Why Does My Prolapse or Hernia Feel Worse During or After a Holiday?
I thought it was time to write a blog on this, as every September I will have the same conversations with my clients about their prolapse and/or hernia, feeling worse after the summer holidays, a holiday or a short break.
What I mean by symptoms feeling worse, is that they feel more symptomatic. More heaviness, more of a protrusion, for a hernia, maybe you can notice more of a bump under your skin.
This happens usually because there has been a big shift in your usual routine. From experience, the holidays that usually cause the biggest swing in symptoms are sunny beach/pool holidays. There is the travel to think about, the stress/anxiety that may come with actually getting there, the packing, being the family CEO, which can have an adverse effect on symptoms. But also the change in temperature - which means you are sweating more, hydrating (but maybe not hydrating enough), maybe drinking more alcohol than usual, which dehydrates you some more.
Then there’s the change in what you are eating, plus all the aforementioned, which can mean our digestive systems can suffer too. You might be eating at different times, perhaps having less fibre than usual, more bread, richer meals or simply foods your digestive system isn't used to. Add a little bloating or constipation into the mix and you've created more pressure through the abdomen than your body is used to managing.
Poo can become firmer, and this can increase the likelihood of straining to go to the toilet, which your isn’t great for your pelvic floor. You may have heard me talk before about the core (including the pelvic floor) as a container for our sloshy guts. And if there is more poo backed up in your system, and you are maybe eating more than normal - that’s more contents in the bag of guts and this extra content needs to go somewhere. This naturally creates more pressure in your tummy.
Aside - I wrote this post “Practical Pooping Tips for Prolapse” which you may find helpful. It covers positioning to aid going for a poo, something called “Moo to Poo” and other helpful ideas to help your plop drop.
So, the sheer weight of that extra content, puts more pressure down on the pelvic floor. If you have a hernia, that protrusion can be more visible, because the contents are pushing against where a weakness is. The pressure will always follow the path of least resistance, and so this can also affect you if you have abdominal separation, and that “gap” down your midline may feel harder with the added pressure, when typically that gap feels soft for you.
One of the biggest changes is often that we're simply less active. Some people laugh when I say this, as they may be chasing children around on holiday, “a chance would be a fine thing” I hear you say. But as children get older and don’t need to be as supervised as much, and we take advantage of that restful time - our bodies aren’t used to that. We aren’t moving as much as we do say on our morning commute, around the workplace or at home. So changes in activity levels, even slight changes, absolutely affect our symptoms, especially when we are not used to being sedentary. Rest is important, but our bodies also like regular movement. Spending long periods in one position can leave us feeling stiffer and more sluggish.
Then there are the things we might not consider. At home we may train, lift heavy. But when we lift weights, it’s in a controlled way, with set reps and rest periods, with huge guidance on breath to manage pressure in our system. On holiday you might be lifting awkwardly - suitcases, beach bags, sun loungers, hills, steps, lifting cases/pushchairs/dogs into car boots, carrying children, walking on sand, getting in and out of swimming pools, wearing flip-flops. All these things can play into how your symptoms might feel, because they are movements that happen outside of your training (that’s why we include so much rotation and swinging (of the weight kind) in our Smart Move sessions - door re-open 1-4 October - join the waiting list here).
The important thing to highlight is that our symptoms don't exist in a vacuum. They respond to all of the above, and if just a few of those things change at the same time, in a short space of time, our symptoms can absolutely flare up…AND just as soon as they flare up, they can revert to the symptoms you are more typically used to. So normally there is no need to spiral. Pre-empting how these variables might affect your symptoms can be really helpful in helping you manage them whilst away, and alleviate the mental space/worry this can take up.
Here are some things which might help minimise symptom flare-ups.
Keep drinking regularly throughout the day. Dehydration can contribute to constipation and bladder irritation, both of which can make prolapse or hernia symptoms feel more noticeable.
Don't wait until you're constipated. If your bowels are slowing down, increase your fluid intake, include fruit, vegetables and fibre where you can, and don't ignore the urge to go to the toilet.
Keep moving, even if you're having a restful holiday. You don't need to exercise every day, but getting up from the sun lounger, going for a gentle walk or moving regularly throughout the day can help if you've been sitting or lying in one position for long periods.
If you're walking far more than usual, build in opportunities to rest. A city break with 20,000 steps may be very different to your normal day. Listen to your body and seek out restorative practices at the end of the day. Even lying with your feet up can help. Here is a lovely breathing drill to try.
Think about how you're lifting. Suitcases, beach bags and children all add load in ways you may not be used to. Where you can, share the load, use wheels instead of carrying and avoid repeatedly lifting awkwardly when you're tired.
Wear footwear that supports the activities you're doing. Walking miles in flip-flops is very different from walking a shorter distance to a pool for example.
Use your breath when lifting. Avoid holding your breath unnecessarily, particularly when lifting luggage or children. Remember your audible exhales on the hardest part of the movement/lift.
If you have exercises that help your symptoms, you don't need to abandon them completely. Even five or ten minutes every couple of days can help you feel more connected to your body.
Prioritise sleep where you can. We know poor sleep affects how our body perceives symptoms and recovers from the physical demands of the day.
Give yourself a few days when you get home. Hydrate, return to your usual eating habits and movement routine and let your body settle before deciding your symptoms have permanently changed.
If you have any questions, please feel free to email me.
If you have experienced what you think is a prolapse or a hernia for the first time, are concerned or your symptoms are prolonged, then please do not hesitate to reach out to your GP, or more appropriately a Women’s Health Physiotherapist who are specialists in this area (please ask for my personal recommendations). If you are met with an answer from a health professional that you do not feel satisfied with, ask to see someone else. Please don’t stop advocating for yourself.
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I am not a medical professional, this does not constitute medical advice and please always seek advice from your GP or healthcare professional for all matters discussed in this article, or otherwise.