Hernia, diastasis recti, and prolapse are all related to excessive intra-abdominal pressure, meaning too much pressure inside your abdomen and/or pelvis. Exercises for umbilical hernia and other issues stated, need to be carefully considered. 

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

What is an umbilical hernia?

A hernia is when a part of your body that should be inside (like part of your intestine or bowel) 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. This means a hernia 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).

An umbilical hernia 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, like diastasis recti or prolapse, is caused by excessive intra abdominal pressure. That’s pressure inside your abdomen and pelvis, that is pushing away (outwards). 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).

There are some factors which can make the pressure inside your abdomen high: multiple pregnancies (more than one baby at a time, and/or 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 doesn’t cause hernia on their own. Your body is perfectly capable of doing those things if your core is working right.

Important factors

Whole body alignment, meaning the way you carry your body every day is important. As is the strength (or lack of strength) of your core muscles. Your core supports your entire abdominal and pelvic region. You need to address core function to minimise the risk and the effects of hernia. They need to be aligned correctly so that the pressure inside your abdomen is holding you in, not pushing away.

Your core muscles consist of:

  • Transverse Abdominis muscle (your deepest abdominal muscle)
  • Multifidus muscles of your spine
  • Your diaphragm (separates your lungs and the organs of your chest cavity from all the stomach parts and enables you to breathe)
  • Pelvic floor

Your core’s job is to contain the entire abdominal and pelvic cavity, and to regulate pressure within it, comfortably and without strain.

How do you fix a hernia?

You may need to have surgery, and whether or not this is 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 a hernia is common, whereby the surgeon will push the offending protruding part back where it belongs, and then sew up the hole. 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. There are certain adjustments and exercises for umbilical hernia that can be done to relieve symptoms.

Non-surgical techniques & exercises to relieve or prevent hernia

Adjust your alignment

The first thing you can do to relieve the pressure inside your abdomen is to stand correctly. This means try not to: 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. Notice if you bend your knees all the time when you stand or stick your chest out or your chin up. All these factors could mean that your body isn’t in a straight line and it’s not holding itself up correctly. What that means for your midsection, is that you’re increasing the pressure within your abdomen. Learn more about how to stand right here.

Find your core

Next, you need to find, train and then strengthen your core muscles, which include your pelvic floor. This what the MUTU System program teaches you.

Try these exercises for umbilical hernia to find your core…

  1. Breath in and out gently
  2. On the Inhale, relax your tummy muscles and your pelvic floor. Let it all go.
  3. When you exhale, gently draw up and engage your pelvic floor and gently draw in your stomach. Tip: Imagine you are trying to pick up a grape or sucking a smoothie up through a straw with your vagina. That’s what this should feel like.
  4. Inhale again and let everything go. Your tummy and pelvic floor should relax.
  5. Exhale and engage your pelvic floor and stomach. Gently draw up your pelvic floor muscles and draw in your tummy.
  6. Repeat this breath sequence a few times each day. This is key to reconnecting with these muscles.

Stop doing…

certain exercises that strain and exert pressure on your abs and pelvic floor like sit ups or crunches. 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. MUTU teaches you this too :)

Try this exercise instead…

  1. Lie on your back, feet flat on the floor.
  2. Exhale and engage your core and lift both knees up to 90°. You can gently hold onto your knees with your hands.
  3. Inhale and relax in that position.
  4. Exhale, engage your core and pelvic floor and drop one heel to the floor slowly.
  5. Inhale and relax and release, keeping your heel on the floor for support.
  6. Exhale and engage your core and pelvic floor and lift your heel back up off the floor and back to 90°.
  7. Repeat the steps with the other leg and do for a few rounds.
  8. Remember to exhale on exertion, and inhale and relax when you rest.

Be aware of…

how your body is positioned and working 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 can totally learn, it’s just forgotten and you need to re-teach and re-align yourself to work right and relieve the pressure

Start here

MUTU System is the online, medically recommended web app exercise and recovery program with step-by-step instructions and exercises that only take 15 to 20 minutes. It will help you strengthen your core and pelvic floor, lose weight, and feel confident and great again. MUTU focuses 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.

Further resources & links

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

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’)

WebMD on umbilical hernia in adults

Medical papers / more technical:

NCBI / PubMed on umbilical hernia repair