| Anthony's Story | | | | he would be able to do this training without |
| Aged 60, Anthony, who was working as a mowing | | | | aggravating his hernia, but by now he had largely |
| contractor, decided in March 2008 that it was time to | | | | forgotten about it, as the bulge was no longer |
| get fit again. He renewed his gym subscription and | | | | appearing. To be on the safe side he kept up his |
| started back on weights. Shortly after trying to | | | | Pilates exercises and wearing his hernia support. |
| bench 220 lbs (100 kg) for the first time in 15 years, | | | | The Ironman is the largest mass participation triathlon |
| he developed a pain in his right groin, which was | | | | on the planet: 2.4 mile swim, 112 mile bike, 26.2 mile |
| diagnosed as an inguinal hernia. Anthony's doctor | | | | run. When the day arrived Roy began at 7.20am. |
| booked him in for hernia repair surgery, which was to | | | | Here is his report: |
| be carried out in September. | | | | "The swim was comfortable, but slow. Had a good |
| While awaiting surgery, Anthony consulted a | | | | bike, taking it easy ready for the marathon. Ran |
| homeopath and osteopath. The osteopath gave | | | | 4,456 metres. Total time: 13hr 2 mins. Placed 1,656 |
| Anthony simple exercises for strengthening his | | | | out of some 4,000 starters, 26th in my age group. I |
| transverse abdominal muscles. | | | | don't think I would have been able to put in the |
| Anthony stopped all other forms of exercise, gave | | | | training successfully without the help of my Pilates |
| up his mowing job, and avoided stretching and lifting | | | | exercises and wearing my hernia support (although it |
| anything heavier than 4-6 lbs for about three months. | | | | was not practical to wear it on race day). I felt |
| He ordered a hernia support garment as this had a | | | | better prepared for this race than most of my |
| guarantee to keep the hernia in during all activities. | | | | previous ten Ironmen and seemed to suffer no ill |
| When the hernia first appeared, it would pop out 10 | | | | effects." |
| times a day, just from walking around or standing in | | | | In September 2008 Roy reported that he had not |
| the shower. This stopped when Anthony started | | | | worn his hernia support for some time, was still very |
| wearing the hernia support. In May it emerged again | | | | active, and had no trace of a hernia. He considers |
| when he tried doing some push-ups without wearing | | | | himself fully healed. |
| the hernia support, so he went back to wearing it for | | | | A Question-Mark Over Surgery |
| a couple of hours a day. | | | | Researchers in the US, UK, Sweden and other |
| By June the hernia appeared to be under control, and | | | | countries have measured the rate of long-term |
| Anthony felt confident enough to start doing some | | | | complications after hernia repair surgery. It's not good |
| mild aerobic exercises and strength training at home. | | | | news. For instance Loos and colleagues in the |
| He also began doing some work on his tractor which | | | | Netherlands found that of 1,766 men followed-up for |
| involved a certain amount of straining. When doing | | | | three years by questionnaire, 40.2 per cent were still |
| these activities Anthony wore his hernia support, | | | | suffering some degree of pain, and 1.9 per cent |
| which he found gave him a feeling of security and | | | | experienced severe pain. One-fifth of the patients |
| took much of the tentativeness out of his daily | | | | felt that their work or leisure activities were impaired. |
| activities. | | | | Some surgeons are very concerned that patients are |
| By September the hernia had improved so much that | | | | being routinely sent for this surgery even though |
| Anthony postponed the surgery for three months. | | | | their hernia may be quite small and painless. The |
| To check that the hernia really had gone, he went | | | | policy of early surgery is intended to prevent a hernia |
| for an ultrasound examination. This showed that | | | | from progressing and avoid the risk of it becoming |
| nothing remained but a small enlargement of the | | | | "strangulated"--an emergency situation. But it has now |
| deep end of the inguinal canal. The doctor asked him | | | | been shown that strangulation is not very common. |
| to strain as hard as he could; this forced just a small | | | | Many surgeons now follow a policy of "Watchful |
| amount of fat into the deep end, but no bowel, and | | | | Waiting" (monitoring) a hernia instead of offering |
| there was no protrusion. | | | | immediate surgery. In the UK elective hernia repair |
| Roy's Story | | | | surgery has been reclassified as "low priority" by a |
| Roy, aged 58 in 2005, was working as a | | | | growing number of regional health policy-makers. |
| window-cleaner and was also an Ironman athlete. The | | | | Non-Surgical Alternatives |
| Ironman Triathlon is one of a series of long-distance | | | | What do men like Anthony and Roy who have |
| races organised by the World Triathlon Corporation, | | | | healed their own inguinal hernias have in common? On |
| consisting of a 2.4 mile swim, 112 mile bike ride and | | | | websites devoted to non-surgical alternatives the |
| 26.2 mile marathon run. This gruelling event requires | | | | most frequently successful alternative system seems |
| months of intensive training and an extraordinary | | | | to be a programme of exercises such as Pilates to |
| degree of fitness. | | | | strengthen the abdominal area. Next in importance |
| Roy had taken part in ten Ironman Triathlons, but | | | | comes the wearing of a hernia support garment to |
| sadly could do no more, as he had developed a small | | | | keep the hernia "in". This is crucial. If the hernia is |
| inguinal hernia. Roy knew two people who were still | | | | allowed to remain protruding, it will prevent the gap in |
| suffering complications years after hernia surgery, so | | | | the abdominal wall from healing up. |
| he had decided against the operation. | | | | Nowadays most doctors and surgeons do not |
| However in January 2006 Roy met Craig, who had | | | | prescribe trusses, and some positively discourage |
| cured his own hernia by means of diet, herbs, Pilates | | | | them. Even today some trusses use metal springs to |
| exercises and also wearing a hernia support garment. | | | | apply pressure to the hernia, via a pad which can be |
| Roy was keen to see if he could replicate Craig's | | | | quite hard, and which presses into the hernia. This |
| success, so in the middle of January he started to | | | | protrusion can cause scar tissue to form around the |
| attend Pilates classes with Craig, and began wearing | | | | hernia's edges, which prevents them from knitting |
| the hernia support. | | | | together and healing. In order to keep the hernia in, |
| Roy kept a diary to monitor his progress. After a | | | | the pad needs to remain in contact with it at all |
| month he reported that he was feeling fitter, | | | | times, and during all activities. Most trusses cannot |
| healthier and more toned around the lower abdomen | | | | follow body movement and so fail to do this. |
| and pelvic area. He decided to run the Dover half | | | | A hernia support should fit well, be comfortable, keep |
| marathon on 19th February, and completed it in 1 | | | | the hernia in at all times, and be free of springs or |
| hour 35 minutes--his best time for several years. Roy | | | | pads that bulge inwards. It should have a guarantee |
| felt so encouraged that he was keen to start training | | | | to hold a groin hernia in, even during sport and heavy |
| for another Ironman Triathlon. | | | | manual labour, and should have a money-back |
| Swimming forms part of the Ironman programme, | | | | guarantee. Also watch out for hernia supports with |
| but Roy's hernia had up till now caused discomfort | | | | metal components as these can set off alarms in |
| during swimming--a feeling of a "pull" in the groin area. | | | | airports. The best type of hernia support consists of |
| Towards the end of February he felt confident | | | | an elastic belt with rigid flat pads that slide together |
| enough to swim a fairly hard 2,000 metres, while | | | | in such a way that the hernia area is supported at all |
| wearing his hernia support. He was amazed to find | | | | times. |
| that there was no discomfort at all. | | | | To cure your own inguinal hernia isn't such a new |
| So in March, Roy began a gruelling 16-week training | | | | idea. After all, A famous 19th century German clinic |
| schedule in preparation for the Quelle Challenge | | | | known as the Bilz Clinic, considered that hernia cures |
| Triathlon which was to take place on 2nd July 2006. | | | | were commonplace, and recommended simple |
| He had to build up to 15-20 hours training per week. | | | | exercises, mineral baths and the conscientious |
| As Roy was approaching 60 years of age and had | | | | wearing of a hernia truss or support until the hernia |
| not done an Ironman for two years, he was not sure | | | | was cured. |