looked 6 months pregnant. A holiday in Disney land was the last straw, where I was advised in 5 different rides that I should not continue in my condition! I know the staff were only doing their job, but it did ruin the holiday for me :( my wonderful GP referred me for physio that didn’t gave any effect. I returned to my GP some months later and after she examined me again, she referred me to an abdominal surgeon with diastis recti/ possible hernia. The surgeon confirmed a ventral/umbilical hernia. I had surgery December 2013 and all is going well and healing nicely. Now that my abs are back in the correct place, Would your MuTusystem be good for me to now tone up my core? Obviously I wouldn’t want to undo the good work of the surgery.
    Thanks for your time and feedback

    • http://mutusystem.com/ Wendy Powell

      Yes – its perfect to hep you reconnect, restore + then strengthen those muscles – see the FAQ pages for more help on post-surgery + hernia http://mutusystem.com/faq.html

  • Erika L.Cortez

    Hi I have 2 kids my oldest going to be 6 and my baby she just turn 3 I just hade a umbilica hernia repair surgery but my muscles are very week I a have díastasis recti my belly has this weird shape no matter how much I tried to lose weight it always seems like if I’m pregnant I want to restored my abdominal muscles if u guys can help me it will be awesome I want to do this to feel better about my self and my body and better health

    • http://mutusystem.com/ Wendy Powell

      The Focus program would be the one to go for Erika. Gentle core restoration + recovery.

  • Apical

    I have pain in my knees from doing lunges and my orthopedic advised me not to do them, will the squats in the program be bad for my knees?

    • http://mutusystem.com/ Wendy Powell

      If you have been told by a Doctor to avoid certain movements then please follow that advice. I would recommend you ask him / her regarding squats as it will depend on your individual diagnosis.

  • LL

    Hi Wendy! I am so very interested in your system but I’m not sure what order to do it in. I do have diastasis recti and an umbilical hernia which has been very uncomfortable for me. Would you recommend doing hernia surgery first then mutu?

    • http://mutusystem.com/ Wendy Powell

      Consult with your doctor regarding any surgery. MuTu Focus (not 12 Week, you shouldn’t do the Intensive workouts at all) may compliment treatment before or after surgery but your Doctor will be able to advise for your individual circumstances

  • shelby

    Can I get mine fixed if I’m 20 wks pregnant? This is my 3rd baby and the hernia is causing so much pain and discomfort now!

    • http://mutusystem.com/ Wendy Powell

      MuTu Focus is recommended to help ease symptoms, but you need to consult a Doctor regarding ‘fixing’ anything Shelby, especially during pregnancy + especially if you are in pain please do this right away!

  • Nene Brown

    One of my kids always poke my belly button and im 2mths along but I wanted to.know why did it hurt so.bad to.the point im in tears and send sharp pain through my body what is this pain from?

    • http://mutusystem.com/ Wendy Powell

      Please consult with a medical professional as soon as possible regarding any pain Nene – we can’t advise or diagnose!

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