I'm 59 yr-old pickup basketball player. I guess I'm the only active member in this thread who is rehabbing without surgery. I've been rehabbing since May 18, so I'm on my 13th week. My approach is that sports hernia is a compound syndrome that involves two things:
(a) tendonous injury
(b) very importantly, the nervous system.
When I say the nervous system, I mean muscle signaling and muscle memory, all managed by the nervous system, which is a distributed system.
http://www.youtube.com/watch?v=HfuhVWK8C0U
I'm slowly succeeding at bringing my upper abdominal muscles back to life, and thanking the heavens for that. My goal now is to be able to do pushups by Thanksgiving (November 26).
Elements of my rehab
- 50 mg. pill of Vitamin B6 daily, as recommended in paper by Dr. Muschaweck for those rehabbing without surgery. This helps in production of neurotransmitters.
http://www.leistenbruch.de/fileadmin/docs/UEFA_engl.pdf
- No caffeine (coffee, tea, colas – they all affect neurotransmitters)
- One Centrum Multivitamin pill daily.
- No other medications of any kind.
Activities that have helped me advance
Concepts
STRENGTHEN THE CORE AND FORGET THE LEGS
For myself, I’ve discovered that as I’ve strengthened my core muscles over the past two months, my adductor pains have subsided on their own.
ERECT POSTURE HELPS ME HEAL
Avoid slouching
Concentrating on my core, I notice that when I sit I often slouch. I also slouch often when standing. By strengthening my back muscles with dumbbells and surfboard paddling, it has become much easier to keep my posture erect, but is still a never-ending challenge to make this a habit.
Suck in the belly
I’m not a fat person. I’m 5’10’’ 172 lbs. Yet when I turn to see my profile in a mirror, I see that my belly is not tight like in my youth, but rather sticking out in a lazy way. So about 3 weeks ago, I began to get more serious about this. I’ve been sucking this in many times each day, and it is slowly getting easier to do it. Very interestingly, I notice that when I’m in an exercise session and my blood is flowing nicely, I can keep my belly in effortlessly, almost naturally. But then later when I’ve cooled way down the next day, that belly muscle will have lost its memory, and I must keep teaching it to hold inward. Slowly, I’m getting better at this, and all the while my symptoms of sports hernia are slowly but steadily improving.
Teaching my upper abdominals to engage
Like almost everybody, one of the first symptoms I had was pain in my lower abdomen when doing a sit-up. Anything I tried to do with my upper abdominals, like sit-ups, chin-ups, or tricep pull-downs, would result in transitory pains in my lower abdomen, and then delayed inflammation to my spermatic cords / testicles the next day. A very interesting fact was that if I did a standing tricep pull-down with my pelvis tilted upward (ie, thrust forward, butt tucked in), it was MUCH more aggravating than if I did the same standing tricep pull-down with my pelvis neutral. I thus discovered that although I could do almost no substantial exercise of my upper abdominals, there was a little window of opportunity to do some light tugging with my upper abdominals as long as I kept the angle of my pelvis “butt-out”, and avoided any upper abdominal work with the pelvis in a “butt-tucked-in” angle.
I’m not sure if this is unique to my particular injury or whether others may have simply not discovered it yet.
So, in my quest to start working my upper abdominals, by sweet serendipity, I chanced upon surfboard paddling, which by coincidence forces one to keep the pelvis tilted “butt-out”. (In hindsight, I think I could have achieved the same with standing tricep pulldowns, with pelvis tilted “butt-out” at very low weights, maybe 3 lb., then gradually worked my way up.)
http://a.imagehost.org/0670/Surfboard_paddle.jpg
I found I could gently paddle a surfboard without subsequent inflammation. This was a breakthrough, the first real exercise for me in 3 months, because up to that, any exercise had caused me much inflammation. The key concept here, for me at least, was the angle of the pelvis while the abdominal muscle is working. See the photo link above.
That day I started the paddling was May 18, 2009, exactly 3 months ago. Since then I’ve been doing a 30 minute surfboard paddling session (with many rests) 3 days per week. I’m steadily getting stronger abdominals, back muscles, shoulders, etc. This means it’s easier for me to improve my posture, although it’s still a challenge.
In my next post, I’ll give some details about benefits I’ve derived from lawn mowing and using dumbbells to strengthen my core muscles.
I’m not sure I’ll be able to rehab into competitive basketball (although I’m giving it up no matter what) or that I’ll be able to lick sports hernia permanently. But I am sure that my life is very much improved, and that at this point my progress seems to be continuing forward. I still have all my original symptoms, but to a much lesser extent, and much less frequent. I can do more things in life now. (But definitely not sports at this stage.)
In summary, it really is, as they say, all about the core. It's all about a strong muscular encasement of the spine in the thorax: A strong front (abdomen), a strong back, and strong side muscles. But the stronger muscles must be continually educated. Back erect, suck in the belly.
As those core muscles slowly become powerful, my lower abodomen tear finally has a chance to begin healing and the adductor problems start going away on their own, even though I'm not doing any adductor exercises or stretching.
This is how it's seeming to me.
I also am indebted to these people for taking the time to post:
http://www.sportsherniaforum.com/index.cgi?board=inactivity&action=display&thread=17
Hope this helps somebody, whether had surgery or not.