Hiatal hernia

I have a question regarding a client with a hiatal hernia. This is a man in his mid 40th with a mild hernia. It makes him want to cough most of the time, but is not especially painful. He feels a lot of pressure under his ribs, and Vata irritates his symptoms, naturally. He gets some relief from general yoga, and some relief from bodywork on the diaphragm and psoas. Do you have some specific pranayama exercises that you can recommend for him? Are there specific Hatha yoga asanas he should be doing? With love, M

For hiatal hernia best practice is to develop the intercostal breathing method described in my book page 55. And in general to feel full range of abdominal tone when he is exhaling. Rapid pranayamas should be avoided unless supervised by someone who knows their practice in detail.

For asanas I would recommend he develop rolling bridge pose as described in page 168. This tones the rectus abdominis from bottom to top and reverse by doing it slowly. It also tones the posterior section of the diaphragm, which is commonly weak with this condition. In general avoid backbends other than this pose. Ideal bodywork would open the upper most tendons of the psoas where they interdigitate with the lower most tendons of the posterior diaphragm. The front of the diaphragm is overworked and the posterior is dull and empty of activity in most of these situations. Also counseling on keeping proper boundaries is sometimes a fertile territory to explore.