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The question

I had surgery for a lower abdominal hernia. Are there exercises I should do to heal properly, and make sure I don't get another one?

The answer

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Get your doctor's permission before starting any exercise program. Once cleared to exercise, you need to strengthen your core.

Abdominal hernias occur when the build-up of intra-abdominal pressure is too high relative to the strength of the abdominal wall, which causes the wall to tear and the intestine to bulge out.

Surgery, and the scars that result, can inhibit the brain's neurological connection to the muscles that have been cut.

Strengthening your abdominals and retraining the neurological connection to the core muscles will increase the strength of your abdominal wall, which will lessen the chances of the hernia occurring again.

Make sure you work all of the muscles of the core, such as the rectus abdominals, transverse abdominals, internal obliques, external obliques, multifidus and pelvic floor. The muscles of the core work together to help support the spine and co-ordinate muscle contractions that allow you to do functional movements such as picking something up or pushing open a door. Try using a piece of unstable equipment, like a foam roller, to "wake up" the neurological connection to the entire core region.

Try this exercise: The foam roller "march"

Lie on your back, hands on floor with the roll positioned lengthwise along your spine. Lift your opposite arm and leg up without letting anything in your spine or pelvis move. Alternate sides for 20 repetitions. To increase the intensity, lift one leg up to 90 degrees and hold it there as you alternate lifting one arm off the ground at a time. Repeat 20 times and switch sides.

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TRAINER'S TIP

Work on maintaining a healthy weight. Excess weight can increase the likelihood of the hernia occurring again.

Send certified personal trainer Kathleen Trotter your questions at trainer@globeandmail.com. She will answer select questions, which could appear in the Globe and Mail and/or on The Globe and Mail website. Your name will not be published if your question is chosen.

The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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