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Is it safe to use the Flex Belt to strengthen lower abs?
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daveva



Joined: 18 Mar 2011
Posts: 22

PostPosted: Fri Mar 18, 2011 4:13 am    Post subject: Is it safe to use the Flex Belt to strengthen lower abs? Reply with quote

Hi, I have a direct inguinal hernia on my right side. I received my Flat pad supports a couple of weeks ago and they are fantastic! (I'll post more detailed comments regarding the support in the feedback forum).

I have a question regarding the recommended exercises. I remember reading once that Bruce Lee used some type of EMS (Electric Muscle Stimulation) device to repair damage to his muscles. I then found a product on the internet called the "Flex Belt", which supposedly uses the same type of technology to strengthen the upper & lower abdominal muscles (please see http://www.theflexbelt.com). I was wondering if anyone has used this product to try to repair their hernia? Do you think it would be safe to use the product, or could it make the hernia worse? The product has been approved as being generally safe by the FDA (not specifically safe for hernias) and apparently, doctors have been using EMS as a form of physical therapy for years on patients that have difficulty performing regular exercises. From what I understand, the intensity of the electrical pulses can be controlled on a scale of 1-100. Perhaps it might be safe to try it at the lower end of the range? From the pictures on the web site, it seems like it might be possible to wear the Flat pad support and the Flex belt at the same time. The Flex belt is positioned around the waist, which would be a bit higher than the Flat pad support. My thoughts are that it would probably be safest to use the device (assuming it is safe) while laying down. The Flat pad support in combination with a horizontal body position would in theory provide maximum protection to the hernia while using the device ? If I was to try this device, I would use it to supplement the pilates exercises. I personally don't believe that it should replace the pilates exercises.

If anyone has any thoughts or opinions on this product (or other better products), please let me know. I'm not trying to promote the product and I don't have enough medical knowledge to know if it would be safe to use this as part of an exercise program to try to heal a hernia.

Thanks.
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admin
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PostPosted: Mon Mar 21, 2011 1:56 pm    Post subject: Reply with quote

We haven't come across anyone else who has tried this equipment, so if you do decide you'd like to give it a go we'd love to get your reports on the forum.
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Richard



Joined: 05 Sep 2009
Posts: 28
Location: Surrey

PostPosted: Wed Mar 23, 2011 2:44 pm    Post subject: Reply with quote

Hi Daveva,

Sounds like this belt could be useful. Iíve just been looking at some reviews of this and other very similar products and they seem to be for the most part favourable (amongst people without hernias of course). If you do decide to buy one to help with self healing your hernia I would also be very interested to hear about your experiences. Iím very tempted to try one out myself, shame theyíre a bit expensive. Below are my thoughts on the safety of using this and why it might be useful.

Regarding the safety of using this device with a hernia, this may depend on how bad your hernia is. Iíve been trying to heal my hernia for some 18 months and am finally now beginning to make some very substantial progress. When I first started doing abdominal exercises, soon after my hernia appeared, I did manage on several occasions to make the hernia bulge out when I was lying down, that was whilst experimenting with different exercises (usually rather foolish over-strenuous ones). But now as the muscles have become stronger and healthier this practically never happens. Last week I tried some sit-ups, something I havenít done for a long time, and the hernia stayed tightly in. A very different story to when I tried doing them soon after the hernia appeared, the bulge nearly always got pushed out then, which is why I stopped doing them. The abdomen does obviously get quite squashed when you do sit-ups in addition to the pressure created by the muscle contraction. The point of me mentioning this is that an electrical device that stimulates contraction of all the abdominal muscle layers together would compress the whole of the abdomen, thereby increasing the abdominal pressure at the same time. Whether this pushes the hernia out will probably depend on whether the sections of muscle immediately either side of the tear are functioning well. If theyíre not, then the extra pressure will possibly push the bowel out, as that weaker area canít resist the overall abdominal pressure created by the healthier sections of muscle, if those nearby sections of muscle are reasonably healthy and strong then they will produce good contractions at the same time and prevent that critical area from behaving as a weak spot.

At least this is what I deduce from the way my hernia behaves; When I first had my hernia it bulged out almost all the time when standing, but as the muscles have got stronger though over time it has bulged out less and less. However, the fact that it [i]can[/i] still bulge out means the tear canít have healed (although it may possibly be shorter by now as the bulge is only about a third of its original size when it does appear), itís just that the stronger muscles are pulling the sides of the tear together (a longitudinal force pulling the two edges taught) and this is preventing the bowel bulging out. The abdominal muscles continuously maintain a slight contraction most of the time, e.g. whilst standing, even when not engaging in any particular movement. The relative strengths of the different areas of abdominal muscle I believe have a significant influence on the likelihood of the bowel bulging out and the situations in which it bulges. So I guess you need to judge how bad your own hernia is, if it bulges out pretty much all the time there may [i]possibly[/i] be a problem using this device, if it bulges out only sometimes, and particularly if it stays in for some time when pushed back by hand (as mine does now), then Iíd say judging from my experiences there wouldnít be a problem using it.

Despite having said what I have above though regarding safety, seeing as you can alter the strength of the pulses as well as move the electrical pads around I guess you could tailor it to some degree to the needs of a hernia anyway. For example you could presumably position the electrical pads quite low down in order to work primarily on the lower sections of the abdominal muscles, which would then help to strengthen these without stimulating the upper sections of the muscles so much. Also I gather you can have only the middle electrode and one of the outer two in contact with the skin, thereby making only one side contract which would reduce the overall pressure in the abdomen somewhat during use.

As far as I can work out, the lower (groin) sections of two of the three abdominal muscle layers are in effect strung between two fixed points (between the pelvis and central trunk). The purpose of these muscle sections when they contract is to pull the lower abdomen in (for supporting abdominal contents, and assisting in forced breathing, coughing etc.) rather than moving one bone relative to another, which is the normal function for a skeletal muscle. This is what makes this section of the abdominals difficult to exercise as there is no straightforward movement to work this area; instead it requires mental focus to manually engage it whilst performing exercises (this being one of the fundamental Pilates techniques). With this device providing easy stimulation of this particular muscle section, I believe this is potentially where it could really score.

I would say give the belt a try if you can afford it, you may have found a useful tool in the self treatment of hernias. Like you say though, Iím sure it would be best to use it in conjunction with other abdominal exercises, not just use it as an easy or lazy replacement for proper exercising.

Hope this helps.
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daveva



Joined: 18 Mar 2011
Posts: 22

PostPosted: Thu Mar 24, 2011 7:29 am    Post subject: Reply with quote

Hi admin and Richard,
Thank you both so much for your encouraging feedback. I'd also like to thank you Richard for your detailed reply, which was very informative and interesting. It's clear that you have a lot of knowledge and experience in this area. Having read more about EMS technology, I'm also very tempted to try the Flex belt and I'll probably place an order fairly soon. Your informative reply has given me more confidence to go ahead and give it a try. If I go ahead, I'll definitely post feedback to this topic in the forum. It seems to be intuitive that a product such as this might help to treat a hernia. Perhaps we are on to something!

By the way, I contacted the company and asked if it would be safe for me to use the product, given that I have an inguinal hernia. I was advised to "contact my physician". The response doesn't surprise me (the company doesn't want to be liable for any injuries). At least the answer was not a definite "No". For anybody reading this, please note that it definitely isn't safe to use the product if you have heart problems (and use a pacemaker), or if you have certain types of diabetes or cancer. Please see the product web site for more details. I might see my doctor just to explain what I'm intending to do, although I suspect I'll get the usual boiler plate response that hernias can only be healed by surgery. As long as he says I'm not likely to harm myself further by using the device (especially on a low setting), I think I'll just pretend I didn't hear his other "official" opinions.

It's been about 3 weeks since I received my Flat pad supports and I've been wearing the support diligently every day, for almost all of the day. The only time when I don't wear the support is in the morning when I'm in the bathroom and in the evening while I'm taking a shower at the gym. I run for about 30 minutes, 5 days a week (I've been doing this for many years now, even before I developed a hernia). I wear the support while I'm running. I've also started to do exercises to develop my lower abdominal muscles. Some of the Pilates exercises on the web site seem to be rather subtle and I'd rather learn them with the help of an instructor to make sure that I'm doing them properly. I bought a book on Pilates and I'm aware that it's important to breath correctly while performing the exercises. I have an appointment next week with a Pilates instructor. However, I am doing exercise 3 on the web site as well as a slightly modified version of the Pilates Double leg lift exercise (instead of keeping my legs straight when I raise them at a right angle to the floor, I keep them bent, so only my thighs are at a right angle to the floor). I always wear my Flat pad support when doing these exercises. When I first started the double leg lifts about 3 weeks ago, I couldn't do them very smoothly. It was obvious that although I run a lot, my abs are not in great shape. This is one of the heavier exercises that probably puts quite a bit of strain on the groin area. I started by doing the leg lift exercise for about 5 minutes a day, for the first week. This doesn't sound like a lot, but I believe that in order to avoid injury, it is prudent to start slow when exercising a muscle group that is not in great shape to begin with. After the first week, I increased each session to about 10 minutes. I'm now able to do the exercise for 15-20 minutes without feeling any serious after effects (the Flat pad support seems to be protecting the hernia). My movement is also smoother. My usual exercise routine during week days is to do the leg lefts and a couple of the other Pilates exercises for about 20 minutes, after which I run for about 30 minutes (wearing the flat pad support all of the time). I plan to gradually increase the time I spend on the leg lifts and/or other appropriate pilates exercises. Hopefully, I'll also be using the Flex belt in the near future!

I've also started to take the following supplements on a daily basis:

- 3000mg of vitamin C (might increase to 4000mg later on)
- a calcium/Magnesium/Zinc tablet (333mg, 133mg and 5mg respectively)
- a protein supplement (about 15g per day at the moment, might increase later)
- An Arginine supplement (500-1000mg per day).

It's only been 3 weeks, but I've noticed that my hernia bulge has decreased in size quite significantly. I can only inspect it during those times when I'm not wearing the support, which is for a brief time in the morning and the evening while I'm in the bathroom and at night just before I go to bed (I don't wear it in bed). There are times when the bulge disappears completely. This always happens after I run. Whenever I take the support off, the bulge is not present (which shows that the support is really working!). Sometimes the bulge will start to appear after a few minutes, but it is definitely much smaller than it was before I started using the support. For me, it's still early days. I think most of the improvement so far (which is quite amazing) can be attributed to the support. I did wonder if it would make sense to hold off for a while on the Pilates exercises in order to give the hernia some time to heal with just the support. Perhaps this would reduce the risk of damaging the hernia with some of the more strenuous exercises. However, as far as I can tell, I haven't make the hernia worse by doing the leg lifts (with the support). In addition, as far as I can tell, running does not adversely affect the hernia (even if I don't wear the support).

Thanks,
David.

(Hope to provide more feedback soon!).
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PostPosted: Mon Mar 28, 2011 1:48 pm    Post subject: Reply with quote

Great feedback David - many thanks Smile

A lot of our successful cases are saying that a combination of Pilates (done the right way) and the Flat Pad Support works better than the support alone, so we think you're on the right track.

Looking forward to the next report
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Richard



Joined: 05 Sep 2009
Posts: 28
Location: Surrey

PostPosted: Wed Mar 30, 2011 2:47 pm    Post subject: Reply with quote

Hi David,

Thanks for your comments in your last post, don't take anything I say with too much authority though as I don't have any medical training, my knowledge is based solely on my own experiences and research. It's good to hear that you are noticing improvements already with your treatment, that is certainly very encouraging.

I wanted to let you know that I went ahead and ordered a Slendertone Gymbody Plus Toning Belt from Amazon a couple of days ago. Slendertone seem to be the main manufacturer of this type of EMS device in Britain, and this is about the cheapest (around £35) product they sell. The reviews for this though are just as favourable as the more expensive models, so I think it should perform well, it just lacks some of the bells and whistles of the more advanced models. I shall put some more posts up in due course when I have had a chance to see how effective it is.

Donít worry too much about any advice from doctors about surgery being necessary, I know from first-hand experience now, as well as from the accounts of others on this site, that hernias can be improved dramatically by self treatment, even if perhaps not cured 100%. Apart from the tiny risk of a trapped bowel, thereís so certainly no harm in trying, as long as the bulge can be kept in most of the time. Even if people who have attempted self treatment do go on to have surgery at some point, the stronger the muscles are at the time of surgery, and after, the more likely it is to be successful, and the lower the risk of the mesh slipping at some point in the future. From what youíve described in your last post I would say your hernia is not particularly bad, you certainly seem to be able to cope with everyday life and look after the hernia at the same time, which is an absolutely crucial factor for making progress.

Just from a purely personal point of view, I have pretty much given up on the Pilates exercises, not because they arenít suitable or effective, they certainly are, itís just that they are so time consuming. As Iím sure you know by now a good work out, just on the abdomen, takes well over an hour, and by the time youíve done that three or four times a week itís rather tedious, I much prefer to do more everyday exercising. The most effective forms of this I have found so far are hill walking and cycling. I tried cycling again recently for the first time since I developed my hernia and was surprised how much it works the abdomen. Iíve had a lovely warm achy sensation in the hernia region the next day after cycling on each occasion, followed by the hernia staying in for longer once the muscles have had a chance to rest. Someone else on this site has also mentioned hill walking as a good form of abdominal exercise, and indeed Iíve found the more hilly and uneven the ground the better. The combination of walking uphill, downhill and on flat ground and particularly if clambering over bumpy ground or rocks is a great workout for the abdomen. Anyone who lives near hills or mountains or even a rocky beach should certainly make use of them if they enjoy that sort of walking. As always though, you need to be able to keep the bulge in whilst doing any exercises. Iím hoping now that a combination of this type of regular exercise and the EMS belt will be the perfect combination for me. Iím not entirely sure running is the best type of exercise to be doing for a hernia, a significant number of people on this site seem to be avid runners which makes me a little suspicious as to whether this might be an aggravating factor in creating hernias in the first place. It certainly produces a relentless hammering action on the abdomen, as each foot touches the ground the slight jolt forces the abdominal contents against the muscle wall, it might be this that causes a problem if the abdominal wall is not in good health or as strong as it should be. I guess if youíre not experiencing any problems then itís worth continuing, but it might be a good idea to do some experimentation and find the best form of exercise that gives the best results and that you enjoy also. Certainly donít be put off continuing with the Pilates by what I have said, it is undoubtedly ideally suited to the task if youíve got the time and donít mind doing it.

You wondered whether holding back on the exercises to give the hernia a chance to heal with just the support might be a good idea. Initially I experimented with long periods of rest, but they donít really seem to help particularly. What muscles need most whether theyíre healthy or healing from damage or injury is to be kept working and stretched regularly. Although having said that Iíve found regular short periods of rest, for one to two days typically about once a week or more are beneficial, the muscles need this time to recover properly from exercise.

I just thought Iíd say a little about diet as well seeing as you mentioned it, Iíve done considerable experimentation with this over the last year and a half. For me, by far the most significant change I made to my diet was increasing the amount of vitamin A; this had a dramatic and almost instant effect, both on my hernia staying in and my muscle performance generally. However I did discover my diet had been very deficient in it for some time prior to the appearance of my hernia, and Iím convinced now this deficiency was the main factor that caused my hernia in the first place. I wrote a post about this at the beginning of last year if you want to read it. For anyone wondering whether they might have a vitamin A deficiency, an easy way to tell is to see how well your eyes cope with very bright light. Take a sheet of blank white A4 or larger paper outside on a sunny summerís day when the sun is high in the sky, and point the paper directly face on to the sun. You should be able to look straight at the paper for some time a short distance away without squinting or finding it painful, if you canít youíre probably not getting enough vitamin A in your diet. Youíd need to spend at least five or ten minutes out in the sun beforehand to get your eyes accustomed to the sunlight though, otherwise it wouldnít be a fair test. I know from my own experiences that this is so, I remember trying to read books and magazines outside in the summer on occasions over recent years and finding it almost impossible (I never wear sunglasses). Since increasing my vitamin A this intolerance of bright sunlight has completely disappeared, I can now comfortably read a book in bright sunlight. Vitamin A is absolutely crucial for retinal function, a deficiency also causes a lack of sensitivity in very dim light. Excessive deficiencies can cause total blindness. The reason it is important regarding hernias is probably because it is also essential for protein synthesis, without it the body canít manufacture its own protein which, amongst other things, is of course essential for building muscle and connective tissue. My deficiency I believe slowly wasted and weakened my abdominal muscles and the associated connective tissue over a period of several years until they eventually gave way.

Regarding vitamin C, Iíve experimented with different amounts of this and havenít really noticed any detectable difference quite honestly. Vitamin C is essential for tissue repair but I donít think the pace at which the abdominal muscles heal themselves calls for excessive amounts of it. Bear in mind that an orange, one of the best natural sources of vitamin C, only contains at best about 100mg of it, so if youíre planning on taking 4000mg daily thatís equivalent to 40 or more oranges! I take 500mg a day now in tablet form and this seems to be more than adequate. This is still roughly five times the regular daily amount a body needs under normal conditions (i.e. when not fighting infections or healing significant injuries). The only other potentially conclusive outcome of my own dietary experimentation was eating peanuts. Iíve eaten these on and off for some time and my hernia usually seems to do slightly better during the times when I am eating them. The nutritional benefits of nuts has been well stated on this site already and peanuts are I think the most nutritious of all nuts. I buy bulk bags of them from a whole-food supplier and roast them myself in an Aga Ė yummy! Obviously each person could have their own unique dietary deficiencies/needs so analysing your own diet and experimenting is a very sensible move.
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daveva



Joined: 18 Mar 2011
Posts: 22

PostPosted: Thu Mar 31, 2011 6:22 am    Post subject: Reply with quote

Hi Richard,
Thanks again for a great reply! I really appreciate the detailed feedback. It looks like you beat me to it with regards to placing an order for an EMS device. I just placed an order for the Flex Belt yesterday. It should arrive in about 5-7 days. Do you think it would be a good idea for us to establish a new topic in the forum where anyone could report their experiences with EMS exercise devices or join in with the discussion ? It would be a privilege to work with you on this. Since the subject line of my original posting is specific to the Flex belt, I thought it might be better to create a topic with a more general subject such as "Can EMS be used to help heal a hernia". The fact that we will be reporting results with different devices could be a good thing (if for example one of the devices produces superior results).

I wanted to provide some more feedback on your other comments regarding alternative exercises and diet, which I thought were very interesting. I read your posting quite late this evening and unfortunately, it looks like I won't have time tonight to go into more detail in this reply, but I will follow up shortly. I also saw two different pilates instructors this week and I'll talk about my experiences in my next posting.

Look forward to talking to you again soon,
Best Regards,
David.
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Richard



Joined: 05 Sep 2009
Posts: 28
Location: Surrey

PostPosted: Sat Apr 02, 2011 11:38 am    Post subject: Reply with quote

David, my belt arrived yesterday and I tried it out briefly for the first time last night. My initial impressions were rather disappointing, the device works very well but it didnít feel as though it was quite targeting the most important muscle areas towards the groin area. However when I woke up this morning I could feel a pleasant achy sensation around the groin area rather implying that it had been targeting the right muscles. So itís not really possible to know much yet, Iíll need to use it for a while to see how things go.

I think youíre right, we should start a new topic when either of us has anything meaningful to say regarding these devices. Iíll probably elaborate more on these early experiences in the coming posts, but for now Iíll just say a few things.

The device itself is quite pleasant to use, the sensation it gives it slightly uncomfortable to start with but you very soon get used to it and then itís quite relaxing and therapeutic. A friend of mine was given EMS treatment for a spinal problem recently and told me he found it very painful to start with but thankfully thereís virtually no pain at all with these devices. Donít be apprehensive about turning it on for the first time, all they do at the lowest intensities is cause a slight tickling sensation.

Any safety fears either of us had can be completely forgotten about as well I think, I actually tried it briefly standing up to start with to get the belt positioned, and my hernia stayed in quite happily despite having no support at all. If used lying down then I doubt it would give anyone any cause for concern, or even whilst sitting down, as long as you sit very upright and donít slouch at all and the hernia is pushed properly in beforehand.

I tried moving the pads around to slightly different positions to those recommended and found you can stimulate different areas by doing this, also you can pull one of the left or right pads away so it doesnít connect, just leaving the middle and the remaining left or right pad. This causes the muscles on only one side to contract, however the unit flashes a warning up to say that there is a poor connection and wonít let you change the intensity level as a result. Also I found you could slightly bias the muscular contractions by consciously flexing certain muscle areas at the same time, this tends to cause those muscles to engage better with the electrical stimulation.

Good luck with yours when it comes.
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daveva



Joined: 18 Mar 2011
Posts: 22

PostPosted: Sun Apr 03, 2011 6:22 am    Post subject: Reply with quote

Hi Richard,
Thanks for the feedback on your SlenderTone belt. I wasn't expecting mine to arrive until next week, but it arrived this morning! When I opened the package, I was surprised to see that the Flex Belt is actually made by SlenderTone. It's printed on the box. So, we probably have very similar belts! Perhaps the SlenderTone belt is marketed in the U.S by "The Flex Belt" company. At first, I had visions of electrocuting myself and I was nervous to try it, but as you say, there really is nothing to fear. After charging the battery and installing the gel pads, I put the belt on and then laid down on my back, in order to ensure that the hernia bulge was 'in'. I didn't wear my support - I think it would have overlapped on top of the belt. I turned the unit on and set it to program 1 (beginner). I set the intensity level to 40 (the intensity ranges from 1-150). I chose 40 since there was an example in the manual that suggests that this is a good place to start. I then had an idea that perhaps I should contract my TVA muscles (just as you would when starting a pilates workout). So I tried to maintain that posture just before I turned the unit on. Just as you reported, I felt a mild tingling sensation (no pain whatsoever) and I could feel the abdominal muscles gently contracting and then relaxing. I think 40 is quite a low setting. I didn't increase the setting during the workout, since this was my first session. The session lasted 20 minutes (as recommended in the manual). After the session, I felt no pain or discomfort and the hernia didn't seem to have been adversely affected. Perhaps I will feel something tomorrow morning, but I think that at level 40, it was just a light workout. According to the manual, the belt should be used 5 days a week and the intensity level should be gradually increased over a number of weeks. After the end of 4 weeks, some people should be able to use the unit at the maximum intensity level (150), according to the manual. The manual also suggests that it can take 8 weeks to see visible results, so we might have to continue testing for a while in order to see if an EMS belt can actually help heal a hernia. Overall, I'm pleased with the product and have hopes that it will make a difference, but it is too early yet to make a judgement (as you suggested). I'll definitely continue with the testing and will post progress report updates. I didn't experiment by changing the positions of the pads. With the Flex belt, the gel pads are glued onto the belt (not permanently). It would be possible to re-position them slightly, but they must always be glued to the belt and they must be in contact with one of the electrodes, which is built in to the belt. It would be easier to either raise or lower the belt towards your waist/hips (respectively) in order to position the pads either further away or closer to the hernia. When I ordered the belt, I also ordered 3 sets of extra gel pads. I can see that these will 'wear down' after a while. The company recommends replacing the pads every 30 days. For anyone who is wondering what the gel pads look like, they resemble small square or oblong pieces of rubber, with a thick 'glue'-like adhesive on one side. The 'glue' side is the side that touches your skin. When you take the belt off, it is best to take it off slowly, to avoid ripping the glue off the pads. The pads do stick to your skin, but don't worry, it's not like taking a plaster (or band aid) off, which can be uncomfortable. There is only a mild sticking effect. I didn't find that any glue came off on my skin, but I could see that over a month or so, the glue-like substance would start to wear down on the pads, which is why the pads need to be replaced periodically.

Richard, in one of your previous postings, you raised so many interesting points about diet and exercise. I have been very fortunately so far in that my hernia doesn't cause me any pain and it hasn't curtailed any of my activities. Sometimes if I twist or bend in certain ways, I feel a little 'twinge', but it's hardly worth mentioning. You mentioned that you suspected that running could either cause a hernia or that it might aggravate it. I have often thought about this and I have wondered if I should continue. I enjoy running so much that I think I must be addicted to it! It would be difficult for me to stop. It's possible that the running caused the hernia, but I don't know for sure. I've been running for many years and so I would hope that something else caused the hernia. I only realized I had a hernia when I was showering one day and I felt the bulge. I've continued to run, while wearing the support and I haven't noticed any worsening of the bulge or sudden pain, but I'll keep a close eye on it. I did some searches on the web to see if running could cause a hernia, but popular opinion suggests that it probably wouldn't. However, I do appreciate your point and the connection that might exist.

I can understand your point about the pilates exercises taking a long time. Perhaps one approach would be to focus on doing 3 or 4 of the recommended exercises in one session and then moving on to the next set of 3 or 4 in the next session and so in, instead of trying to do all 12 of the recommended exercises in a single session. I saw 2 pilates instructors last week, just for an initial consultation. One of the instructors has had experience with clients that have had hernias or similar injuries, so I'll probably take lessons with that instructor. Both instructors seemed confident that pilates could be used to treat a hernia and that it was realistic to expect an improvement. I agree with your point of view that if you can get the hernia bulge to reduce to a point where it is almost insignificant, then that should still be regarded as a success (even if it doesn't disappear completely). One thing that struck me having spoken to the instructors is the importance of correct posture and breathing. It is really important to understand how to engage the TVA and to get your abdominal muscles to "pull in" at the start of an exercise. When I first tried the exercises (without an instructor), I was sucking in my breath and inflating my chest at the start of each exercise, which I've now learned is incorrect. I was told that I should breath out and let the rib cage "melt down" toward the pelvis, then engage the TVA and take a shallow breath in before the compression phase of the exercise (where the abdomen muscles are made to contract). For a beginner, it takes time to master this and I plan to do more practice this weekend just on technique. Now I know why beginners such as myself need an instructor. I was warned that bad technique could actually make the hernia worse.

Your comments about riding and hill climbing were interesting. I haven't tried either of these forms of exercise as yet, but the gym that I go to has bicycle machines and stair masters (which I presume would be a close approximation to hill climbing). I'll definitely give these exercises a try to see if I feel the same type of burn in the abdominal area. I can see that some pilates exercises might provide a similar experience. For example, i found an exercise in a pilates book called the "Single leg stretch" (which exercises the legs in a bicycle style of motion). However, this exercise is not on the recommended list on the web site. It might be more suited to advanced pilates students who have gained sufficient strength and have good technique. I'm wondering if the exercises on the web site have been chosen not just because they are beneficial, but also because they can be performed relatively safely by beginner students? After gaining sufficient strength by performing these exercises, I wonder if it is a good idea to move on to the more advanced pilates exercises which potentially could help build even stronger abs?

Before I discovered that I had a hernia, I had read a book called Superfoods RX. "Superfoods" are health foods that are very high in nutrients (but not necessarily calories). If anyone is interested in this, please visit: http://www.superfoodsrx.com/ Having read the book, I decided to start eating lots of fresh spinach on a daily basis. At the moment, I eat about half a bag of spinach a day (about 4.5 oz). According to information on the bag, that amount of spinach provides 240% of the recommended daily amount of vitamin A. From what I understand, spinach doesn't actually contain vitamin A, but it contains carotenoids that are converted to vitamin A in the body. You had mentioned that you suspected that your hernia was caused by a vitamin A deficiency. I wondered if perhaps you had tried spinach? I read in another post that you were eating liver pate in order to gain more vitamin A. I actually like liver! I had liver and onions today, following your suggestion Very Happy I'm not sure if my hernia was caused by a vitamin A deficiency. I also take fish oil on a daily basis, which also contains vitamin A. Spinach is not very exciting by itself, so I steam it lightly for about 10 minutes, then I add some salsa (not the runny type that is served with tortilla chips), chopped peppers and onions and finally about 1.5 tablespoons of virgin olive oil. I find it's delicious! I eat it every night after I do my workouts.

One thing that the Hernia Bible web site recommends is to reduce the transit time of food in the intestines. I take a soluble fiber supplement everyday which I find works really well (keeps me regular). The product I buy is called "BeneFiber". I take about 6 tea spoons of this supplement each day, which provides about 8g of soluble fiber. I also eat high fiber cereal. The supplement comes in a powder form and can be mixed in any drink. It has no taste and it doesn't turn drinks into a sludge or make them gritty. There are many brands out there.

I'll let you know how I progress with the Flex Belt and I look forward to hearing your progress reports with the Slender Tone EMS.

Thanks and hope to talk soon,
Best regards,
David.
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Richard



Joined: 05 Sep 2009
Posts: 28
Location: Surrey

PostPosted: Sun Apr 03, 2011 9:15 pm    Post subject: Reply with quote

Hi David,

Iím glad your belt arrived quickly, weíll both be starting together now, so it will be interesting to see how things progress. I think Slendertone is an American company that markets their belts through different outlets. I really like my belt now, I find it quite disappointing when the program stops as I want it to carry on. I ran the beginner program twice in a row last night at a moderate intensity and my muscles didnít complain at all today. As you must be very fit I think you can probably push it a bit too. Iím curious as to whether itís working all three muscle layers or perhaps just the outer external obliques. I think Iíll probably email them at some point and ask them that, I guess it depends whether the nerves for the two deeper layers run close to the skin also. Itís obvious that it is stimulating the rectus abdominus muscles. I experimented moving the belt up and down the waist, in fact I think I might run the program twice from now on, once fractionally above the mid point where they suggest and again about 3 inches lower, this seems to extend the range it covers downwards a bit. I found moving the outer pads further outwards causes the muscle sections further around the side to contract, but I guess thatís not terribly useful as far as the hernia is concerned.

Regarding running, I didnít think it actually causes a hernia as such, I just thought it might make it more likely to occur if youíre heading for one for other reasons. As you say if you can easily protect the hernia at the same time when youíre running then there shouldnít be any problem.

Itís good that youíve found Pilates instructors that have some experience of people with hernias. I had a couple of Pilates sessions with an instructor, he was actually a personal trainer and sports injury therapist but he was very familiar with Pilates exercises. He said he couldnít see any reason in theory why a hernia couldnít be healed naturally, but thought it would prove extremely difficult in practice. He also said the injury would never heal 100%, because muscle and tendon injuries never do, theyíll always remain a slight weak point where the tissue tore. But hey, as long as it proves strong enough, which, going by the accounts of the few that have claimed total success, it presumably can, then thatís good enough for me. Like you I struggled with the breathing, itís the exact opposite of what you naturally want to do, if you take your mind off it at all when youíre learning you just revert back to the way you shouldnít do it. I think the exercises on this site are all part of the beginners set, probably so they are easier for people to master and also theyíre less likely to strain the hernia than some of the more advanced ones might.

Doesnít sound as though a vitamin A deficiency played any part in your hernia. I normally also have a couple of spoonfuls of cod liver oil every day now, itís one of the easiest ways for me to get vitamin A. Interesting you mentioned spinach, this was one of the foods that I regularly used to crave in recent years, my body seemed to instinctively know that it contained what I was short of. Since taking regular daily doses of cod liver oil this craving has vanished, though I do still like spinach and eat it sometimes. Be careful with too much of it though, some people think that large regular doses of it can lead to problems with gout and kidney stones.

Nice to talk to you again, and Iíll keep you informed of any progress.
Richard
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daveva



Joined: 18 Mar 2011
Posts: 22

PostPosted: Tue Apr 12, 2011 6:13 am    Post subject: Reply with quote

Hi Richard,
I thought I'd post a brief update on my experience so far with the Flex Belt. I've been using the belt for about a week now. It took a couple of sessions to get used to it (anything new seems strange at first), but I now really enjoy using it. I decided to follow the example plan shown in the manual and so I started on the "Beginner" program at an intensity level of 40. I'm now on the "Intermediate" program at an intensity level of 70. At this intensity level, the muscle contractions in the stomach area are noticeably stronger, but I havenít felt discomfort or pain (even the day after). I hope to progress to the maximum intensity level of 150 after a further 3 weeks. Judging from my experience so far, I can imagine that level 150 would provide a very intense work out of the abdominal muscles. When I use the belt, I always lie flat on my back in order to keep my hernia bulge Ďiní . The instruction manual recommends that the belt should be placed over the navel area on the stomach and so Iíve followed this advice so far, rather than trying to move it lower down on my hips (closer to the hernia).

I've also been doing Pilates exercises for the last few weeks (admittedly without the advice of an instructor for most of the time). My stomach area is starting to look a little bit flatter. Since I've only been using the Flex Belt for a week, I'd attribute most of my progress so far to the Pilates exercises. The hernia bulge does not seem to have been adversely affected by any of the exercises that I've done so far. There are occasions when the bulge doesn't show and at other times it does become visible a few minutes after I remove my Flat pad support. So far at least, the bulge doesnít seem to have increased in size.

I intend to continue using the Flex Belt. Iíll also keep up with the Pilates exercises. Iím very impressed with the Pilates instructor that I now have. She has worked with clients that have had injuries such as hernias. She even visited the Hernia Bible web site and familiarized herself with the recommended exercises. She realized immediately that I needed to focus on mat work, rather than the Ďotherí apparatus. With regards to the Flex Belt, Iím really looking forward to trying the higher intensity levels on the belt (from 100 to 150). Iím hoping that the higher intensity levels will make a real difference over the next few months. I appreciate that if I make some real progress (which could take some time), it will be difficult to tell which form of exercise made the difference, but Iíd rather attack the problem from different angles with the hope of finding a quicker resolution. I'll keep you updated with my progress.

I hope that you are also having a positive experience with your Slendertone belt and any other exercises that you are performing.

Hope to talk soon,
Best Regards,
David.
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admin
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PostPosted: Tue Apr 12, 2011 10:53 am    Post subject: Reply with quote

Hi David

Your feedback so far is much appreciated. It's good to know you have found a good Pilates instructor. Would you like to put her contact details on our brand new forum section here?

http://groin-hernia.com/phpBB/viewforum.php?f=8

With continued good wishes for your success.
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Richard



Joined: 05 Sep 2009
Posts: 28
Location: Surrey

PostPosted: Wed Apr 13, 2011 9:48 am    Post subject: Reply with quote

Hello again David, and Admin,

Glad youíre having favourable experiences with your flex belt so far. I think youíre wise to use both forms of exercise and indeed any other tool at your disposal to tackle the hernia, itís certainly a challenge healing a hernia naturally and the body needs all the help it can possibly get.

My experience with the belt so far has been extremely encouraging, this last week has undoubtedly been the best week ever regarding my hernia staying in of its own accord. I even cut the grass a couple of days ago without any support and the hernia stayed in nearly all the time, it popped out a couple of times but I pushed it back in and each time it stayed. I could only have dreamt of doing this last autumn when I gave the grass its last cut for the year. This improvement could be a temporary blip that is largely unconnected with the belt or it could be directly attributable to it, itís too early to tell yet but Iím quietly optimistic. I shall certainly keep everyone updated on the site.

I am only now going to do regular cardiovascular exercising that is also good for working the abs, i.e. walking, climbing, cycling, and use the flex belt regularly. I probably wonít do much Pilates any more, if any. This is what I would prefer to do and should also provide a slightly different scenario to yours which might help to determine the usefulness of the belt better. As you say youíre not really going to know which is giving the greater benefit to you, the belt or the Pilates. Also I havenít ever really used a flat pad support. I bought a couple about a year and a half ago but quickly discovered that unfortunately I was one of the few that they donít work very well for. Whenever I slipped my fingers under the pad I could nearly always feel the bulge slightly out and resting against the pad. Iíve had to struggle without the use of any support so far which is I think mainly why my progress until recently has been quite slow. Only now that the muscles are becoming just strong enough not to need the support is everything really beginning to take off.

I am now up to about intensity 60 out of 100 on my belt so it seems weíre finding we can increase it at about the same rate. Usually I run the beginner program once but occasionally twice (my belt only has two programs, beginner and advanced).

Fingers crossed that you have discovered a really useful tool in tackling a hernia.
Richard
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daveva



Joined: 18 Mar 2011
Posts: 22

PostPosted: Wed Apr 27, 2011 6:28 am    Post subject: Reply with quote

Hi Richard,
I hope you are continuing to make progress with your Slender Tone belt. Since we last spoke, Iíve increased my intensity level setting to 110 (the maximum setting on the belt is 150). The strength of the abdominal contractions at this setting is incredible! If anyone reading this is wondering what the contractions feels like, imagine someone putting their fist on your stomach and then pressing in as hard as possible (not punching your stomach). Even at this intensity level, I havenít experienced any pain or discomfort while using the device. In the last day or so, Iíve started to feel a tiny bit of muscle soreness in the stomach area during the day (my hernia isnít hurting). This might be due to the higher intensity setting on the Flex Belt or it could also be due to the fact that Iíve been spending more time on the Pilates exercises. At the moment, Iím exercising about 5 days a week. On an average exercise day, Iím doing about 45-60 minutes of Pilates, a 30 minute run and 30 minutes with the Flex belt. Itís very time consuming (as you pointed out in a previous posting) and a bit tiring! My stomach area is definitely starting to get flatter. Iíve also noticed that some of the exercises are starting to feel a little less strenuous and so Iím hoping that means that Iím starting to gain a little bit of strength in the abdomen area. Despite all of this exercise, the hernia bulge has been behaving itself, most of the time. Last week, I thought there were times when the bulge looked a little bit smaller (when I wasnít wearing my support). However, one night I woke up at about 4am and stayed up for about an hour without wearing the support. After an hour, the hernia bulge was more pronounced. I felt like I had regressed to the time before I started to wear the support. Strangely, the hernia bulge was back to its normal smaller size the next day and has been ever since. Iím not sure what to make of this. I guess it means I still have plenty of work to do.

The more I use the Flex Belt, the more I like it! My belief is that it has partly contributed to my progress so far and Iím optimistic about its future potential to help in the healing process. I will definitely continue to use it. I donít doubt the general claim that the device will strengthen the abdominal muscles. Supposedly, visible results should be obtained in 8 weeks. Iíve only been using the device for about 3-4 weeks.

My Pilates instructor has been giving me some great tips on exercising. I asked her why Iíve only recently started to feel some muscle soreness in the abdomen area on days after I exercise. Iím surprised because I have been trying to incorporate some more advanced Pilates exercises into my routine, such as single and double leg stretches, which should put a little more stress on the muscles. She recommended that I should slow all of the exercises down and focus on grace and precision. According to my instructor, one should strive to perform the Pilates exercises at ultra-low speed with the grace of a ballet dancer and without a hint of shaking or shuddering. Until one reaches this level, the abdominal muscles havenít reached optimal strength. In other words, if an exercise seems too easy, it might be because it is being performed incorrectly, or it is being performed too quickly. She also gave me a great suggestion for exercise 7 (hip rolls) on the recommended list. Instead of keeping your feet on the floor, position a large exercise ball behind your legs and rest the backs of your knees on top of the ball. Grip the ball gently with the backs of your thighs and knees and keep your knees close together. The ball should fit snugly against the back of your legs. I use an inflatable ball that is about 65cm in diameter. Then perform the hip roll movement, while maintaining a gentle grip on the ball with the backs of your legs. With this technique, itís easier to feel the abdominal muscles really working, especially as the roll angle is increased and held for say 10-15 seconds before returning to the start position. She also recommended that if beginners with weaker abdominal muscles want to practice some of the more ambitious Pilates leg lift exercises, such as single and double leg stretches and the double leg lift shown on Falcon Blancoís video (on the web site), then they should try placing a small inflatable (soft) exercise ball directly under their bottom (butt) before performing the exercise. The ball that I use for this purpose is 8 inches in diameter. I donít over-inflate the ball so as to avoid any soreness. For some reason, the ball makes it easier to perform the exercises. Once the abdominal muscles develop sufficiently, it shouldnít be necessary to use the ball.

I was thinking about what you had previously said about runners being susceptible to hernias. Having thought about it more, I can see that in my own case, there could possibly be a connection. Iím wondering if I might have developed the hernia due to a protein deficiency. I never used to take a protein supplement. Perhaps when a person runs frequently, protein is burned up faster, since the leg muscles need extra protein to restore any damage caused by the running? If there is insufficient protein left to maintain other muscles, perhaps over a period of time, those muscles start to deteriorate? I donít really know what Iím talking about, this is just a guess. Iím now taking a 50g protein supplement daily, just in case Iím right.



Hope to talk soon,
Best Regards,
David.
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Richard



Joined: 05 Sep 2009
Posts: 28
Location: Surrey

PostPosted: Mon May 02, 2011 2:29 pm    Post subject: Reply with quote

Hello again David,

The first paragraph of your last post was very interesting and timely for me. I tried turning the intensity level quite high on my belt for the first time about two weeks ago and experienced very powerful contractions like you that felt good at the time (I actually found it hard to breathe when the muscles were contracting, as my lungs could only partially inflate due to the abdomen being squashed!). However, since then the ability of my hernia to stay in has deteriorated quite considerably, having been doing consistently well just prior to a fortnight ago. I strongly suspect the powerful contractions of the belt overstressed the sections of the muscle that are important for holding the bulge in. In addition I felt a strange aching in an area to the left of my belly button, I would guess that the high intensity setting on the belt could well be the cause of your muscle soreness as well. Over the last couple of days it seems the muscle strength has pretty much returned to normal, but it has taken ten days or so for the damage done to heal itself. I guess this has been an important experiment though, firstly because it would seem to demonstrate that the belt is indeed stimulating the area of muscles that are important for supporting the torn sections of aponeuroses, and secondly it was a reminder to me of how important it is to let the muscles strengthen and heal at their own natural pace without any undue force. I guess the risks with Pilates are somewhat less as your body has control over the intensity of muscle contractions rather than artificial stimulation from the belt. I still think the belt could well prove extremely useful but needs to be used sensibly in the context of healing a hernia. Iím only using the belt on a fairly gentle setting now, focussing more on increasing the time spent on each section rather than increasing the intensity. As I mentioned before, I used a low intensity initially for the first week or so and this resulted (albeit possibly coincidentally) with the best week Iíve ever experienced since developing my hernia. Considerably more time will be needed I think for me to establish exactly how much benefit is coming from the belt, and separate its influence from other factors and the general day to day and week to week variations in muscle strength that always occur anyway.

Following on from that very last comment, you mentioned that one night your bulge had enlarged but became smaller again the next day, this is very natural and to be expected. It seems every hernia sufferer experiences day to day and hour to hour variations in the ability of the bulge to hold itself in. I think this is mainly caused by variations in muscle strength, and there are probably numerous factors that influence this. For instance, differences in heart rate affect the amount of blood being fed to the abdominal muscles, variations in blood sugar level affect the amount of energy available in the blood being supplied. Iíve noticed on numerous occasions a slight increase in Ďholding in abilityí soon after eating a meal (presumably because of increased blood sugar levels), and a considerable prolonged increase when walking and exercising as the increased heart rate keeps the muscles well fed with blood. Also when you exercise the ab muscles fairly hard they tend to weaken temporarily for a day or so (as any muscle would) before becoming a fraction stronger afterwards. State of mind plays a part as well, feeling happy and relaxed makes it more likely that the bulge will stay in as the mental motivation associated with good feelings gives your whole body a boost of strength, and conversely stress causes the abdominal muscles to tense and hence increases the abdominal pressure. The other major influence is of course is the amount of food digesting in your bowel affecting the pressure on the abdominal wall. All these factors combine to produce significant variations in the ability of the bulge to stay in, and also affect its size when it does bulge out. Itís very likely that a hernia will bulge more during the night as your heart rate is likely to be slower and blood sugar levels slightly lower than during the day. Also as your body switches from an Ďactiveí mode during the day to a Ďhealing and regeneratingí mode at night the normal muscle strength is compromised. As the abdominal muscles have to maintain a slight contraction all day I guess the night-time is the only time they ever get to rest properly and regenerate, if you get up in the night you interrupt them in the middle of this process. Iíve found from experience itís doubly important to keep the bulge supported when getting up in the night.

Regarding your last paragraph, you might be thinking along the right lines regarding protein deficiency, itís very difficult to say, as you know I personally suspect nutrient deficiencies are a major contributory factor in the development of many hernias. What you should probably do is look up all the common deficiency symptoms for protein and see if any of them ring true with you. I did this with vitamin A when I first started researching diet and soon realised I was suffering from pretty much all the symptoms! A protein deficiency would have essentially the same affects as a vitamin A deficiency regarding the deterioration of muscles. Iíve rather come to the conclusion that mild nutrient deficiencies can have a Ďpatchyí affect on the body, by that I mean certain areas of the body, for whatever reason, succumb to the effects of the deficiency more than others. I have good reason to suspect this for a vitamin A deficiency, for reasons which I hope to explain at some point in a separate post. I believe that this Ďpatchyí influence could be a possible explanation as to why groin hernias are twice as common on the right side as on the left. No explanation seems to currently exist that explains this right side bias, at least none that I can find searching on the internet. (Figures obtained from sources on the internet suggest that when groin hernias are first discovered, 50% find one on the right, 25% on the left and 25% develop one on both sides at around the same time.) Itís not specific to inguinal hernias either, femoral hernias have the same above mentioned right/left distribution (This type of hernia produces a bulge slightly further out than inguinal hernias, towards the crease between the groin and upper leg, the bowel passing out beneath the inguinal ligament). I canít help feeling that there is a big clue as to what is going on regarding weakening of the abdomen in this right/left asymmetry, itís odd that there is no mention of it on the net.

Anyway, Iíll stop now before I waffle on forever! Iíll keep you informed of my progress, thanks for keeping me posted on how things are going with you.
Richard
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