Ventral hernia refers to hernia in the abdomen. Think of your abdomen as a big bag or a box containing many structures well packed and set into the small space called abdominal cavity. Solid structure like spleen, liver, kidneys and pancreas are all packed in the upper and back part of the cavity loose, mobile tubes of intestines (32 feet) and stomach are loosely coiled into the central and front space.

Looking at the material with which the box is made of, the back wall is very tough with bones thick muscles of the spine. Upper wall is the moving dome of muscle the diaphragm useful for breathing. The side walls are well supported by the ribs and pelvic bones connected by thick muscles. The front wall is the moving anterior abdominal wall made of only soft tissues. The two major layers are the flat sheets of muscles covered by the varying thickness of fat with an inner lining of peritoneum and outer lining of skin. These abdominal muscles consists of sheets and bands of muscles which are attached to the ribs above and pelvic bone below.

Ventral or abdominal hernia occurs if these muscles become weak and loose their strength or if there is a hole (gap) in these muscles. This hole or gap (even if the entire sheet of muscle) usually occurs in the naval, which is the natural passage through which the umbilical cord was connected to the mother, when you were in the womb. This gap may also occur through a surgical cut, if the muscle in the suture line does not heal perfectly (called incisional hernia). The incisional hernia can occur if the surgical tear in the abdomen took longer than expected to heel due to infection or if stitches give way during coughing or sneezing within 2 weeks after the surgery. Excessive fat on abdomen and weakness of the abdominal muscles (with or without a surgical sear) are the commonest factors that cause ventral hernia. The reason for this is lack of exercise. Any muscle in the body becomes weak and thinned out if you do not exercise it regularly. The exercise that keeps the abdomen strong are forward body bending exercises. In the present day sedentary life style with enough gadgets available for transport, kitchen and cleaning work there is very little need for you to use the abdominal muscles. Hence unused abdominal muscles become too weak and thin.

What is the remedy? How to prevent abdominal hernia?

• Avoid constipation
• Treat chronic cough if you have it.
• Reduce excess weight in general and abdominal fat in particular.
• Practice bending exercises regularly including Suryanamaskar daily for 30 minutes.
• Start exercises within first week after any abdominal surgery.

What are the yogic practices to prevent abdominal hernia?

Yoga practices which contracts the abdominal muscles help in preventing the abdominal hernia. Suryanamaskara, Loosening exercise including forward backward bending, straight leg raising (alternate and both), Navasana, Dhanurasana, Sarvangasana, Matsyasana followed by Deep relaxation, Kapalabhati, Sectional breathing, AAA chanting before meditation (total 30 minutes). Immediate post operative period on the 2nd day of surgery start with practices of abdominal breathing with AAA chanting (10 minutes) 4 times a day, after 4 days start straight leg raising (alternative legs only) with breathing (21 repetitions 4 times a day). Head lifting or dorsal stretch also helps in strengthening the abdomen.

In the chronic stage where the incisional hernia is well set and you wish to avoid surgery or prepare for an effective surgery you need to do the practices very regularly. Dieting and regular walking for weight reduction is an essential prerequisite. If the hernia is big and protruding too much you may have to practice yoga with the supporting corset belt on. After you feel stronger it is better to practice without abdominal support corset.

Avoid fast practices of jogging, forward bending or side bending, Sit-ups, Sputa vajrasana, start with practices in supine (flat on your back) posture. Alternate straight leg raising (repeat 4 to 5 times/ day), Ardha navasana (head lifting 20x5 times/ day). In viparitha karani with wall support do deep abdominal breathing (9 rounds). AAA chanting (9 rounds) and kapalabhati at 40 strokes per minute. Repeat this practice 2 times a day other asanas are Sarvangasana, Matsyasana, Halasana, Padhastasana, Ardhacakrasana, Paschimottanasana, Sasankasana, Shavasana, Pranayamas include sectional breathing, Suryanuloma viloma (if you are overweight and not hypertensive or diabetic), Nadanusandhana.

This should help you to strengthen the abdominal and this will overcome the problem of incisional hernia or lax abdominal. If there is a narrow hole umbilical hernia with normal abdominal muscles and body weight it may be possible to overcome this through yoga.

Eka means one, single. Pada means the foot. In this variation of Sarvangasana, one leg is on the floor in Halasana, while the other is in a vertical position along with the trunk.

Technique

Sthithi : Lie flat on the back, legs stretched out, tighten at the knees, hands by the side of the body.

• Exhale, bend the knees and move the legs towards the stomach till the thighs press it.
• Raise the hips from the floor with an exhalation and rest the hands on them by bending the arms at the elbows.
• Raise the trunk up perpendicularly supported by the hands until the chest touches the chin. Shoulders and the back of the arms up to the elbows should rest on the floor. Stretch the legs straight with toes pointing up (Sarvangasana).
• Keep the left leg up in Sarvangasana. Exhale and move the right leg down to the floor to Halasana. Right leg should be remain stiff and straight and not bend at the knee. Left leg should be kept straight, facing the head.
• While resting the right leg on the floor, the left knee should bee kept taut and not allowed to tilt sideways. The left leg should be kept straight, facing the head.

Effects

This asana tones the kidneys and the leg muscles.