Anyone ever had a "Sports Hernia" aka: "Sportsman's hernia", "Gilmore's groin", or &quot

I'm thankful to you guys for the detailed responses. Its much easier to narrow down what's going on when there are some names/places to follow on as opposed to picking from my insurance carrier's list and hoping for the best.

Hockey Player: There are 2 Kelly's out of Hosp. Special Surgery in NYC - Bryan and Anne, looks like Bryan is the hip expert? I'm 30 minutes away from New Brunswick, so it may be worth it to see Boyarsky, and he is also in my plan too.

Albert- Did you actually go in to see Jim? I see they are offering a phone consult too (not sure how much value you get out of that, but.).

Den- Solid advice. I have access to a pool and enjoy swimming a lot (was a varsity swimmer in HS).

JCsportsman- My right side is where I first started feeling things, and about 3 months later while doing some crunches, started feeling it very slightly in my left.

The Myers MRI did reveal:

-no RA tear

-mild adductor tendinopathy

-slight labral tear in Left hip (but issues is predominantly on my right)

A couple more questions for you guys, if you wouldn't mind (and feel free to email me directly if easier to take offline, so as not to clog up the board):

1) I don't feel pain in my RA (realizing that doesn't mean there isn't a tear). Mostly near hips, groin. My adductors were tight the first few months but haven't hurt in weeks since I really started the PT. Did any of you have zero abdominal pain yet had a MRI showing a tear or surgery that showed a tear? Sounds weird, but my body is "telling" me that its not the RA.

2) Scar - for those of you having the surgery, how long is the scar? Did you have 2 incisions (if bilateral)? Where were they (wish you could draw a picture)? Did they fade?

3) Residual Issues - For those of you having the surgery. Now post op, are there any issues which still remain unresolved? Any "new" issues developed that were not there prior to the surgery?

Thanks again for your help. I feel like I am learning more from this forum than I have from all the medical providers I've seen.

EBox

Ebox-

I saw Jim. His appointment is for 90 minutes and he gave me 2 full hours and then some. He was very very thorough and I felt unlocked in the hips afterwards and I learned so much. I can not imagine how he can truly evaluate you without feeling the muscles.

I had HUGE RA pain so i can not answer that.

No residual pain post op other than back weakness on op side from compensating/

My scar is on the large side. it is a little over 5 inches and is not fading. it is actually getting finer but it will be visible for a long time. However, it is pretty low and whoever sees it will get the "knife fight" version war story.

I had labral tears in both hips and have zero hip pain.

So I am also 5 weeks out of my surgery, bilateral. And to answer your question, the scars are 2" long, just on either side of the pubic symphysis. You can see my scars here: http://docs.google.com/present/edit?id=0AbZ7hkqD787YZGdieG00am1fMWRnOW1icGRu&hl=en. They're still numb and they still are thick underneath, and attached to all kinds of structures (e.g.inguinal ligament). But there's just a little tightness from it...not pain.

I had Bilateral ...RA and Adductor Tears.....My Incisions were just above the pubic bone but further apart and higher up then Kents and they went up at an angle parallel to the crease in the top of your leg when your sitting..where your groin meets the pubic area...right one is 3" and left is 2.5"

At 4 weeks post op theres a little puffyness still around the incision but not much and the line is a dark red to purpleand it feels like a hard line....lie the feeling of rubber

Ebox most seem to develop some post op new aches and pains.....could be from dysfunctions that formed or just the rehab in general since you will spend a good 2-3 hours a day doing rehab stuff

Also Id say its hard to compare peoples pain to access what you have...For instance I could do a sit up no problem even with Bi lat RA years.....others counldnt....lots of variables with this injury..............Id jsut work it hard right now and see if you can strengthen things thru PT....If there is a tear you will know it if your doing some hard work with PT.....LIke Meyers told me 6 months before surgery...workout as hard as you can and ust avoid any sharp pain...basically it will either make you or break you

2-3 hours a day??? Crap. here i am 5 weeks out, and I am lucky if I get in 4-6 hrs a week!

who did your surgery???...did you only have adductor tears or RA also?....adductor releases???

JCsportsman wrote:

who did your surgery???...did you only have adductor tears or RA also?....adductor releases???

Meyers did it. I had RA tears only -- but adductor inflammation/scarring (reactionary?? who knows). So I got bilateral RA repair and bilateral adductor release. I am still waiting for the official reports from my surgery and from my MRI, by the way. NEone else waiting for that stuff??

Thanks!

kent

Kent-

Your incisions are small and real close to the midline...

Mine is at least 2x longer....much higher....on an angle and more in line with the inguinal canal.

I had a focal detachment which is on the outside of the RA....I think many people tear towards the center which i think is better. I think when you tear the outside completely the damage is greater because nothing is holding it together..

Looks good

I've done some searching through the past posts, but haven't seen anything specific in this regard-

Can anyone share or email their physical therapy exercises that they've been doing, either to avoid surgery or as part of the rehab?

Thanks!

I had United, and they said they wouldn't pay. Basically they said they gave pre certification for surgery but its not a guarantee of payment. At Dr. Meyers office in Philly they said that means they won't pay and they never do. Meyers was in network for me, but the hospital wasn't. I heard online, from Meyers office, as well as from someone I know who had it done that Horizon BCBS is much better and will probably cover it. I switched to an EPO Plus plan immediately, was protected by HIPAA, and since the Dr I went to here in NJ was in network and the hospital was too, I only have to pay $250 for outpatient.

He may not be as well known as Meyers, but the Doctor I saw is very skilled and has performed on other family members before for very complicated surgeries. Dr. Meyers isn't the only option. You should look at Dr. Andrew Boyarsky in NJ. He is straight-forward, knows exactly how to look for it, and is no BS. He isn't the first surgeon I saw, but he's the one I trust the most, so I just had the surgery done a few days ago, and so far so good. I'd definitely give him a try, and if possible, change your coverage plan with Horizon.

guys its been now 7 weeks now recovering from my ingunial hernia surgery. today i went for a run around the park and i had slight pain in the lower abdomen.

is this normal ?

how long will it last ?

should i keep running t ostrenthen the muscles ?

Lou:

I made an appt to see Boyarsky, and the first appt I could get was Nov 2nd (either operates a lot, is in real demand, or both!). Did he do a sports hernia repair like Meyers for you? What did he exactly do?

Ebox, here is my take on Boyarsky:

He is a disciple of Dr. Muschaweck. He uses ultrasound and a finger exam (not unlike the one docs use to find inguinal hernia) to diagnose what he calls sports hernia. He told me he learned the ultrasound technique directly from Dr. Muschaweck. The ultrasound will clearly show a "bulge" in the inguinal canal. This is the injury that Dr. Muschaweck and Dr. Boyarsky diagnose and repair. He did not find any evidence of such injury when examining me (he told me that patients usually experience sharp pain during the finger exam; i didn't) and said he found no reason to operate on me.

In my opinion (which should be taken with generous helpings of salt because I am most certainly not a doctor) Dr. Meyers diagnoses and repairs a different set of syndromes, which he refers to as athletic pubalgia. These tend to be less focused in the inguinal canal region and more on the rectus abdominis and adductor muscles in the lower abdomen and groin, respectively. His MRI showed tears in my RA on both sides, at the insertion point with the pubic bone.

Despite Dr. Boyarsky's diagnosis, I knew that something was definitely wrong with me. At its worst, my pain was such that it spread from my abdominal muscle into my groin and even to the inner knee, to the point where I was limping around. I shut it down at that point, stopped playing hockey and all other athletic activity, and went for two rounds of physical therapy. I continued PT exercises on my own after my insurance stopped covering the visits, all the while avoiding hockey and other working out. By the time I saw Boyarsky (about a month after my first visit with Meyers; this was while I was still determined to avoid surgery if possible) I was without pain quite often, and even when the pain kicked in it was a shadow of what it was at its worst. So I'm not sure whether that affected his diagnosis.

I liked Boyarsky (except for his suggestion that "at my age" -- I was only 36 at the time and am 37 now -- I might just consider not playing hockey anymore) and agree that he is very straightforward. He came recommended by my sports medicine doctor, who studied under him in medical school. He works with a lot of Rutgers athletes, from what I understand. Boyarsky referred me to a Dr. Bechler, a sports orthopedist, in an effort to determine whether there was something else causing my pain. I did not like Bechler at all. He ultimately made a not unreasonable suggestion — try to slowly return to all the physical activity I wanted to engage in before undergoing surgery — but in the process he slandered Meyers, all but suggesting that Meyers is a kook and rushes to perform unnecessary surgery. "I've seen a lot of his patients -- they're not better," and "I can't believe you don't already have a scar" (when I told him I'd seen Meyers once and was seeking other opinions in an effort to avoid surgery) and "I don't see any of these things he's referring to on your films; If you're going to have surgery the only person I'd want you to have it with is Andy (Boyarsky)." Bechler tried to scare me and I think he irresponsibly slandered Meyers in an effort to direct more patients to his friend. Boyarsky did acknowledge to me that although he disagrees with what Meyers does (specifically bilateral repair and adductor release), that Meyers is the acknowledged #1 guy in the US for this injury. He was the good cop. Bechler was the bad cop. If he asks you to go see Bechler, be forewarned. If you do go see him and mention Meyers, I'd be very interested to hear his reaction.

Ultimately I felt much more comfortable with Meyers (he was fine with me trying to slowly return to activity in an effort to avoid surgery and at no point did I feel like he was rushing me to go under the knife) and trusted that he correctly diagnosed me and could fix me. I am 6 weeks post-op with him and feeling very good. But, as I said, I think that as a disciple of Muschaweck, Boyarsky simply approaches the injury differently. I think that Muschaweck/Boyarsky look for and fix a different variety of the injury than does Meyers. If your symptoms are mostly in the inguinal region, Boyarsky/Muschaweck are likely for you. If you primarily have RA/adductor pathology, see Meyers.

Hope that helps, and good luck!

Guys - throughout my battle with this injury one thing that gets me is trying to sit comfortably, Basically i cant do it!

I wake up and pain is low, not even pain just a vague sensation that something is not right but then as i move around things get more agitated. When it comes to sitting through a day at work i get pain in my inguinal canals and also adductor/hamstring insertion points.

Is this anything anyone can relate to? I am trying my best to get to see Dr UM but the waiting and not knowing is getting to me again, i have had this for a LONG time!!

thanks

london---Yes, I, along with many others here can relate to the issue of sitting. Sitting definitely causes more pinching of the nerve in my case. Feels much better to stand. Luckily I have a job where I don't have to sit in a chair all day.

How long have you had your injury? Keep trying to get in to see Dr. Muschaweck. I saw her while she was in Colorado and am heading to Munich on friday for surgery next week. I am ready to put this behind me!

Hi Guys,

Like Ebox, I am also curious as to what exercises you guys are using post-op -- and finding the most effective.

If you don't mind posting your schedule/protocol, I think a lot of people might benefit.

thanks!

kent

Hey Garrett

It causes me pinching in the inguinal canal(s) that then progresses to burning/throbbing pain but this pain also spreads to adductor/hamstring insertions so sitting on them it a PITA quite literally!!

I am embarrassed/worried that in all i have had this just over 7 years ! I have seens sports docs / GP(s) / physio(s) / ostepaths(s) / chiropractor(s) over the years and none has ever given me a diagnosis which is why i feel i have no option but to go the Munich route and i think at this stage Dr UM has the best chance of fixing me. The thing that freaks me is the fact that people talk of 'permanent nerve damage' if you leave this too long, well i have left this too long but not through want of trying to find a solution. The fact that i wake up not in pain though and if i say gently swim then i dont get pain gives me hope there.

It has not been bi-lateral for 7 years though. 5 years it was strictly left side and what i find interesting on that side is that in certain positions sitting the left inguinal canal goes numb which i think clearly demonstrates something is interferring with the nerve(s) there so if i find that then i think i have the solution. Right side came about a little under 2 years ago when lifting the wife at our wedding dance of all things!!!

Eagerly awaiting my chance to see UM!!

thanks

Guys go to page 140 theres a few there including mine...........that was mine at 3 weeks and its pretty much the same going on 5 weeks except I added the following:

Crunches 2x20

Bicycle Crunches 2x10

Pelvic Tilts with March 10x

Bridges 20x

Bridges with 10 sec holds 10x

Open Clams 10-20x

Bike 2-5 minutes

Stairmaster 50 steps

Swinging a bat with chute attached 20x

Throwing a ball maybe 50% effort @ 60 ft 25x

Added in some upper body stuff...Bicep Curl, Tricep pushdowns and shoulder stuff to start with

Some is done every day, some every other and some 3x/wk

Starting the end of this week and next week I plan on easing out of the pool and into the gym

PS: My team has there last game of the year on Monday 8/24 which they need to win to get into the playoffs ...... a tiny bit of me is actually thinking of playing....but only if I can get to the batting cages and take a round with minimal discomfort or minimal next day discomfort...of course only on good days I think this way...If Im having a painful day then I say no way!!.....Which I am having today...Left RA, Groin, SI and Glute(probably from new stuff and increased workload) ....In my mind I know I should probably just wait and maybe get in a playoff game down the road or some Fall Ball.....Probably the smartest thing would be to just wait till the Spring....Its the battle thats going on inside my head right now

How did you make out play Hockey HP?????

While looking for an image or diagram of the inguinal ligament, I came across this site. Yet another surgical approach to sportsman's groin / sports hernia / athletic pubalgia. The site has several images that seem useful.

http://www.lloydrelease.com/procedure/