According to Medlineplus.gov, a hiatal hernia is a condition in which the upper part of the stomach bulges through an opening in a diaphragm. As we know the diaphragm is a muscle in our body. It divides the thoracic cavity and the abdominal cavity. Its main function is to help with respiration, but it also helps to keep acid from coming up into the esophagus. When this happens it can cause what we know as heartburn. When a Hiatal hernia happens, it is easier for the acid to come up into the esophagus, causing what is medically known as GERD or Gastroesophageal reflux disease.
According to Mayoclinic.org, small hernias can cause no symptoms, but persons with large Hiatal hernias may experience the following: heartburn, regurgitation of food or liquids into the mouth (also known as vomiting,) acid reflux (which is the stomach acid coming up into the esophagus,) difficulty swallowing, chest or abdominal pain, shortness of breath, vomiting of blood, and passing of black stools which may indicate gastrointestinal bleeding.
A Hiatal hernia must be diagnosed by a physician through x-rays or an endoscopy. In worse cases, Hiatal Hernia surgery may be necessary.
Massage therapy may be able to alleviate the symptoms. To clarify, I need to mention that this is not a cure, but it does provide temporary relief of the symptoms. With massage, the client may be able to see results in two to three sessions. The benefits of the sessions may last up to four months. The Hiatal hernia should be diagnosed before the massage. It is out of the scope of practice to mention to the client that we think they may have one.
The Massage itself must be done gently, and it is pain-free when done properly. Remember, to keep communicating with your client, before and during each technique. Clients might feel extra vulnerable while you’re working on their stomach, make sure to be assuring.
This medical massage requires us to work on the stomach area. Since, the stomach is located more on the left-hand side, than the right, you will be working mainly on the left side of the abdomen.
First, we need to warm up some of the stomach muscles, such as the internal and external obliques as well as the rectus abdominis muscle.
Once you’ve warmed them enough place your fingers under the ribs and ask your client to take a deep breath, as they exhale, pull on the ribs and look for resistance. Do this technique two to three times before moving on.
Next, place your thumbs more medially, at the edge of the false ribs, which are ribs eight through ten. Ask your client to take a deep breath and as they exhale slide your thumbs inferiorly. You should be pushing down into the cavity using firm but gentle pressure. You have to work with their breathing. Do this technique two to three times, as well.
For this technique you will place your fingers close to the xiphoid process, then move inferiorly along the edge of the ribs, again, pushing down with firm but gentle pressure. Do this technique two to three times.
For the last Technique, place your right fingers under the ribcage and pull while sliding your left fingers inferiorly. You need to work simultaneously. While you are pulling the ribs with one hand slide your fingers inferiorly with the other.
If your client mentions that they feel like they might get acid reflux during your session make sure to place some pillows on their back making it a semi-reclining position for comfort.
To help maintain the benefits of the massage tell your client not to overeat. Suggest that your client drink a glass of warm water on an empty stomach and jump for one minute. This allows the muscles to relax and allows the stomach to release the acid.