great post, joe
relating to that- with my own story-
in my case, i beleive i started the sh injury back in 1999. i had been doing lots of mtn biking, kayaking and other activities. i had the pains in the groin/testicle/pubic bone and went to a doc, then ur. all was ok, i was assured. so i went on doing stuff like usual, after a week or 2 of rest.
2 years later, the same thing, only a bit worse. same results from docs, same protocol of rest for a few weeks.
then 3 more years later, the final straw. pain was immediate and bad, and got untolerable over the proceding 4 months. eventually had surgery.
so, my own thoughts on this, right or wrong, is that i "healed" my initial 2 tearings by continuing my sports. my passion was paddling kayaks in whitewater, a sport that is a huge core workout in itself. i had very strong abs and back muscles.
then one day, i overextended at the hips, over flexed, and overstrained. then it went from there.
i was by no means a pro athlete but i did do my sport about 4-6 days per week and traveled to do it both for fun and to compete. i think that i continued to strengthen the area by doing sports, thus maybe "stabilized" the sh injury. but then one day, it was too much and it tore to a point where there was absolutely no way i could do core excercises enough to actually help out in the long run.
i did see a competant pt for 10 months pre-op, and did all the exercises and whatnot. it got me to the point to where i could walk again, do some light swimming here and there, and even light hiking. but i still could not bend over, lift, or twist, let alone get past the constant pain, even thought it seemed to jump around a lot, and some days i was able to "deal with it." but the bottom line was, in my case, that this injury was past the point of being able to heal itself. i went 18 months of doing my best to heal it, with many approaches, to no avail.
at that point surgery was the only option because my quality of life had turned to shit.
the sports hernia has numerous setups, as meyers says. for example, my left hip has a labral tear and a bit of impingement. it probably occured in conjunction with the sh tears, and maybe even contributed to it if it happened before. lots of speculations. but, just as joe says, it takes everyone different times to heal. look at donovan mcnabb. then look at grant hill, who supposedly retired due to post-op problems. now he is playing. dominic hasek- spent the mid and late 90's in pain with an undiagnosed sh, then retired due to it. he eventually found the right approach (surgery) and now he is playing again, years later (and doing well).
so, from what i can tell, the injury can be tended to with conservative care, and may even "go away." but keep in mind that if the tear does "go away," the result will be scar tissue in the area of the tear. that scar tissue will not be as elastic as the tissue around it, therefore there is still the possibility that another tear can happen there since the "weakness" has not gone away. you can even tear the scar off of it's neighboring tissues (that is supposedly what happened to yours truly), resulting in sh symptoms again. and so on.
i guess my point, correct or not, is that conservative treatment can get you by for only so long, if you continue to do motions that put great stress on the muscles around the pelvis and abdomen. if the pains have gone on for too long, and you have tried pt, etc, then surgery is probably the only way renew your functioning and rid yourself of the pains. but it is essential that your pt has a good understanding of the injury or you may go down the wrong road and try to strengthen the muscles before they are past the accute, inflamed stage. a mistake like trying to overwork injured tissues can easily cause more microtrauma.
at least that has been my experiences.