What is the turn your head and cough for? Explaining the Inguinal Hernia Exam

September 30, 2025 •

4 min read

Inguinal hernias are one of the most common types of hernias, especially in men. During a physical exam, a physician often conducts the simple procedure known as what is the turn your head and cough for to check for this condition, which occurs when a weak spot in the abdominal wall allows tissue to bulge into the groin or scrotum.

Quick Summary

The 'turn your head and cough' maneuver is a diagnostic tool used during a physical examination to check for an inguinal hernia. The action increases abdominal pressure, making a potential hernia bulge more noticeable and easier for a doctor to detect.

Key Points

Hernia Detection: The primary purpose of the maneuver is to detect an inguinal hernia by making a bulge more prominent.
Increase Abdominal Pressure: The act of coughing increases pressure inside the abdomen, which pushes tissue through any weak spot in the abdominal wall.
Courtesy, Not Medical Necessity: Turning the head is a simple hygienic courtesy to prevent the patient from coughing on the doctor.
Diagnosis is Physical: A healthcare provider can often diagnose an inguinal hernia with this simple physical exam alone, without needing advanced imaging.
Further Action Required: If a doctor detects a hernia, they will typically recommend a consultation with a surgeon to discuss repair options.

What Is an Inguinal Hernia?

Before diving into the exam itself, it's important to understand the condition it's designed to detect: an inguinal hernia. An inguinal hernia occurs when there is a weakness or tear in the lower abdominal wall, allowing soft tissue, such as part of the intestine, to push through into the groin area. In men, this can lead to a bulge in the scrotum. While hernias are common, especially in men, and not always serious, they can worsen over time and may require treatment. A doctor's physical examination is the most common way to initially diagnose this condition.

The Two Actions Explained

The 'turn your head and cough' phrase breaks down into two separate but equally important parts during the examination.

The Cough: The primary medical purpose of this action is to momentarily increase the pressure inside your abdomen. When you cough, the abdominal muscles contract and tense, which forces any potential tissue that has pushed through the weakened abdominal wall to become more prominent and easier for the doctor to feel with their fingers. This is essentially a way to simulate straining, which is one of the movements that can cause a hernia to appear.
The Head Turn: The reason for this part of the instruction is purely for the doctor's comfort and hygiene. It is a simple courtesy to ensure you don't cough directly into the doctor's face while they are in close proximity performing the exam. The direction you turn your head does not affect the outcome of the test itself.

The Examination Procedure

During the examination for an inguinal hernia, a healthcare provider will first visually inspect the groin area for any obvious bulges while the patient is standing. The doctor will then use their fingers to feel the area around the scrotum and groin, where they will then ask the patient to cough. For men, this often involves the doctor placing a finger near the scrotum and gently invaginating the skin toward the inguinal canal. As the patient coughs, the doctor feels for a soft impulse or bulge against their fingertip, which is a key sign of a hernia.

Comparison of Diagnostic Methods


Diagnostic Method	Description	Pros	Cons
Physical Exam (Turn and Cough)	Doctor palpates the groin area while patient coughs.	Quick, inexpensive, and often sufficient for diagnosis.	Less reliable for complex or occult (hidden) hernias. Subjective findings.
Ultrasound	Uses sound waves to create an image of internal organs.	Non-invasive, widely available, helpful for unclear physical exams.	Can have varying sensitivity and specificity depending on the operator.
CT Scan	Uses X-rays and computer technology to create cross-sectional images.	Provides detailed anatomical views, useful for complex cases.	Involves radiation exposure and is generally more expensive.
MRI Scan	Uses magnetic fields and radio waves for high-resolution images.	Excellent soft-tissue contrast, best for diagnosing occult hernias.	More expensive and time-consuming. Requires patient to lie still in an enclosed space.

What a Positive Test Means

If the doctor feels a bulge or impulse during the exam, it indicates that a hernia is likely present. The doctor will then assess the hernia's characteristics, such as whether it can be pushed back into the abdomen (reduced). In most cases, if a hernia is diagnosed, a surgeon will be consulted to determine the best course of action. While some asymptomatic hernias can be monitored with watchful waiting, most will require surgical repair eventually to prevent complications like incarceration or strangulation. A surgeon can repair the hernia using minimally-invasive laparoscopic techniques or traditional open surgery.

Understanding Your Health

Knowing the reason behind a medical procedure can help alleviate anxiety and empower you to be a more active participant in your healthcare. The 'turn your head and cough' test is a prime example of a simple yet effective diagnostic tool that has been used for generations to help physicians assess a common health condition. If you ever have questions or concerns about a physical exam, don't hesitate to ask your doctor for an explanation.

For more information on inguinal hernias and their diagnosis, you can visit the Mayo Clinic's detailed resource on the topic.

Conclusion

The seemingly unusual request to 'turn your head and cough' is a time-tested and simple physical examination for detecting inguinal hernias. The action of coughing provides the necessary intra-abdominal pressure to make a hernia more palpable for the physician, while turning the head is a straightforward courtesy. Though imaging techniques like ultrasound or MRI can provide additional detail, the physical exam remains a cornerstone of initial diagnosis. By understanding the purpose of this test, patients can feel more informed and comfortable during their medical examinations.

Frequently Asked Questions

Doctors ask you to cough during a physical exam to increase the pressure within your abdomen, which can make a bulge from an inguinal hernia more apparent and easier to feel.

While the exam is more commonly associated with men, who have a higher incidence of inguinal hernias, doctors may also perform similar assessments on women, though different hernias are more common in females, such as femoral hernias.

An inguinal hernia is a condition where soft tissue, typically part of the intestine, protrudes through a weak spot or tear in the abdominal wall near the groin.

If a physical exam is inconclusive, doctors may use imaging tests such as an ultrasound, CT scan, or MRI to diagnose a hernia, especially for occult (hidden) hernias.

Yes, the physical exam remains a standard and effective method for the initial diagnosis of inguinal hernias. It is often supplemented by imaging for complicated or unclear cases.

While you can feel for bulges in your groin, it is best to have a qualified healthcare professional perform a proper examination. They can accurately determine if a bulge is a hernia or another condition and whether it requires treatment.

If a hernia is detected, the doctor will evaluate its severity. They will likely recommend a follow-up with a surgeon to discuss treatment options, which most often involves surgical repair.