Yoga for a diaphragmatic hernia

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Bernie
Posts: 1216
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Yoga for a diaphragmatic hernia

Post by Bernie »

I recently received the following question:
  • Hello,
    I teach Yin Yoga to an elderly lady who has an Hernia in her diaphragm. What Yin poses should she avoid doing and which ones do you recommend for her?
    Thank you in advance.
    M
Hi M…

Very interesting question. I do not know much about this condition and I am not a doctor, but I do know that a true diaphragmatic hernia is very dangerous. This is not the same as a hiatal hernia, where the stomach starts to push up through the hiatus between the stomach and the esophagus. A diaphragmatic hernia is the abdominal organs passing upward through an opening or tear in the diaphragm and endangering the lungs. It usually happens in new born babies, but can happen to adults after a trauma. I assume your student does not currently have a diaphragmatic hernia, but rather she had one and it was surgically repaired.

If your student does currently have a diaphragmatic hernia, she should get to her doctor right away, but most likely it was her doctor who told she has it…so the real question is … “what does her doctor say?” Are there some movements or positions that she recommends avoiding? Since you and I are not doctors, any suggestions we can offer are just guesses: best to hear from the experts.

My suspicions would be 1) your student doesn’t currently have a diaphragmatic hernia but she did have one that was repaired; 2) the site of the repair may be the weak link in the integrity of the diaphragm; 3) care must be taken to ensure the student does not over stress the diaphragm; 4) the best approach for the student is to slowly strengthen the diaphragm and abdominal/core muscles.

Given all this, Yin Yoga is not going to strengthen her core. For that she needs yang exercises but not the traditional sit-ups or crunches, which could make her problem worse. Instead I would suggest the McGill Big 3 core exercises, which I have described here and here. Her doctor may have already suggested some strengthening exercises which may be incorporated into a yang yoga practice.

Yin Yoga is probably benign, but I would suggest avoiding any postures that put pressure on the belly: avoid Sphinx, Seal and Snail postures. Go slow: start with shorter holds and teach her how to pay attention to sensations. Any sign of pain or discomfort in the core areas means to come out right away. She should also notice how she feels after she has come out of the pose and even over the next day or two. Over time, she will learn what is okay and what doesn’t work for her.

Good luck, and let us know how it goes.
Bernie
Mira
Posts: 2
Joined: Fri Dec 18, 2020 10:56 pm

Re: Yoga for a diaphragmatic hernia

Post by Mira »

Hello Bernie,
The woman has not had surgery. Her main difficulty in the practice is her breathing. She gets out of breath whenbshe walks. She does I kapal habalti breathing while walking. I advised her not to. I suggested her to ask her doctor what poses she should avoid but she claims she knows her body the best. I would like to suggest to her to do opening chest exercises on the chair rather than sphinx on the floor. She takes anti acid medication for her reflex. So the whole situation reflects her breathing and stomach. I can help her with slow breathing exercises. The reflex is a challenge.
Any other suggestions?
Bernie
Posts: 1216
Joined: Sat Sep 23, 2006 2:25 am
Location: Vancouver

Re: Yoga for a diaphragmatic hernia

Post by Bernie »

Hmmm...it sounds to me that your student does not have a diaphragmatic hernia but the more common hiatal hernia. If she had a diaphragmatic hernia I am sure her doctor would have had her in surgery quite quickly. A hiatal hernia on the other hand is the protrusion of the stomach through the hiatus leading to the esophagus. This could cause acid reflux, GERD and heartburn. Many people live with this, but it is not nice!

Like you, I would suggest she avoid strong breath work like Kapalabhati or Bhastrika. That could force the stomach higher into the esophagus. Slow, abdominal "belly" breathing is better. Also avoid inversions and postures that put pressure on the belly. If she is having breathing problems, she should work on slowing down her breath, not speeding it up. Work on extending the exhalations more than increasing inhalations. Avoid breath retentions however as that can increase intra-abdominal pressure. Core strengthening work could still be helpful, as long as she is not straining and increasing intra-abdominal pressure.

But, again, I am not a doctor! So your student should test these idea out slowly and see how she does.
Cheers
Mira
Posts: 2
Joined: Fri Dec 18, 2020 10:56 pm

Re: Yoga for a diaphragmatic hernia

Post by Mira »

Thank you Bernie for reinforcing what I assumed is right for her.
I love your face yoga video and do the Popye face with my grandkids although, unfortunatley they do not know who he is. They have other heros in their lives who are mostly violent.
Namaste
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