YOG THERAPY FOR HERNIA
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Hernia” is derived from the Latin word for rupture. It is defined as an abnormal protrusion of an organ or tissue through a defect in its surrounding walls.[1] It may be operationally defined as the abnormal protrusion of a structure through a defect in the tissues that normally contain that structure.[2] Although hernia can occur at various sites of the body, these defects most commonly involve the abdominal wall, particularly the inguinal region. Abdominal wall hernias occur only at sites when the aponeurosis and fascia are not covered by striated muscle. These sites most commonly include the inguinal, femoral, and umbilical areas, the linea alba, the lower portion of the semilunar line, and sites of prior incisions. The “neck” or orifice of a hernia is located at the innermost musculoaponeurotic layer whereas the hernia sac is lined by peritoneum and protrudes from the neck. There is no consistent relationship between the area of hernia defect and the size of hernia sac.
Inguinal hernia is due to weakness of the abdominal muscles which holds the organs in their original positions. So the organ gets protruded through inguinal canal and sometimes to scrotum. The causes for inguinal hernia are congenital weakness or the developmental defect in the abdominal muscles or ligaments, unexpected pull while handling heavy item, which split the muscles and ligaments, elevated intra-abdominal pressure, flabbiness of the abdominal muscles and obesity.
Hernias are a common problem; however, their true incidence is unknown. It is estimated that 5% of the population will develop an abdominal wall hernia, but the prevalence may be even higher. Approximately 75% of all hernias occur in the inguinal region. Based on national operative statistics, incisional hernias account for 15% to 20% of all abdominal wall hernias, umbilical and epigastric hernias constitute 10% of hernias, femoral hernias for about 5%, and unusual hernias for the remainder. The prevalence of hernias increases with age, particularly for inguinal, umbilical, and femoral hernias. Men are 25 times more likely to have a groin hernia than women.[1
Treatment
Reversible inguinal hernia may be treated non-surgically or surgically. The non-surgical intervention includes special type of belt, called a truss, to support the hernia and keep it from bulging out. The subjects will be advised to avoid any activities that cause abdominal strain. Surgical intervention is done by pushing the piece of intestine back into place and repairing the abdominal wall and so the intestine cannot push through again. Surgery is preferred to avoid the possibility of a strangulated hernia.
Vajrasana, ushtrasana, paschimottanasana, pawanmuktasana, utthanpadasana, matsyasana and sarvangasana were selected based on its effects to compress inguinal canal, strengthen the abdominal muscles and to reduce the intra-abdominal pressure, because weakness or flabbiness of abdominal muscles and elevated intra-abdominal pressure may be the causes for the hernia in non-congenital subjects included in this study.
Vajrasana is a meditative asana not involving much of muscle work and was used as a preparatory for yoga therapy with added benefits of compressing inguinal canal which will prevent protrusion of abdominal contents.
Ushtrasana and paschimottanasana were included based on the principle of proprioceptive neuro muscular facilitation technique namely repeated stretch[8] i.e. the stretch reflex elicited from muscles under the tension of elongation will facilitate muscles to contract. Ushtrasana will facilitate abdominal muscles to stretch and paschimottanasana will facilitate them to contract along with compression over inguinal canal.
Pawanmuktasana strengthens abdominal muscles, compresses inguinal canal and also reduces intra-abdominal pressure by releasing air from gastro intestinal tract and utthanpadasana has got direct strengthening effect over abdominal muscles.
Matsyasana is complementary to sarvangasana included to neutralize the flexion force created over the normal neck and sarvangasana is to move abdominal contents toward thorax thereby reducing abdominal pressure and to prevent protrusion of abdominal contents or to facilitate replacement of herniated contents.
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