Exercise guide
A hernia is when part of the bowel or fatty tissue pushes through a weak spot in the muscle wall, most often in the groin, at the belly button or through an old scar. Exercise can't close the gap, but most people can stay active with a hernia, and the British Hernia Society says being as fit as possible helps you prepare for surgery.
The evidence linking lifting to hernias is weaker than many people think, and advice on lifting after a repair differs: the NHS (National Health Service) says no heavy lifting for at least 4 to 6 weeks after a groin repair, while the international guideline says no restriction is needed. Follow your own surgical team.
This guide covers exercising with a hernia, lifting and core work, support belts, getting ready for surgery, the return after each type of repair, and exercising with a hiatus hernia and reflux, with 3D demos and the warning signs that need urgent help.
The British Hernia Society says you can exercise while you wait for surgery, and staying fit helps. You may need lighter weights with more repetitions, and if a movement hurts, stop. Exercise can't repair a hernia: only surgery closes the gap.
A review of 23 studies found too little evidence to say heavy work causes groin hernias. Jumping and coughing raised the pressure inside the tummy far more than lifting a light weight, and how you lift matters: breathe out and don't strain.
For men with a painless or barely painful groin hernia, waiting is safe: in a trial of 720 men, about 2 in 1,000 a year had a hernia become stuck. Many choose surgery later, mostly for pain. Women with groin hernias, and anyone with a femoral hernia, should have it repaired promptly.
Walk from the start. After a groin repair, the NHS says no heavy lifting or strenuous activity for at least 4 to 6 weeks, while the international guideline says no lifting restriction is needed. After a repair of a hernia through an old scar, European surgeons advise no heavy lifting or straining for 4 weeks.
People who exercise regularly have less reflux, but hard exercise soon after eating can bring it on. Our suggestion: leave a couple of hours after a meal before a hard session or heavy lifting.
Call 999 if a hernia becomes very painful, more swollen than usual or discoloured, or comes with being sick or not being able to fart or poo: it may be trapped, which is an emergency.
A hernia is where part of an organ, such as the bowel, or fatty tissue pushes through a gap or weak area in the muscle that keeps it in place. The main types are named by where they are: inguinal (where the leg meets the tummy), femoral (the top of the thigh), umbilical (at or near the belly button), incisional (through the scar of an earlier operation), hiatus (part of the stomach pushing up into the chest) and stoma hernias (by a stoma).
Usually a lump that may get bigger when you cough, sneeze or cry and smaller when you lie down, sometimes with a heavy, dragging feeling in the leg with a groin hernia. A hiatus hernia causes heartburn or reflux instead. Pain is more common with smaller hernias, and it can be a sign of strangulation, when the blood supply to the trapped tissue is cut off.
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Between 27% and 43% of men and 3% to 6% of women have a groin hernia at some point. Inguinal hernias are far more common in men, and femoral hernias in women, mainly over 50. Many babies have an umbilical hernia, which usually goes by the age of 5, and a hiatus hernia is very common over 50.
The British Hernia Society lists age, smoking, obesity, repeated straining, a long-term cough and frequent heavy lifting. For groin hernias, a family history, a previous hernia on the other side and being male add to the risk. After abdominal surgery, a higher body mass index (BMI), smoking, diabetes and a wound infection make a hernia through the scar more likely.
The risk of a groin hernia becoming stuck is under 3% a year, and only about 2 in 1,000 men a year in the largest trial. For a hernia through an old midline scar that goes back in, the risk of an emergency is about 1% in the first year and 2.5% over 5 years. Femoral hernias are different: most become tightly squeezed, so they need treatment in hospital. A strangulated hernia, where the blood supply to trapped bowel is cut off, is an emergency.
Most groin repairs are done through one cut in the groin or by keyhole surgery, usually with a mesh, as a day case. Over the years, 10% to 15% of people need another operation because the hernia comes back, and 10% to 12% have pain lasting more than 3 months, severe in 1% to 3%.
A sports hernia is groin pain without a lump and isn't a true hernia, diastasis recti is a stretched midline with no hole in it, and a herniated or slipped disc is a back problem. Our sports hernia, diastasis recti and herniated disc guides cover those.
No trial has tested exercise programmes in people with a hernia, so the advice on exercising with one is expert opinion. The trials here are about lifting, watchful waiting, activity after surgery and reflux.
A review of 23 studies found too little evidence to say whether heavy work causes groin hernias. In 17,967 Danish men followed through national records, direct (medial) groin hernias weren't linked with physical work at all, and indirect (lateral) ones were about 45% more likely in men who stood or walked for 6 hours a day or more at work. Exercise in their spare time wasn't linked with either. The international guideline calls the evidence on work contradictory and says heavy lifting may make a hernia more likely.
In 20 healthy adults, jumping and coughing produced by far the highest pressures inside the tummy, while lifting a 10-pound (4.5 kg) weight raised it only a little above standing. In 30 women, many activities people are often told to avoid after surgery, including lifting up to 20 pounds (9 kg) from a counter, climbing stairs, brisk walking and crunches, raised the pressure no more than getting up from a chair; lifting 35 pounds (16 kg) from the floor raised it most, and how the lift was done made a difference. Neither study looked at hernias themselves.
In a trial of 720 men with a painless or barely painful inguinal hernia, pain and physical function after 2 years were similar with waiting and with surgery, and a hernia became stuck in about 2 men per 1,000 a year. Across 9 studies of 858 men, about a third of those who waited had surgery within 3 years and over two-thirds within 10, mostly because of pain; emergency operations were uncommon (2% to 3%).
Femoral hernias are more likely to need emergency surgery: 36% to 39% of them in Scandinavian records were repaired as emergencies, against 5% of inguinal hernias, and 17% of women with groin hernias needed emergency repair, against 5% of men. The international guideline recommends prompt repair for women, and the NHS says femoral hernias need treatment in hospital.
The international groin hernia guideline recommends going back to normal activities without restrictions as soon as you feel comfortable, and says no study has shown that an early return increases the risk of the hernia coming back; its 2023 update didn't change this. In 34,822 Danish men, heavier lifting at work after a groin repair didn't raise the risk of another operation, though it meant longer off work.
European surgeons advise avoiding heavy lifting and straining for 4 weeks after an incisional hernia repair, while saying there's a lack of evidence; surveys of surgeons favour 2 to 4 weeks of reduced activity after simpler repairs and longer after complex ones. A German trial comparing 3 and 6 weeks of restrictions has published only its plan so far.
European surgeons advise losing weight if needed, controlling diabetes, stopping smoking and improving fitness before a planned repair. In a trial of 118 people with obesity waiting for a hernia repair in the front of the tummy, diet and exercise coaching meant more people were free of the hernia and complications soon after surgery (70% against 48%), but not at 2 years (73% against 66%), and more needed emergency surgery while they waited.
Across 5 small trials (297 people) after hernia repairs in the front of the tummy, people who wore a binder had slightly lower pain scores at 2 weeks and fewer wound infections. After keyhole umbilical repair in 56 people, a binder made no measurable difference, though most people liked wearing one. Before surgery, the British Hernia Society says a support garment can reduce pain. We found no study showing that a belt stops a hernia getting bigger.
In a Norwegian study of 43,363 people, exercising for 30 minutes or more at least once a week went with half the odds of severe reflux, and a review of 33 studies (242,850 people) found less reflux disease with more activity. Both are observational. Hard exercise can also bring reflux on: in 30 athletes who already had heartburn with exercise, weightlifters had the most reflux, runners less and cyclists the least, with more after eating.
Across 10 small trials (476 people), diaphragmatic breathing modestly improved reflux symptoms, with very varied results. In a laboratory trial, slow breathing after meals cut reflux episodes in people whose reflux comes on when they're upright.
Surgery is the only repair for a hernia, and many don't need it urgently. For a hiatus hernia, the NHS and NICE (the National Institute for Health and Care Excellence) put lifestyle changes first; a pharmacist may suggest medicines such as antacids or alginates, a GP (general practitioner) can help if symptoms don't settle, and surgery is only for people whose symptoms don't respond to other treatment. Don't stop a prescribed medicine without talking to a doctor. Exercise supports these treatments but doesn't replace them.
"You can still exercise while preparing for surgery. In fact, staying as fit and healthy as possible will be beneficial." You may need to adjust your workouts: "This might mean using lighter weights with more repetitions. If a movement causes pain, stop and try again another time." It calls walking "a great way to stay active". This is expert advice: no trial has tested exercise programmes in people with a hernia.
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Keep up the NHS's 150 minutes a week of moderate activity, such as brisk walking, cycling, swimming or a cross-trainer, at an effort where you can talk but not sing. Add strength training on 2 days, using a weight you can lift 12 to 15 times without straining: that number is our editorial suggestion, following the society's lighter weights and more repetitions. Breathe out on the effort and don't hold your breath.
Build up jumping and running carefully, since jumping produced the highest pressure inside the tummy. Maximal lifts and holding your breath to strain are the most likely to push on a hernia, so leave them out until it's repaired (our suggestion). Crunches raised the pressure no more than getting up from a chair in one small study, so there's no need to ban them, but leave out any core move that makes the hernia bulge.
Stop any move that hurts, makes the hernia pop out or grow, or leaves it aching more afterwards, and try an easier version another time. If the hernia gets more painful over time, see a GP.
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An inguinal hernia that isn't causing symptoms may not need treatment at all. While you wait, keep active as above, and know the warning signs below.
How you lift changes the pressure inside your tummy. Our suggestion: keep the load close to your body, bend your knees, breathe out as you lift and don't hold your breath. Our deadlift guide covers bracing and breathing for heavier lifts.
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Lifting is only one risk factor. The NHS suggests keeping to a healthy weight, staying active, stopping smoking and seeing a GP about a cough that doesn't get better or keeps coming back, and the British Hernia Society adds repeated straining.
Advice on lifting after a groin hernia repair varies, and it's expert opinion rather than trial evidence. Follow your own surgical team:
The British Hernia Society says a support garment can help with movement and has been shown to reduce pain, and some people with large hernias find one makes exercise more comfortable. Some are available on prescription.
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European surgeons suggest a binder or compression clothing for comfort for the first 6 weeks after an incisional repair. Trials found small, short-lived benefits at most.
A belt doesn't repair a hernia, and we found no study showing it stops one getting bigger or becoming trapped. Use one for comfort if it helps.
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European surgeons advise losing weight if your body mass index is high, controlling diabetes, stopping smoking and improving your fitness before a planned repair. The British Hernia Society says smoking almost triples the risk of a wound infection and raises the chance of the hernia coming back by more than 30%, and suggests asking for help to stop.
In the trial of diet and exercise coaching before surgery, more people needed emergency surgery while they waited. Getting fitter is worth doing, but not at the cost of ignoring the warning signs below.
The NHS says keep moving and do gentle exercise such as walking, increasing slowly; no heavy lifting or strenuous activity for at least 4 to 6 weeks; usually at least 1 to 2 weeks off work, or up to 6 if your job involves heavy lifting; and no bath or swim until the wound has healed, usually about 2 weeks. The international guideline says most people can go back to normal activities as soon as they're comfortable: with that advice, people took about a week off housework, 1 to 2 weeks off work and 1 to 3 weeks off sport.
The NHS says recovery usually takes around 4 to 6 weeks: avoid heavy lifting in that time, and you may be back at work after 1 to 3 weeks. Ask your doctor when you can drive and return to your usual activities.
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The NHS says full recovery can take up to 4 to 6 weeks, with at least 1 to 2 weeks off work, or up to 6 if your job involves heavy lifting. It gives no exercise limits; the European advice for incisional repairs below is the closest guideline (our reading).
European surgeons advise moving about and doing what you feel able to from the start; avoiding heavy lifting or exercise that makes you strain for 4 weeks, while the mesh settles in; no swimming in a pool or the sea until the wound has healed, usually about 2 weeks; driving once you can do an emergency stop without hesitation; and a binder or compression clothing for comfort for 6 weeks.
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After keyhole surgery to repair a hiatus hernia, one NHS hospital's leaflet says go back to your normal daily activities as soon as you feel able, avoid heavy lifting for 4 weeks, and expect to drive and go back to work after about 4 weeks. The NHS says it can take up to 6 weeks before you can eat what you want, and a few months for bloating and swallowing to settle.
No trial has tested a core programme after a hernia repair. After an umbilical or incisional repair, start with breathing, a gentle deep tummy draw-in, pelvic tilts, heel slides and knee fall-outs; avoid straining for the first 4 weeks; leave sit-ups, double leg raises and planks out at first; and build up when the moves feel controlled with no bulging at your scar.
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With no restrictions, most people were back to sport within 1 to 3 weeks of a groin repair. After an incisional repair, avoid straining exercise for 4 weeks. For contact sport and maximal lifts, build up gradually once your team's restriction period is over (our suggestion).
The NHS suggests smaller, more frequent meals, raising the head of your bed by 10 to 20 cm, losing weight if you need to, finding ways to relax, not eating within 3 or 4 hours of bed, avoiding clothes that are tight around your waist and not smoking. NICE also advises healthy eating, losing weight if needed and stopping smoking.
People who exercise regularly have less reflux, in observational studies. Aim for the usual 150 minutes a week, choosing upright, moderate exercise such as walking or cycling.
Leave a couple of hours after a meal before a hard session or heavy lifting. This is our suggestion, based on one small study of 30 athletes in which hard exercise brought on more reflux after eating; the NHS notes reflux is often worse after eating. A gentle stroll after a meal is fine (also our suggestion).
Straining set off reflux in most people with upright reflux in one study, and the NHS says symptoms are often worse lying down or bending over. Breathe out on the effort, and leave head-down and lying-flat moves for later in a session, or out, if they bring on symptoms.
Slow breathing into your lower ribs after meals may help a little: in small trials, diaphragmatic breathing modestly eased reflux symptoms.
The NHS lists a burning, indigestion-like feeling in the chest among heart attack symptoms. Call 999 for chest pain that feels tight, heavy or squeezing, or that spreads to your arms, neck, jaw or back. New chest discomfort that comes on with exertion needs a doctor, not an antacid (our suggestion).
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Lighter weights, more repetitions: a load you can lift 12 to 15 times without straining, breathing out on the effort (our editorial suggestion). Stop any move that hurts or makes the hernia bulge.
3D demoTreadmill walkingBeginner · Cardio machine
3D demoStationary cyclingBeginner · Cardio machine
3D demoElliptical trainerBeginner · Cardio machine
3D demoSit to stand from a chairBeginner · A bench or box
3D demoDumbbell goblet squatIntermediate · A dumbbell
3D demoHip-hinge practiceBeginner · No equipment
3D demoBand rowBeginner · A band + An anchor point
3D demoIncline push-upBeginner · A bench or box
3D demoGlute bridgeBeginner · No equipmentWith an unrepaired hernia, or after a tummy repair once your team allows. 2 sets of 6 to 8 slow reps to start (our editorial starting point); leave out any move that makes the hernia or scar bulge.
In this order over the first weeks (our editorial order), 3 to 5 gentle reps of each at first. Avoid heavy lifting and straining for about 4 weeks after an incisional repair, and leave sit-ups and planks out at first.
3D demoAnkle circlesBeginner · No equipment
3D demoLateral breathing (Pilates breathing)Beginner · No equipment
3D demoSide-lying tummy draw-inBeginner · No equipment
3D demoPelvic tilt into bridgeBeginner · No equipment
3D demoSupine heel slideBeginner · No equipment
3D demoBent-knee fall-outBeginner · No equipment
3D demoKnee foldBeginner · No equipment3D demoTreadmill walkingBeginner · Cardio machineUpright and moderate, away from big meals. Slow breathing for at least 5 minutes, sitting upright, can follow a meal.
With a hernia: the low-impact cardio and band workouts, with lighter loads. After a tummy repair, the bowel surgery core routine follows a similar order (it was written for stoma surgery). With a hiatus hernia, a gentle walk after meals is fine; skip the face-down crocodile breathing in the relaxation routine if you have reflux.
A 25-minute standing cardio circuit with no jumping: marching, step jacks, sit-to-stands, punches, step-ups and wall push-ups, with a seated option for most moves.
25 minBeginner9 movesA bench or box, A stepA steady 30 to 45 minute cardio session at talk-but-not-sing pace: walk, cycle, row or cross-train, counting toward weekly activity guidelines.
40 minBeginner3 movesCardio machine, A wallA full-body resistance band workout: squats, presses, pull-aparts, band walks, good mornings and flyes.
25 minBeginner7 movesA band, An anchor pointA gentle 20-minute beginner home workout with a chair, a wall and a band: sit-to-stands, wall push-ups, band rows, step-ups and dead bugs.
20 minBeginner11 movesA bench or box, A wallA 20-minute full-body dumbbell workout: two supersets of squats, rows, Romanian deadlifts and push-ups. Twice a week covers the minimum dose.
20 minBeginner8 movesA dumbbell, A bench or boxA gentle 20-minute core routine for the weeks after bowel or stoma surgery: breathing, tummy and pelvic floor work lying down, then chair and standing moves.
20 minBeginner14 movesA bench or box, A wallA gentle 15-minute Pilates-based routine for ongoing low back pain, built from neutral-spine moves with options for backs that dislike bending or arching.
15 minBeginner10 movesNo equipmentA 10-minute routine for straight after a meal: an easy walk, a few simple standing moves from blood sugar trials, then a short walk to finish.
10 minBeginner6 movesCardio machine, A bench or boxA 6-minute breathing routine: slow breathing, crocodile breathing, alternate nostril breathing, box breathing and 4-7-8 breathing.
6 minBeginner5 movesNo equipmentBuilding towards 150 minutes a week before surgery, or getting back to it afterwards.
A free 8-week walking plan for beginners: build to 150 minutes of brisk walking a week, with intervals, hills and two short strength sessions.
6 training days40 minBeginner2 days a weekYour first four weeks: two, then three short strength sessions a week at home plus walks, building gently to a full routine.
2 training days20 minBeginnerCall 999, and don't drive yourself to A&E (accident and emergency), if you have a hernia and:
If you have a hernia and:
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These can mean a blood clot in the lungs. Don't drive yourself to A&E.
If you have heartburn or reflux and:
Stop and get advice if a hernia hurts, won't go back in when you lie down, or grows or aches more after exercise. If it stays out with severe pain, sickness or no wind, call 999 (our reading of the society's and the NHS's advice).
"The only way to repair a hernia and close the hole is through surgery", says the British Hernia Society. Exercise keeps you fit for surgery and for life, but it doesn't close the gap.
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The British Hernia Society says you can still exercise while you prepare for surgery, and the NHS lists being active among the ways to lower your chance of some hernias. This is expert advice rather than trial evidence, and it comes with a rule: stop any movement that hurts.
A review found too little evidence to say heavy work causes groin hernias, and in nearly 18,000 men, direct groin hernias weren't linked with physical work at all. The international guideline says heavy lifting may make a hernia more likely. Coughing and jumping raised the pressure in the tummy far more than moderate lifts.
Even the NHS's more cautious advice is no heavy lifting for at least 4 to 6 weeks after a groin repair, and the international guideline sees no need for any lifting restriction. Heavier lifting at work didn't raise the risk of another operation in 34,822 men. Build back up to what you did before.
In 30 women, crunches raised the pressure inside the tummy no more than getting up from a chair. With an unrepaired hernia, the rule is to stop any move that makes it hurt or bulge; after a repair in the front of the tummy, leave sit-ups out at first.
A support garment can ease pain and make exercise more comfortable, and binders eased pain a little after some repairs, but we found no study showing they stop a hernia getting bigger or becoming trapped.
For men with a painless or barely painful groin hernia, waiting is safe, though many choose surgery later because of pain. Women with groin hernias and anyone with a femoral hernia should have prompt repair.
People who exercise regularly have less reflux. Hard exercise soon after eating can bring it on, most with weightlifting and least with cycling in one small study, so choose and time your sessions rather than stopping.
Usually, yes. The British Hernia Society says staying as fit as possible helps you prepare for surgery: walking is a great way to stay active, and you may need lighter weights with more repetitions. Stop any movement that causes pain, and see a GP if the hernia gets more painful.
Yes, with lighter weights. Our suggestion is a weight you can lift 12 to 15 times without straining, breathing out on the effort rather than holding your breath. Leave out maximal lifts until the hernia is repaired, and stop if a lift makes it hurt or bulge.
No. Only surgery closes the gap in the muscle. Exercise keeps you fit, can help you reach a healthier weight before surgery and helps your recovery afterwards, and many hernias don't need urgent surgery.
Possibly, but the evidence is weaker than people think. A review found too little evidence to say heavy work causes groin hernias, and in nearly 18,000 men, direct groin hernias weren't linked with physical work at all. Smoking, a long-term cough, repeated straining and a higher weight all play a part.
There's no fixed list. Leave out moves that make the hernia hurt, bulge or ache afterwards, maximal lifts and holding your breath under load, and build up jumping and running carefully. In one small study, crunches raised the pressure in the tummy no more than getting up from a chair.
Walk from the start. After a groin repair, the NHS says no heavy lifting or strenuous activity for at least 4 to 6 weeks, while the international guideline says you can go back to normal activities as soon as you're comfortable. After a repair through an old scar, avoid heavy lifting and straining for about 4 weeks. Follow your own surgical team.
The NHS says at least 4 to 6 weeks after a groin repair, and European surgeons say 4 weeks after an incisional repair. The international groin hernia guideline says lifting restrictions aren't needed, and no study shows that early activity makes the hernia come back. Follow your surgical team, and build up from light loads.
Usually after 1 to 2 weeks, or up to 6 weeks if your job involves heavy lifting, the NHS says. In studies where people were told to go back when they felt ready, most took 1 to 2 weeks off.
Not at first after a repair in the front of your tummy: start with breathing, a gentle tummy draw-in, pelvic tilts and heel slides, and avoid straining for about 4 weeks. Then build up through harder core moves, stopping if your scar bulges. After a groin repair, do what feels comfortable.
It's up to you. A support garment can ease pain and make exercise more comfortable, and some are available on prescription. It won't repair the hernia, and there's no evidence it stops one getting worse.
Regular, moderate, upright exercise such as walking or cycling: people who exercise regularly have less reflux. Hard sessions and heavy lifting soon after a meal can bring reflux on, so our suggestion is to leave a couple of hours after eating. Slow breathing into your lower ribs may help a little.
Call 999 if a hernia becomes very painful, more swollen than usual or changes colour, or you're being sick, can't keep food down, or can't fart or poo. These can mean the hernia is trapped or its blood supply is cut off. Get help from NHS 111 for pain in or around a hernia, a bloated tummy or constipation.
Exercise education, not a diagnosis or treatment plan, and clinical review of these guides is pending. Stop and get advice for chest pain, unusual breathlessness, dizziness or fainting, or new pain, and check with your doctor or midwife first if they have told you to limit activity. Health disclaimer.
