A hérnia umbilical (hérnia do umbigo) ocorre quando as camadas da parede abdominal não encerram completamente ao nível do umbigo e as estruturas intra-abdominais fazem saliência (saem) através desse ponto fraco. Ou seja, a hérnia umbilical ocorre numa zona de fraqueza das camadas da parede abdominal na região do umbigo, por onde surge a saliência.
Para além do umbigo, as hérnias podem surgir noutras regiões do abdómen, designando-se genericamente por hérnias abdominais. As hérnias também surgem, frequentemente, na região da virilha, designando-se neste caso por hérnia inguinal.
Por norma, os doentes que padecem de hérnias umbilicais podem levar uma vida perfeitamente normal e sem que ocorram complicações. No entanto, podem em alguns casos surgir complicações, algumas potencialmente graves, que sem tratamento atempado e adequado podem, em último caso, implicar risco de morte.
A hérnia umbilical é mais frequente na criança. Algumas estimativas referem que cerca de uma em cada dez crianças (10%) apresenta hérnia umbilical. A maioria das hérnias umbilicais encerra até ao final do primeiro ano de vida do bebé. Contudo, existem casos de hérnias umbilicais que demoram mais tempo a encerrar, sendo mesmo necessário em alguns casos efetuar tratamento cirúrgico. Veja mais informação em “tratamento” para melhor perceber quando operar a hérnia umbilical e que cuidados devem ser tomados.
Apesar de menos frequente do que na criança, este tipo de hérnia também afeta os adultos de qualquer idade, sendo mais frequente no sexo feminino do que no masculino.
Hérnia umbilical – causas
Nos adultos, a hérnia umbilical, geralmente ocorre quando há aumento da pressão abdominal. A presença de líquido intra-abdominal (ascite) causa aumento da pressão abdominal, sendo uma causa frequente de hérnias umbilicais.
Determinados fatores que provocam um enfraquecimento da parede abdominal podem também levar ao desenvolvimento das hérnias. O excesso de peso (obesidade), realização de esforços violentos, (como levantamento de objetos pesados no trabalho), algumas atividades desportivas intensas (como a musculação), a tosse crónica (tosse persistente no tempo, originada por algumas doenças pulmonares – DPOC, etc.), a obstipação, a cirurgia abdominal prévia, são exemplos de fatores de risco para o desenvolvimento da hérnia umbilical.
A gravidez é um fator de risco para a ocorrência de hérnias umbilicais, aumentando o risco com o número de gravidezes. As gravidezes multigemelares (gémeos, trigémeos, …) também aumentam o risco.
Algumas hérnias umbilicais não podem, infelizmente, ser prevenidas. Contudo, podem ser adotadas algumas medidas de prevenção que permitem reduzir os riscos de ocorrência de hérnias. Os adultos devem evitar o sedentarismo (praticar exercício físico), entre outras medidas que estimulem hábitos saudáveis.
Hérnia umbilical – sintomas
Nos adultos o sinal principal é uma saliência desconfortável, podendo até provocar dor na região umbilical. Por vezes, a hérnia pode ser bastante dolorosa.
Na criança, as hérnias umbilicais, por norma, não provocam dor, contudo a sintomatologia está muito dependente da gravidade da hérnia. Na infância, o ato de chorar, quando a criança tosse, fica mais agitada ou realiza esforços, podem agravar os sintomas. Por outro lado, quando a criança se deita ou acalma, os sintomas aliviam.
Hérnia umbilical – diagnóstico
O exame físico do abdómen demostra a hérnia, que se evidencia com aumento da tensão abdominal.
Se o conteúdo não puder ser reintroduzido no abdómen, diz-se que a hérnia umbilical está “encarcerada”. Esta situação é perigosa porque o conteúdo pode ficar sem irrigação sanguínea, falando-se então em “hérnia estrangulada”. Uma hérnia umbilical estrangulada é a mais temível complicação e requer tratamento urgente. Veja mais informação em “complicações”.
Para além do exame físico que é esclarecedor, o médico pode solicitar alguns exames de diagnóstico em casos especiais: pode ser feita uma radiografia, ecografia ou análises ao sangue, para melhor caraterizar a hérnia ou verificar se o intestino encarcerado está viável.
Hérnia umbilical – complicações
A complicação mais temível é o estrangulamento da hérnia. O estrangulamento ocorre quando não existe irrigação sanguínea da porção de intestino encarcerada na hérnia. Ou seja, o sangue não circula porque existe uma obstrução à sua passagem e ocorre necrose (o tecido morre). Devido à necrose, pode ocorrer uma inflamação / infeção da cavidade abdominal e peritonite, que em último caso pode levar o doente à morte.
Os sintomas de hérnia estrangulada são:
Febre;
Obstipação;
Dor abdominal intensa;
Náuseas e vómitos;
Saliência dolorosa no umbigo, com vermelhidão ou tom azulado.
Deve existir uma vigilância apertada, devendo consultar o seu médico em caso de suspeita de encarceramento ou estrangulamento da hérnia.
Hérnia umbilical tem cura?
Não existe qualquer tipo de tratamento médico que permita “curar” a hérnia umbilical. A única opção possível é realizar tratamento cirúrgico.
Pode optar-se por medidas de vigilância, sempre com o cuidado de prevenir possíveis complicações e desde que a hérnia não apresente sintomas que afetem de forma significativa a qualidade de vida do paciente.
Hérnia umbilical – tratamento
A maioria das hérnias umbilicais na criança acaba por encerrar naturalmente até aos 18 meses de idade, podendo em, alguns casos, encerrar de forma mais tardia. Se não ocorrer o encerramento até aos 3 anos de idade, se ocorrer dor, se a hérnia ultrapassar os 1,5cm de diâmetro ou existir o risco de encarceramento ou estrangulamento, então deve ser considerado tratamento cirúrgico.
Nos adultos, o tratamento cirúrgico permite resolver o problema e deste modo evitar possíveis complicações.
Alguns medicamentos podem ser prescritos para aliviar a dor (como o paracetamol, por exemplo).
Contudo, a única opção para resolver de forma definitiva o problema é realizar tratamento cirúrgico.
Hérnia umbilical – cirurgia
A cirurgia evita as complicações e pratica-se geralmente nas seguintes situações:
Hérnia dolorosa;
Diâmetro maior que 1,5 cm;
Ocorrência de encarceramento ou estrangulamento.
A cirurgia visa o encerramento da zona de fraqueza da parede muscular. Após a anestesia, a operação é feita de forma a recolocar o conteúdo da hérnia dentro do abdómen, encerrando-se o orifício com pontos. Em alguns casos, reforça-se a zona de fraqueza com uma prótese. A cicatriz que resulta após a cirurgia, depende da extensão da zona de fraqueza e da técnica cirúrgica utilizada.
Na atualidade, a intervenção por laparoscopia, realizada através da utilização de instrumentos cirúrgicos acoplados a uma câmara de filmar, permite em alguns casos realizar a operação de uma forma minimamente invasiva, através de pequenas incisões, reduzindo os riscos e as complicações.
A cirurgia é rápida e de baixo risco, exigindo um internamento de poucas horas e o doente pode reiniciar alimentação imediatamente. Durante uma semana deve evitar realizar atividade física.
Complicações da cirurgia
As complicações são pouco frequentes:
Infeção;
Recidiva ou reaparecimento da hérnia;
Ocorrência de dores de cabeça, náuseas ou vómitos;
Febre.
Recuperação, prognóstico
No pós-operatório é normal que surja alguma dor e edema (inchaço), que podem ser facilmente resolvidos com a prescrição de medicação analgésica / anti-inflamatória. Apesar de ser uma cirurgia de rápida recuperação e o doente poder regressar a casa após a cirurgia, deve ser mantido algum tempo de repouso, tipicamente pelo menos 2 a 3 dias, de modo a acautelar possíveis complicações.
Nas hérnias sintomáticas ou complicadas do adulto, a cirurgia é muito eficaz e a taxa de complicações e recidiva é muito baixa.
A atividade física normal pode ser retomada três semanas após a cirurgia.
Quando existe estrangulamento e a cirurgia é realizada rapidamente, o prognóstico é também ele excelente.
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Once you’ve hit them, bend your elbows to decrease
the bar in the uprights. Not Like the Squat or Deadlift, the bar doesn’t
transfer in a vertical line whenever you Bench Press with correct kind.
It moves diagonally out of your mid-chest over your shoulders.
This is the most secure way to Bench Press for your shoulders.
It’s also the best method to Bench Press heavy.
The correct options will goal the identical muscle teams while matching your health objectives and circumstances.
Variations can maintain your workout routines fresh,
increase motivation, interact different muscles, and cut back the chance
of harm. If you want to embrace benching in a well-rounded routine, you probably can bench
once every week and do two other upper-body help workouts.
Typically you can’t force correct kind method.
Train causes your mind to release endorphins which can positively impact your temper.
Additionally, exercise can enhance your sleep, and getting higher-quality sleep can put
you in a greater temper. The dumbbell bench
press is a compound lift and requires multiple steps to carry out accurately.
To maximize their efficiency on a dumbbell bench press,
an athlete must defend their concentration and grasp every section of the dumbbell bench press.
Since the dumbbell bench press is a compound carry, it’s essential to
grasp each exercise stage. If you realize the individual
phases of the train, then you know the way to follow
and master the form of each one. Make positive that you do this with complete management.
It won’t be lengthy before you begin experiencing vital improvements in your bench press numbers.
Flat bench press workout routines engage the whole chest muscle
but primarily target the middle and decrease portions
of the chest. Incorporating incline variations can enhance muscular activation in the upper
chest muscle tissue. The incline dumbbell press primarily
builds chest energy. The exercise works the pectoral muscular tissues,
including the pectoralis main, pectoralis minor, serratus anterior,
and subclavius.
When pressing the weight, you should at all times preserve control.
Shifting the load too rapidly can cause injury,
and also you won’t maximize your positive aspects.
Additionally, the load ought to be saved immediately
above your chest to maximize the focus on your pectoral muscle tissue.
When you do, you’ll Bench Press heavier weights on 3×8 because of the energy
you construct with 5×5. If you double your Bench Press from 50kgx8 to
100kgx5, what number of occasions do you assume you
can Bench Press 50kg? They’ll be easier too because every rep takes your stronger
muscular tissues less effort. It takes longer on your chest
and shoulders to get drained. You get more reps. Rising your Bench increases muscle endurance.
Nevertheless, plenty of lifters like to do decline barbell or dumbbell bench presses as accent lifts.
The type is the same as with the usual dumbbell bench
press, besides that you simply lift one weight at a time, maintaining the opposite by your chest.
The effect is to isolate each side of the body much more successfully than the
standard model of the move. Start in your weaker aspect and you’ll soon see
how rather more of a problem it is to carry one weight at a time.
If your bench press is weak, it is doubtless since you are loading up
with heavier weights before guaranteeing you are using proper bench press form.
The Barbell Rear Delt Row is carried out by gripping the barbell with an overhand grip, barely wider than shoulder-width aside.
You will then pull the barbell up towards your chest while maintaining your back straight
and core tight. This exercise will assist to strengthen your back muscles and create steadiness in your upper body strength.
The reverse grip barbell bench press could be done utilizing a flat or incline bench.
Here’s my good friend and world champion Mike Tuchscherer Bench Urgent over 200kg/440lb.
He Benches all alone, with out spotter, in his house gym as I do.
However he’s safe as a end result of he Bench Presses contained in the Power Rack with the security
pins set. For rest durations in between units, you’ll need to rest for 1-3
minutes depending on how heavy you are going with the train.
Once More, Bench Press in the Energy Rack so the protection pins can catch failed reps.
Set the pins even when you have a spotter. Then Bench Press with correct kind to cut back the danger of losing the bar.
Use a full grip, lock your elbows and rack
properly. Don’t put your ft on the bench or within the air to really feel your muscular tissues
higher.
Choosing the suitable weight for a dumbbell bench press is essential for performing this
train. To begin, an athlete ought to select a weight
that they’ll management for 3 units of eight repetitions.
Athletes can adjust the amount of weight up
and down based on the number of units and repetitions.
It is crucial to have a powerful foundation when completing a dumbbell bench press.
That being mentioned, most preliminary dumbbell press workouts are supposed
to be accomplished with mild dumbbells. As at all times, choose
a lighter weight as you are beginning and scale as much as heavier weights as you learn the correct type and turn out to
be stronger. You’ll quickly discover that the reverse grip dumbbell press is
a protected and efficient motion and value doing for most common health and
muscle constructing purposes. You’ll feel the
consequences of these workout routines in all your chest
muscle tissue, however especially in your upper pecs.
These workout routines will target the opposing muscle groups of the Dumbbell Bench Press to make certain you
are creating a fair and balanced physique. When performing a bench press, the primary muscle tissue
used are the chest, shoulders, and triceps.
Leveraging kettlebells provides a component of instability, compelling stabilizing muscular
tissues to work more durable, thus enhancing the general workout’s effectiveness.
I’m a gym enthusiast who has been a professional cardio trainer in California for 11 years now.
There are many struggling individuals who need the most effective physique shape.
I know the biggest wrestle just isn’t getting the correct
tips and efficient coaching tools.
Maintain your palms on the bar and assist him by pressing the
weight up with whatever strength you have left. Once the bar is racked within the uprights give him an enormous thank you for serving to you.
You could have to unload the bar to get it in the uprights after a fail.
To work on constructing energy, guarantee you’re using correct type before loading the bar with heavier weights.
When you would possibly be on the point of do a reverse grip dumbbell press workout, always full a proper warm-up first
to keep away from debilitating accidents. It additionally helps to follow a customized food regimen plan that will allow you to construct muscle.
As per traditional, it is dependent upon your targets and preferences.
Getting to the point the place you’re pressing plenty
of weight can also pack on muscle in your triceps and shoulders.
The bench press is a foundational upper-body
exercise utilized by bodybuilders, athletes, powerlifters, and health
fanatics alike. It has a number of variations, like the
incline dumbbell press.
The correct type will maximize your strength when urgent
the weight away from you. If you fail to make use of an acceptable kind, your gains from the dumbbell bench
press might be restricted. With that mentioned, within the meantime, don’t worry about incline or decline bench urgent.
Right now, I wish to focus on the normal Bench Press train with a flat degree.
The angle of the weight bench dramatically impacts which muscular
tissues are activated. Flat bench press exercises without any angle interact the middle portion of your chest.
An upright angle of ninety levels will target the shoulders.
You’ll know this if you transfer to free weights later because the same weight will be tougher to bench.
Worse, you don’t determine how the bar or weight strikes.
You can’t bench the bar in a diagonal line to maintain your
shoulders safe. Your muscles stay tensed if you don’t lock your elbows on the top of your Bench Press.
However if your muscular tissues are tired, you probably can lose the bar and drop it on you chest.
My girlfriend was there however not prepared to spot.
And the weight was too heavy for her to carry.
I received away by rolling the bar to my stomach
(the “roll of shame”, see below). Some folks
assume Bench Urgent in the Energy Rack is bad fitness center
etiquette.
This is a normal bench press by method of kind and physique
positioning and every thing. The only distinction is you’ll use
bands to hold weights off the ends of each sleeves of the barbell.
By doing this, you’ll be completely altering the dynamics
of stability. You will need to focus rather more on stabilizing the barbell
as you lower it and press it.
“The bench press makes use of your shoulders, triceps, forearms, lats, pecs, traps, rhomboids, and pretty much every muscle in your higher body,” says Niren. The dumbbell
bench press is a compound train that targets the pectorals,
triceps, deltoids, and rotator cuffs.. It’s helpful for athletes hoping to overcome a
plateau with the barbell bench press or trying
to stability the chest muscles. Additionally, this train offers athletes a higher
vary of motion than the normal barbell press. As Quickly As you’ve got determined
roughly what elbow angle is finest for you and your physique, it’s now time
to set up your grip width. This is the factor that’ll enable you to truly use
that elbow angle as you press. This shifts extra of the emphasis to your triceps rather than your
chest.
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But you all the time need to keep the weight gentle to reasonable because in any other case, this would
defeat the purpose of the train as you don’t want your body to move from the unique stance and place.
By including a bit of instability, you can add an extra bit of
depth to your core and upper physique. Use the Pallof Press as an accessory movement in your energy coaching program.
The authors and publishers of this blog are not
answerable for any accidents or health issues that will result
from the use or misuse of the data offered. Begin with a lighter resistance and focus on mastering proper type before
progressing to more difficult variations. If you’re recovering from an injury, the Pallof Press can be a valuable addition to your rehabilitation program.
Seek The Guidance Of with a bodily therapist to make
sure it’s acceptable on your condition and to tailor the exercise to your specific needs.
Additionally, have interaction your core all through the movement to keep up stability and alignment.
People who don’t have a mirror in their garage fitness center can film themselves on their type or get their training partner to observe their type.
One frequent mistake whereas performing the Pallof Press is
opting for too heavy a resistance.
If you need to take it up a notch, raise one foot off the ground and
slide it back a quantity of inches but don’t put
it again on the ground – hold the toes a few inches off the
ground. Then, as you stability on the one foot,
hold your hips even, focus your eyes ahead, and press out and
again in while keeping the core sturdy and resisting the pull to rotate.
The half-kneeling Pallof press targets major core muscular tissues
while selling good posture and stability. You can place one knee on a cushion or lay down an train mat to make the exercise extra comfy to perform.
The exercise requires a steady, safe anchor spot that will hold a resistance band that is pressed utilizing the Pallof hold, working the core within the course
of. The commonplace Pallof press is a wonderful train, but it’s not probably
the most thrilling core exercise going round.
Start with a lightweight band to nail the form first, before
increasing the resistance. You should be succesful of perform
the movement with none rotation, pressing your arms straight out in front of you and be in a position to full the total rep range.
Only enhance the thickness of the band (or weight
on the cable weight stack) should you can carry out this
motion without any rotation in any respect. And bear in mind, you
can make this movement simpler by shifting nearer to the
anchor point, or tougher by stepping further away.
The banded Pallof Press is the most typical method
to carry out the train. You’ll need an extended, light—to medium-weight resistance band looped around the rig or power rack
at chest peak. If you’re doing all your ab workout at residence, you will want to safe the band
around some extent that isn’t going to maneuver,
for instance, a heavy desk or desk leg.
Instead of crunching, twisting, or bending, anti-rotation ab
exercises drive you to resist the twist and keep your torso still
and regular. Positive, six-pack abs underneath your muscle fit t-shirt is cool, however so is being
robust. And whereas there’s nothing wrong with these per se, they aren’t
the end all be all of coaching your core.
In addition, the constant rigidity throughout the exercise is a good way to make sure
correct core engagement. As you’re pushing and pulling the
band away and towards your torso, hold your core strong and engaged.
Resist any rotational pull from the band – the whole level of this
train is to be taught to manage rotation. The Pallof Press is
a tremendous exercise designed to assist you construct a powerful and stable core.
Incorporating variations of the Pallof Press into your routine can provide further challenges and goal
completely different muscle teams. Let’s take a glance at a step-by-step guide on tips on how to
carry out the train with correct type. A robust and
secure core can significantly cut back the chance of accidents,
notably within the lower back.
Here is an in depth step-by-step guide on correctly doing the banded
pallof press. He also loves to assist others to realize their health
objectives and unfold the information the place needed.
Matthew’s different passions embrace learning about mindfulness,
strolling by way of nature, touring, and always working to enhance overall.
This beginner’s variation will allow you to to
maintain better balance and stability of your core should you select to do the Pallof press in a kneeling place.
The vertical Pallof press is a wonderful anti-extension movement since you
have to prevent your body from extending backward. You’ll want either a double-handle rope attachment for cables
or single bands for each hand. Plus, your back and backbone may also expertise the positive effects of this great exercise as a end result of training correct posture and optimum core power
is essential for preventing back pain.
References:
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