Wait … can you get a hernia from wearing tight pants?

The Guardian

2 days ago

On 14 July, actor and singer Suki Waterhouse shared a tweet explaining her recent absence from X: ''suki you never tweet anymore' have you ever considered I wore pants so tight 6 months ago it caused a hernia & I've been too scared to tell you.'
She followed up with two pictures: one shows her wearing what are presumably the offending pants, and the other shows her in a hospital bed, hooked up to an IV. (There is also a vape resting on her hospital gown. That's not relevant to this story, just a fun detail.)
Like many rich texts, the post raises a lot of questions. Like: could I pull off leather pants? They let celebrities vape in the hospital? And most importantly: can tight pants really cause a hernia?
We asked experts.
A hernia is a hole in the abdominal wall, explains Dr Yewande Alimi, a bariatric and minimally invasive surgeon at MedStar Georgetown University hospital. The hole results in 'protrusion of tissue from the abdomen', she says. 'Commonly fat, or sometimes intestine.'
These look like small bulges, and often appear in areas where the abdominal wall tends to be weaker: around the groin, the front midline of the abdomen, through the diaphragm, in the belly button or through a previous surgical incision.
Hernias are 'very, very common', says Dr Marcoandrea Giorgi, an associate professor of surgery at Brown University and bariatric surgeon at Brown Surgical Associates.
Symptoms vary. Some hernias are visible – bulges around your trunk 'where you shouldn't have one', as the Cleveland Clinic puts it. They can appear during certain strenuous activities, like exercising or sneezing, and then retract at other times. They may be painful – a sharp pain or a dull ache – or they may not feel like anything at all. Other hernias are too deep to see from the outside, but you may feel an ache or pressure.
Inguinal hernias, those that appear around the groin, are the most common – about 25% of men and 2% of women will develop these at some point in their lives, according to the US National Library of Medicine. Giorgi estimates that he personally treats about 100 inguinal hernias a year.
Hernias that only contain fat are often not very dangerous, says Alimi. But 'when hernias contain intestines and are associated with pain, there is an increased chance that those intestines can get stuck, resulting in the need for an emergency operation', she says.
Hernias can be present from birth – umbilical or belly button hernias, for example – or they can develop over time as the result of wear and tear on the abdominal wall. Incisional hernias, those that appear through a former surgical incision, occur in about 15% of patients following surgery. Weight gain, pregnancy, strenuous exercise and a chronic cough or constipation can all weaken the abdominal wall and lead to potential hernias, says Alimi.
Children who are born prematurely or who have connective tissue disorders, cystic fibrosis, hip dysplasia or problems in their urinary or reproductive systems are more likely to be born with congenital hernias, according to the Cleveland Clinic.
'Absolutely not,' says Dr Charlotte Horne, a metabolic and abdominal wall reconstructive surgeon at the Mayo Clinic. Tight clothing 'might put pressure on something that was already there, but the outside layer is not going to result in breaking down layers of your abdominal wall'.
Giorgi says he has never heard of a hernia related to tight pants. The only way this might be possible, he says, is if the pants were so tight that they put significant pressure on the upper abdomen. 'It's like you have a balloon with some water in it – if you squeeze one part of the balloon, the other part will be under more pressure,' he says. But even then, the balloon will only pop if the plastic is already stretched too thin, he says. In other words, wearing tight pants would only exacerbate an existing hernia, putting pressure on it and possibly resulting in a bulge, but it would not create a new one.
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'Oftentimes, people have hernia disease for years before they seek any intervention,' says Horne.
If a hernia is neither painful nor particularly bothersome, it is something one can potentially live with. But most hernias never go away, and experts recommend consulting with a doctor to figure out the best course of action.
'Some patients I counsel to wear a binder to prevent the hernia popping out all the time,' says Giorgi.
For hernias that are painful or risk causing intestinal blockages, surgery is the usual course of action.
'The goal of a hernia surgery is to restore the integrity of the abdominal wall, which means to close the hole,' says Horne. This is done by stitching the hole up or patching it closed with the help of mesh prosthetics. The complexity of the procedure depends on the severity of the hernia.
'Some of them can be done as an outpatient procedure, but some require an inpatient stay,' says Horne.
Although you can't prevent congenital defects or surgical incision complications that may make you more susceptible to developing a hernia, you can reduce the strain on your abdominal wall by maintaining a healthy weight, eating high-fiber foods and being careful when lifting heavy objects.
Horne says she also recommends that people who do a lot of heavy lifting wear supportive and compressive clothes to 'hold things in'.
So don't throw out all your tight pants yet – unless you want to look like you're gen Z.