Physical Therapy–Based Core Activation Program for Improving Musculoskeletal Outcomes in Hiatus Hernia: Case Report

BACKGROUND: Hiatus hernia (HH) results from elevated intra-abdominal pressure, which causes the stomach and other abdominal viscera to protrude into the mediastinum due to weakened muscles from aging, obesity, pregnancy, or heavy lifting. The aim of this case report was to evaluate the effects of a core activation exercise protocol on muscle strength, endurance, and postural imbalance in a patient with HH. CASE PRESENTATION: A 37-year-old man with a known case of HH presented with worsening clinical features of regurgitation. The patient also reported body weakness, fatigue, occasional dizziness, and breathlessness. OUTCOMES AND FOLLOW-UP: Manual muscle testing and pressure biofeedback were used to evaluate muscle strength, and the Hernia-Related Quality of Life Scale was used to assess the quality of life of the patient. DISCUSSION: This case report focused on a patient with a hiatal hernia who presented with abdominal wall weakness and evaluated an individualized physical therapy protocol. The intervention was found to be safe and associated with improvements in regurgitation and related symptoms without establishing any causal relationship. JOSPT Cases 2026;6(3):178-182. Epub 11 May 2026. doi:10.2519/josptcases.2026.0230