What are your thoughts on the safety of doing Pilates with any kind of hernia? I can find very little information on the subject.

Hi Susie ~ It is very hard to answer that question without more information. I know from experience that Pilates can help a hernia, but I can't comment on what I did as if it would apply to all other hernia's. I can tell you that what I did was very subtle in terms of mechanics and exertion and it took some time for my client to become pain free.

I know, it is a difficult question- and I don't know how to simplify it. I no longer work in a studio setting with other teachers- I really miss the opportunity to hash things out with them. I'm finding that my very highly regarded training program somewhat lacked in the area of learning contraindications. Now that I don't have that network of minds I want to make sure that I am doing no harm as an instructor. For example, one client I have has a hernia right below his belly button. I have been focusing on stabilization work, heel slides, toe taps, foam roller, etc. and really trying to get him to deepen the abs without "bearing down" so to speak. I would imagine that this kind of work would be safe for most hernias? I know you can't answer it per say, but any thoughts would be helpful.

Hi Susie, I'd be interested to know if you've found anything helpful on hernias. From my experience, in the case of an umbilical hernia (right above the belly button), it seems like all these movements need to be eliminated: forward flexion, rolling down, twisting of torso in any direction, twisting of the legs with a stable torso, lowering the legs too low, back extensions, plank positions, and too much resistance on arms. As you can see there aren't many movements left! There are certain very small movements that can assist in strengthening (and maybe pulling in together) the TA, such as small pelvic tilts, either supine or on the knees, but they need to be done in a very careful manner, with a small range of movement. These are my 2 cents, I would love to see if anyone has any feedback on the issue, thank you!

And to answer your question related to the safety of Pilates on hernias: unfortunately it seems like it can make it worst, if not done in a VERY careful way, and it looks like for some exercises the safest way would be for the client to hold on to the hernia with their fingers in order to make sure they don't make it bulge out. It can be very frustrating, but it might be the only way to avoid making it worst. As an end note, I read somewhere that Joe Pilates himself had a hernia! Too bad he didn't write anything about it!