After being diagnosed with a hiatal hernia you will likely have been advised not to lift weights at the gym or engage in any heavy lifting. This is due to the risk of such activities causing the stomach to rise entirely into the chest cavity. This is considered to be a medical emergency. In this article I will explain what happened when I was diagnosed with a hiatal hernia and how I continue to lift weights safely. This article does not constitute medical advice. You should discuss its contents with your healthcare professional in the event you wish to lift weights after a hiatal hernia diagnosis.
The doctor looked uneasy. He was uncomfortable to be around during even routine appointments, but today he looked especially awkward.
“Sit down” he said, avoiding eye contact. I knew something was amiss.
“So I’m referring you for urgent scans and an endoscopy. The weight you’ve lost isn’t normal and I need to rule out stomach cancer.”
My doctor is nothing if not blunt.
Perhaps I should’ve been shocked, but by this point I’d been feeling desperately ill for two months and had lost nearly 20% of my bodyweight in that time. I knew I was ill and I’d googled my symptoms enough to know that “the big C” was a possibility.
That conversation began a season of tests and scans which revealed that I was healthy, other than suffering from a sliding hiatal hernia.
After the endoscopy, as I was recovering from the anesthetic, a nurse gleefully proclaimed that I’d never lift a weight again whilst she boasted about breaking her personal deadlift record the previous weekend!
Was this to be the end of my weight lifting workouts?
What is a Hiatal Hernia?
A hiatal hernia, also known as a hiatus hernia, is when the stomach slides up into the chest cavity. There are two types of hiatal hernia which are called sliding and paraesophageal. The most common kind of hiatal hernia is a sliding hernia where the base of the esophagus and stomach slide up through the diaphragm and into the chest.
The paraesophageal hernia is less common but more dangerous. With this kind of hernia the esophagus and stomach remain in the correct position but part of the stomach rises up through the diaphragm and sits next to the esophagus. The danger comes from the risk of the blood supply to the stomach becoming cut off.
Hiatal little hernias are thought to be caused by:
- congenital defects,
- injury to the area,
- weakening of the diaphragm with aging,
- or an increase in abdominal pressure from such things as pregnancy, coughing, straining when pooping or…
- lifting heavy things!
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Symptoms of Hiatal Hernia in Adults
I’ll deal first with the most common symptoms of a hiatal hernia before describing some of the early symptoms I had which I wish I had recognised when they first presented.
Common symptoms:
- Bloating
- Heartburn
- Burping
- Bad taste in mouth and bad breath
- Upset stomach
- Nausea
- Regurgutating food after eating
- Loss of appetite
Many months before I presented at the doctors’ surgery in the episode I described in the introduction to this article, I’ve been experiencing some strange symptoms that I foolishly ignored.
When working out intensely, I began to have dizzy spells that I’d never experienced before. These were often accompanied by sharp stabbing pains in my chest.
As I write this I can’t believe that I didn’t go to the doctor at the time! Many hiatal hernia patients initially present fearing that they’ve had a heart attack. Regardless, if you ever suffer chest pain when exercising, don’t be a dummy like me – go and get checked out!
Exercises to Avoid with Hiatal Hernia
If you’re suffering from a hiatal hernia I’m sorry to have to tell you that you need to abandon your quest to smash your deadlifts and squats records!
In fact any weightlifting activity has the potential to massively increase internal pressure in the abdomen so you need to be really careful when selecting your exercises.
Here’s a list of exercises which I consider to be the most dangerous for those with a hiatal hernia and which I personally avoid:
- Barbell Squat
- Deadlift
- Barbell Push Press
- Clean and Press
With 1 & 2 out of your exercise repertoire, you may despairing at what your leg day will look like. If that’s you, then check out this recent blog post about how I structure my current – hiatal hernia friendly – leg workout:
===> How Indoor Cycling Can Boost Your Muscle Growth
The Exercises I Perform With a Hiatal Hernia
Reading the above, you may be worried that the most effective exercises are out of bounds, but there are plenty of alternative exercises which are still effective but which don’t cause such an increase in internal pressure.
Instead of barbell squats:
- Goblet squats with a kettlebell and rep out
- Bulgarian split squats with dumbbells
- Walking kettlebell lunges
Instead of deadlifts:
- Stiff legged deadlifts with light weight and high reps
- Lying back extension
Instead of barbell push press:
- Seated dumbbell press
Instead of clean and press:
- Compound movements with kettlebells.
- Resistance Band Shoulder Press
I have also been harnessing the power of occlusion training towards the end of my workouts to ensure that I get the pump that I used to when lifting heavy weights. If you haven’t tried training using blood flow restriction bands then you should definitely read my review of BFR Bands to learn some of the astounding benefits of training in this way.
How Much Weight Can I Lift with a Hiatal Hernia?
After being diagnosed with a hiatal hernia, the initial advice was stark: avoid weightlifting and heavy lifting to prevent exacerbating the condition.
Ignoring this could lead to the stomach rising into the chest cavity, a severe medical emergency.
However, my journey didn’t end there. I gradually found ways to safely incorporate lifting into my routine, adapting to my new reality.
This article reflects my personal experience, not medical advice. Always consult with your healthcare provider before making changes to your exercise regimen after a hiatal hernia diagnosis.
Phase 1: Building a Foundation with Bodyweight Workouts
Initially, the prospect of lifting heavy again seemed distant. The focus shifted to bodyweight workouts, laying the groundwork for recovery and strengthening without straining my condition. This period was crucial for building up conditioning and preparing my body for what was to come.
Phase 2: Introducing Light Weights
As my condition stabilized and eating became less of an ordeal, I cautiously started incorporating light weights into my routine. Guided by the principle of starting light, I began at 30% of my previous maximum weights achieved through the 5×5 strength training program. This cautious approach helped me gauge my body’s response without overburdening it.
Phase 3: Progressing Safely
Over time, and with continuous monitoring, I’ve managed to return to lifting my prior max on dumbbell bench press, embark on moderately weighted farmers walks, and enjoy a broader range of weightlifting activities without triggering my hiatal hernia symptoms. This gradual progression underscores the importance of patience and adaptation in the recovery journey.
Guidelines for Safe Lifting Post-Diagnosis
To visualize the progression, here’s a simple guideline that I followed, illustrating a safe increase in lifting intensity over time:
| Month | Activity | Weight Guideline |
|---|---|---|
| 1 | Bodyweight Workouts | Focus on conditioning and strengthening |
| 2 | Light Weights (Introduction) | Start at 30% of previous max weight |
| Ongoing | Gradual Increase in Weight | Never exceed 50% of previous max weight* |
This table serves as a basic roadmap for gradually reintroducing weightlifting into your routine post-hiatal hernia diagnosis. It’s a testament to the possibility of returning to a form of weightlifting that honors your body’s limits and promotes healing.
*You may find yourself, like me, choosing to push beyond the 50% limit – but please seek medical advice before choosing to do so.
Heal Hiatal Hernia Naturally
In the years that have passed since I originally wrote this article back in June of 2021, I have remained completely free from the need to take the medicines I was prescribed. I have regained all the muscle I had lost and enjoy lifting weights most days.
OK, so ego-lifts are a thing of the past and I tend to work in the 10-15 rep range but those could easily be construed as positives as opposed to setbacks.
In fact, I can say with confidence that, as I update this article in the spring of 2024, I am genuinely in the best health of my life. Physically fitter than I have ever been as I look forward to my 45th birthday later in the year.
Crucially, I feel as if my hiatal hernia has healed and only very rarely do I suffer any symptoms.
Here are the things I attribute my recovery to, in order of priority:
- Faith – I read Derek Prince’s God’s Medicine Bottle (paid link) and followed the advice set out. I also watched David Hathaway’s incredible testimonies of his own healing. I decided after 12 months of dependence on omeprazole, to quit and trust God. Amazingly, I was spared any of the widely reported withdrawal symptoms and have enjoyed perfect digestion ever since. That was way back in December of 2020!
- Diet – I switched out cow’s milk – which is proven to be inflammatory to the bowel – for goats milk which is proven to be anti-inflammatory. I also eat fresh and powdered ginger, at least once a day. Ginger takes away nausea and is again, anti-inflammatory.
- IQoro – this simple plastic gizmo is said to help strengthen the esophageal sphincter and help with the symptoms of hiatal hernia. I can’t say that I noticed any specific change from using this device. However, it was part of my regime in the first 3 months after diagnosis, so it is worth mentioning.
- Posture / Stretching – I have recently incorporated stretching and posture exercises into my daily routine. It has occurred to me that perhaps my desk job and slumped poor posture have contributed to the weakening of the diaphragm and the emergence of my hiatal hernia. I’ve found no evidence of a link, but the overall enhancement to well being from my stretching regime merit inclusion in this article.
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Embrace Adversity
If you’ve been diagnosed with hiatal hernia and are concerned about what the future holds for you, I hope that this article gives you hope and encouragement for the future. There’s absolutely no reason why you can’t go on rebuilding your health and attain to greater levels of fitness than you’ve previously known.
To help kick-start your return to health, why not explore these follow-along workout programs that offer amazing results using largely bodyweight resistance only.
And don’t forget to take a look at this recent blog post about how I structure my current – hiatal hernia friendly – leg workout:
===> How Indoor Cycling Can Boost Your Muscle Growth
Be smart. Accept that your diagnosis means that you’re going to have to change things up, but remember that change can be a great thing.
Thank you so much for giving me hope, Matt! I was diagnosed with mine 3 years ago and it has completely changed my life for the worse! I used to workout regularly and I was in great shape when one day I puked after eating and the nightmare began! I was getting panic attacks and I was also feeling dizzy when I would workout. I was prescribed omeprazole and even though it improved my symptoms a lot, I know it has side effects if taken long term and the one that scares me the most is B12 deficiency. I stopped working out and went into depression, because of the realisation that I was never going to be the same again. I had to give up doing things I loved, like weight lifting and also had to give up many foods and drinks I loved, like coffee and chocolate. You just gave me hope that I can stop taking the pills and live a normal life, even though I have to be extremely disciplined when it comes to my eating habits. I was considering surgery, but even my gastroenterologist told me not to even think about it because apparently they are not very successful and do not last long. Anyways thanks again for this article and I hope you live a long and healthy life! Take care!
Stoyan, thank you so much for taking the time to read the article and for commenting. I know exactly what you’ve been going through and I completely empathise with you. It sounds like you are on the right track: be super strict with your diet and find the exercises that you can do that don’t cause a flare up of your symptoms. For me, that increasingly means lots of body-weight exercises, some stretching and walking / jogging. And that’s fine with me. I keep the omeprazole close to hand, but I haven’t had cause to use it for ages now and my prescriptions have all expired.
Don’t let that depression take hold my friend and if you ever need a word of encouragement, you’re always more than welcome here.
He man! Thanks for giving some hope! I was diagnosed with hiatal hernia at the ripe age of 23 (two years ago)! Besides GERD like symptoms I have occasional pinching chest pains as well
I was able to keep it relatively under control via my diet and cardio exercises like running for last two years. But, I was underweight my whole life, and this year I decided to gain muscle mass.
But, the moment I started doing standard weight lifting exercises and core exercises, they flared up my symptoms. Upon further research and through reading your article, I realized I was doing all the wrong kinds of exercises.
Your article gives me some type of hope that I can continue on the strength training journey without aggravating the hernia!
Hi Aaron, thanks for stopping by. I’m glad to read that you found the article helpful. Please do come back and let me know how you’re getting on. I look forward to hearing that you’re packing on the muscle!
In the meantime, to help maximise your gains, you may find my article on myostatin suppression helpful – it’s full of great tips that I wish I’d have known when I was your age.
I wish you all the best with your health and your gains, Aaron.
Thank you so much for this article. I have been rock climbing, doing aerial fitness, and power lifting for about 5 years now. I was diagnosed last week with a small hiatal hernia and my entire world almost felt like it was crashing down. I am in recovery from an eating disorder so to read horror stories online about not being able to exercise anymore sent me into a brief spiral. The relapse with the ED actually prompted an endoscopy. I wasn’t having any symptoms of a hiatal hernia or GERD other than some burning in my throat after lifting which I attributed to pre-workout. They found a small hiatal hernia (no cm noted) and Grade B Esophagitis. This was a wake up call that I need to stop with the disordered eating and body dysmorphia, and give up the control to God. My doctor told me that my esophagus will heal with PPI and not vomiting. (I’ll never vomit again.) she didn’t touch on the hernia though. So for a brief moment I felt a wave of depression. However, I quickly remembered I am a daughter of the Most High and He’s got me. My family and I have been praying over my stomach for His healing. I have been going to the gym since the diagnosis, but going extremely easy and very unsure of what exercises to do. It has been a humbling experience knowing I can’t pick up the heavy weights and finally have to put my ego at the door. Everything I do should be glorifying God and it definitely hasn’t been especially when I step into the gym. I’m actually reading your article while I’m on the treadmill at the gym. It made me so happy to read. I am still a bit unsure if I should continue rock climbing, but I am doing pull-ups with no issues as I don’t brace my core. I’m assuming no more aerial fitness as it’s all core and most movements are upside down. Either way, I appreciate this article. Thank you.
Hi Brittany,
Thank YOU so much for commenting – I’m pleased to read that you’ve been encouraged by this article.
Yes, I agree, the upside-down movements are probably out of bounds for you(!), but I love your optimism and determination.
Moreover, I love your faith. You know who you are in Christ and are spiritually aware enough to know that all things are working together for your good. I too have faced the battle with body dysmorphia as well as sometimes slipping into narcissism. I know that our bodies are the temple of the Holy Spirit and are to be looked after as such, but Paul warns us that “…bodily exercise profits a little, but godliness is profitable for all things”. How much of our lives should we devote to something that has only a little profit?
That’s why my focus here is on ways we can maximise the results of our training: in limited time and limited space… and even in limited health!
If you’ve not already read them, you may want to check out this article about lifting weights with gastritis and this article about lifting weights with costochondritis. They both have some great tips for keeping inflammation low – which will definitely help as you manage your hernia and perhaps even ultimately come off the PPI meds.
Anyway, thank you for stopping by. May God bless you in all things and especially your health.
Have you found a good way to do arm curls using free weights without it affecting the hernia? I’m just trying to get some insight on that.
Hi Nick. Thanks for stopping by.
That’s a good question and one which I didn’t address in the article – principally because arm curls are not something that I have struggled with since being diagnosed with a hiatal hernia.
However, there are likely to be some good reasons for that:
I don’t barbell arm curl
I train exclusively with adjustable dumbbells
I rarely have a dedicated arm workout (preferring full body routines)
If I do have an arm workout, I train in the 12-15 rep range
So this means that that I haven’t been pushing heavy barbell curls and as such haven’t encountered any problems.
Check out my article on occlusion training as this will provide you with a key to including barbell curls in your workout, but at a much lower weight, while retaining all the benefits of lifting heavier poundages – thus protecting your hiatal hernia.
Hi Matt can you suggest a full body workout routine for people with hiatal hernia
Hi Arjun, thank you for your question.
Because I’m pressed for time at the moment, I’m having great results with a modified CrossFit workout called Cindy.
I love it because it’s a simple full body workout that is all done in 20 minutes and it doesnt aggrevate my hiatal hernia whatsoever.
I perform 5 chins, 10 press ups using push-up stands and 15 deep bodyweight squats using a squat wedge within a minute. I rest one minute and repeat 10 times.
If I’m feeling energetic, I’ll reduce the rest interval to get 12-14 rounds in the 20 minute session.
Although if you haven’t already checked it out, you should read this article which explains why I’m not pushing myself too hard this year.
If you’re after a more varied full body workout that contains a greater variety of exercises, then check out my curated selection of workout programs.
Here you will find a program called Crunchless Core. I’ve yet to complete my full review of the system, but it could be just what you’re looking for.
The article is not available anymore right?
Hey John, sadly not.
I believe we all end up in surgery. Because we are not already 80 years old.
But maybe it’s possible to heal, and I saw some people which can lift again after surgery.
Hey John… well, I’m not planning on going under the knife at any point soon!! I’m the wrong side of 40 now and despite my diagnosis 4 years ago and doctor’s recommendation to stop lifting weights, I am enjoying regular weight lifting sessions with moderate weights. I’m completely symptom free and not on any medication! I hope that this article you will help you achieve similar results.
Hi Matt, great article, there’s really too little information about this topic online. What exercises would you recommend for chest and triceps? I’ve tried doing push ups but even just a few reps seem to alleviate my symptoms and my hiatal hernia is pretty small, no cm. Thanks a lot
Hi Leon, thank you for your comment, and I’m glad you found the article helpful! I can understand your concern about finding the right exercises to work your chest and triceps without aggravating your hiatal hernia.
I’m fortunate in that press ups have not aggravated my hiatal hernia at all, and I’ve even managed to get back to incorporating relatively heavy (at least heavy for me!) dumbbell presses.
As for triceps, I tend to just blast out a few sets of standing french presses using a kettlebell, which I hold by the horns.
Have you tried modifying the push-up? Instead of doing a push-up on the floor, you can try doing them against a wall or stairs to decrease the pressure on your diaphragm. Additionally, you could try dumbbell presses on an incline bench, which may help reduce stress on your hiatal hernia while still targeting the chest and triceps.
To further expand my exercise options, I’m planning on purchasing a functional trainer, which will allow me to perform chest exercises in a more upright position. This can help minimize strain on the hernia. Here’s a link to a recent article that features the compact cable machines that I’m considering. And the truth is that cables give the ultimate tricep workout, so definitely do check these machines out.
Regarding the symptoms you’re experiencing, I’ve found that drinking a pint of water with a tablespoon of apple cider vinegar is incredibly effective at alleviating my symptoms. It might be worth trying to see if it works for you as well.
Please do come back to let me know how you’re getting on.
Matt
Hi ! i am just 23 yo and have recently been diagnosed with hiatus hernia of 2 cm . My doctor has said that do not go to gym(basically to lift heavy) and do normal excercises and i was really sad that i won’t be able to have a good body anymore but reading your article gave me a lot of hope and i am feeling more confident about hitting the gym again .
Can you please tell me a full workout schedule for this hernia and tell more in detail as in what all excercises to do for different different body parts? it will be a really great help. thanks
Hello!
Thanks for stopping by – I’m really sorry for the delay in responding – it’s been a whirlwind balancing work and blogging lately. But your message truly resonated with me, especially since I’ve navigated similar fitness challenges with my own hiatal hernia.
It’s fantastic to hear that you’re not letting your diagnosis dampen your fitness aspirations. That’s the spirit! Remember, a hiatus hernia doesn’t spell the end of your fitness journey; it’s just a new route to explore.
I’m in the process of crafting a detailed article specifically for those of us with hiatal hernia, focusing on exercises that are both safe and effective. This will be a practical guide, filled with insights and routines that align with our unique fitness needs.
For now, if you’ve not clicked the link in the article, I want to share a resource that I’ve found incredibly helpful: Gut-Friendly Workouts. These workouts are tailored to be gentle on the stomach while still offering a solid exercise regimen – I’ve used them all to good effect.
Your fitness journey is far from over; it’s just evolving.
Keep up the great work and stay tuned for my upcoming article – it’s going to be packed with valuable tips and strategies for staying fit with a hiatus hernia.
All the best,
Matt