A second type occurs in men who are born with a slight defect in their innards that can cause problems at any time in life. It’s like this. In a male fetus, the testes start out in the abdomen, but shortly before birth they descend into the scrotum through a passage called the inguinal canal. As they drop, the testes stretch the lining of the abdomen, forming a droopy pouch. Normally, this pouch spontaneously fuses shut. But in some males, that doesn’t happen and a tiny opening remains. All is well until one day you hoist a bowling ball or your overweight beagle–and “Oomph!” The increase in internal pressure that occurs when you lift a heavy object, forces part of your intestine or a pad of belly fat to wedge into that small opening in the inguinal canal.

The hernia forms a lump in your groin and can even descend into your scrotum. (which is why doctors do all that poking and prodding. The cough is to produce internal pressure, making the hernia easier to detect) So begins your battle with the bulge. Hernias can usually be pushed back into place with gentle massage and disappear on their own when you lie down. But stand up, sit down or do anything that places pressure on your gut and it can reappear. A hernia might be as small as a marble–or even bigger than a basketball. Regardless of size, hernias almost always hurt. The pain varies, some men describe a heavy feeling, others feel a stabbing sensation. Giving up smoking is about the only thing you can do to avoid developing a hernia, since the inhaled fumes weaken collagen, the building block of muscle. (a smoker who gets a hernia also has an increased risk of developing a second one.) You might also choose jobs carefully. If you load trucks for a living and your buddy Felix is an accountant, you could be up to 2 1/2 times more likely than Felix to develop a hernia.