Fist full of hernia part 2: So you’ve blown your guts out. Now what?

Written by: Adam Thomas

So, You blew your guts out, now what?

There are different places a hernia can occur. The most common are Femoral, Inguinal, umbilical, abdominal and hiatal. Each of these hernias has slightly different consequences on when you can return to Brazilian Jiu-Jitsu (BJJ). For the purposes of this writing we are to focus on the recovery (i.e. once you have been formally diagnosed and operated on). There is not enough space to cover diagnosis, non-operative treatments, and consequences of non-treatment.

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Define Hernia: A condition in which part of an organ is displaced and protrudes through the wall of the cavity containing it (often involving the intestine at a weak point in the abdominal wall). Or in plain English, you pushed your insides to the outside.

Is it painful? Yes usually. Why? Because of local tissue entrapment, inflammation, and nerve pressure. Consequences? Yes. The worst consequence being that it is possible that part of the intestines that have protruded out can get stuck (strangulated) causing a medical emergency for the safety and longevity of bowel health.

Surgical choice between keyhole and open cut surgical methods does not appear to effect recovery times. However there is anecdotal evidence (i.e. not research proven) that open hernia repairs have a lower fail rate and therefore are often preferred choice by the surgeon. However each professional will have their particular skill set and opinion based on their best knowledge at the time you consulted with them. Once the hernia has been reduced (replaced inside) the surgeon will most often insert mesh to create stability over the opening to ensure no reoccurrence. This mesh is analogous to a trellis which a vine grows in and around. As your body heals the scar tissue forms a solid intertwining with the trellis making a solid recovery of the region stabilising the hernia in situ.

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As a result of the surgical incision, placement of the mesh into the abdominal wall and localised trauma from the incident of herniation itself healing time is somewhat individual. Depending on your state of health, previous, medical history, diet, fitness and post surgical expectations the time will vary. Generally speaking to return to contact sports such as BJJ you would expect to be rolling between 6 – 8 weeks after the operation. However as with all injury rehabilitation this should occur gradually and on an ‘as tolerated’ basis.

Here are some generic guidelines:

Return to sedentary jobs such as deskwork with no requirement to lift more than 10kg within 10 days.

Return to light to moderate physical activity such as delivery drivers, maintenance men, light construction/plumbing jobs with lifting required up to but not over 25kg within 3 weeks. Many non contact sports not requiring lifting also fit into this timeframe. However for Brazilian Jiu-Jitsu you fall in to the heavy lifting/contact sport category, which requires the longest of times frames, being 4-6 weeks.

As a rule of thumb (remembering every person is different and this is not direct advice for your personal circumstances), you can light jog/swim after 10 days, you can perform body weight exercises after 3 weeks, lightly drilling technique with a partner you can trust after 4-5 weeks and return progressively to rolling (trusted partners) after 6 weeks. All going well back to rolling at comp speed after 8 weeks.

If you are the academic type and want more info on N/cm pressure tolerance or intra-abdominal pressure measured in mm/Hg to nerd out on check out:

Forbes, J., Fry, N., Hwang, H., Karimuddin, A. (2012). Timing of return to work after hernia repair: Recommendations based on a literate review. British Columbia Medical Journal (54:7). Pages 342-345.

Adam Thomas
Osteopath Central
2/2 Classic Way, Burleigh Waters, Qld
0425 876 929 for appointments.

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