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

Garrett - also what are your pain issues and how long have you had them? Interesting that she is saying surgery for something small so are you in a lot of pain and is it all the time?

London---My pain is mostly upper thigh and testical pain. My upper thigh/hip area have a constant dull burning sensation all the time that gets much much worse with exercise. The testical pain mostly happens when I am doing exercise or sometimes when I just twist my torso. My pain is pretty constant on both sides with the right side being slightly worse most of the time. I first had the signs of this injury about one year ago and it got worse and worse over the winter while snowshoeing. I consider myself very lucky that I found this forum and got in to see Dr. UM in July. She diagnosed me with a bilateral "sportmans groin", a classic case she said. "a discret protrusion of the posterior wall" that is pinching on the branch of the genitofemoral nerve that goes to your upper thigh and testicals (go figure). It has been very difficult dealing with this injury for only about a year, i can't imagine what you have dealt with!

Good luck!

Wow, thanks for the great download, HockeyPlayer. I too am 37 and also would take slight offense to someone saying "at your age", as I feel I still have quite a bit of life and vitality left in me. Appreciate the tip on Bechler too, good to know.

I found when I saw Myers in May, he was very pleasant, and was willing to write me a PT prescription, although he did say he didn't see any RA tears on my MRI yet he "suspected" there were some (radiologist final reading also reflected no RA tears) and could "fix that right up".

I'm really all over the map with how I'm feeling. I think I may have lesser pain (strong discomfort is probably a better word) than others here, but feel it sometimes in my groin, testicles, spermatic cord, lower abdomen and even near my hips.

So, here's the diagnostics:

-CT Abodmen/Pelvis: Negative for everything.

-MRI: Mild adductor tendinopathy, slight left hip labral tear (I don't feel pain there)

-US Testicles: Normal

-X-Ray of Thoracic and Lumbar Spine: Normal

Here's my gameplan (welcome other's thoughts):

-Will probably discharge myself from PT and continue my daily program at home and gym (as I can do all the exercises myself and will)

-Seeing Boyarsky 1st week of October

-Followup appt with Meyers 2nd week of October

-Followup ortho hip surgeon appt 1st week of November

Considering:

-Acupuncture (why not?!)

ebox,

You seem to be dissatisfied with the results of your current PT. How confident are you that your PT is the right one for you? Have you given up caffeine yet?

Of the PT exercises you've been doing, which do you feel is (are) the most beneficial?

I'm saying this because I'm getting very good results with my own rehab plan, and I think your original symptoms are less severe than mine.

My original symptoms:

- Pain in left groin upon movement, part of every day, whether any exercise, or not.

- Pain/inflammation in left spermatic cord/testicle usually related to exercise the day before. This is the most depressing of all my pains.

- Sore/tight adductors in left leg, sometimes interfering with sitting over 15 minutes.

- Pains in lower abdomen, usually lasting only a minute.

- Difficulty getting in/out of a car normally because adductors in left leg are usually tight/sore.

- Difficulty getting out of bed normally.

- Difficulty/pains sleeping on either side, especially my left side.

Garrett - thanks for this info sounds like you have a very good diagnosis there. Its been a difficult 7 years but i think the most difficult is just not having a diagnosis but i am 99% sure that when i see Dr UM that diagnosis will come.

My issue is definitely coming from the inguinal canal(s) and even though i seem to have some symptoms that are not classic to a SH eh adductor/hamstring insertion pain i think if these are not directly attributed to the nerve then they are most likely due to compensatory patterns as my body tries to brace from the pain.

Keep us informed how you get on!!

Surf - No surgery for me yet although that is now what i want. As i can do a situp OK or adduct OK then i dont think i have a RA issue, i think i have a inguinal canal issue and 7 years of rehab is enough for anyone and when you are rehabbing when no-one has actually told you whats wrong thats even worse. Good luck with your protocol and let us know the routine you have been following.

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.

Sorry for all the bold, by mistake.

Surf-

When talking about the core you should also look into the Transverse Abdominis Muscle which acts like a corset when lifting.

Also you could have an anterior tilted pelvis for a variety of reasons...tight hip flexors (illiacus) which in turn shut off the glutes. So it is just as important to get those glutes firing to get you upright. I am also getting my core in shape while losing weight...so it is a challenge but that is the key ...with or without surgery.

I was lucky enough to go to a podiatrist and got arch supports and my plantar fasciatis is lessened 95% and my mcl tear is symptom free and it has only been 3 days. I imagine this effected me all the way up to my hips. Anyways....

Albert -

Yes, that corset-like muscle. I've got to get that thing activated and strong. It's like all the muscles in my core lost their memory. I also do a light twisting exercise with no weights or bar or anything, but am extremely careful even with that, remembering your log unloading injury.

Glad to hear your plantar fasciatis and MCL tear problems are subsiding.

I have been experiencing a sharp pain in my lower abs on the right side 2-3 inches below belly button for almost 8 weeks now (a little above the pubic bone, maybe an inch or two to the right of my belly button). It only bothers me at the start of my runs (for 1-2 min tops) and then is pretty much fine at my normal pace (6:30-7:15). I\'m able to run in the hills for 2.5 hours and feel great the whole time and I\'ve been relatively pain free on tempos.

However, when I do strides it is very painful for the first few steps but gradually gets a little better. I also feel a little more sore the day after doing strides or a tempo. Basically, the pain is triggered by more intense workouts. Cross country season is coming up and repeats will be starting soon and I\'m worried about feeling pain for the first 400m or so of races or mile repeats and such. The starting and stopping is what gets me.

Also, it hurts to do most ab exercises and occasionally hurts when I cough or sneeze, but I have no other symptoms and generally feel alright. I took like 3-4 days off in early July and it didn\'t seem to do much. I\'ve been able to run 80-90 mpw this summer but haven\'t done much core work or many strides bc they are painful.

Should I start doing a ton of core work to strengthen my core and hope I get over this, or would that just make things worse?

Any advice is appreciated!

collegiate runner -

I have zero medical credentials, so take anything I say with a grain of salt.

I'm 59 yrs-old pickup basketball player. My very first symptom, almost exactly a year ago, was I noticed pain in lower abdomen, about an inch below my navel, with each sit-up I did. So I simply decided to stop doing situps. I continued to play basketball for about 5 months after that with zero problems, doing great. Then I started playing almost every day instead of my usual once or twice per week, and came down with typical sports hernia.

Knowing what I know now, I WISH I WOULD HAVE:

1. Immediately started working on my core muscles, but very, very gently the abdominal muscles. For example standing tricep pull-downs with only 3 or 4 pounds instead of 30 or 40 lbs. Weights low enough that I would feel zero pain below my navel, but still feel my abdominals engaging, and doing some work, if only a little tiny bit of work.

I wish I would have started sucking in my belly for several minutes, gradually building up to where I sucked it in almost all the time every day.

For my side muscles (love handle area) I wish I would have started hanging a 30 lb. dumbbell in my right hand, standing erect, then bending my torso to the left so that I could feel my left side core muscles (love handle area) working.

And I wish I would have immediately started doing some work on my back muscles, maybe very, very light dead-lifts or something.

2. I wish I would have immediately slowed down my basketball game, maybe to only once per week, and no competitive games, just very light stuff to keep my blood circulating well.

I think if I would have done those 2 things, i.e., gently and patiently increased the strength of my core muscles (front, back, left side, right side, and corset) over a couple of months, I probably would have prevented my falling into the abyss of sports hernia.

Like I say, take this with a grain of salt, collegiate runner. Remember, everybody in this forum is an addict. Every single one of us. We are addicted to the endorphins produced by vigorous sports activity. Good luck.

Collegiate runner -

It's possible you may instead have inguinal hernia, but I'm guessing you don't. In either case, however, you'd be better off with a good strong core muscles supporting your spine.

By the way, if you view your profile in a mirror, collegiate runner, does your belly stick out much, or is it naturally flat? I've been working on sucking my belly in as a matter of habit for the past couple of weeks, and seem to be making progress. But I wonder if most others that get sports hernia have lazy bellies? I wonder if persons with good tight bellies are also vulnerable to sports hernia?

Thanks.

collegiate runner -

Remember that sports hernia is a repetetive stress injury. I would consider stopping running completely for a short while, until you make some noticeable progress in the strength of your core muscles.

Also, consider giving up caffeine which works by disrupting your neurotransmitters. It's mainly in coffee, tea and colas. Giving up colas was the hard part for me, but I'm glad I did.

Sports hernia is by far the most serious health problem I've ever faced in my 59 years. It can be very debilitating. You don't want to get it.

london sufferer -

Seven years of pain is too much to bear. I don't know how you've done it. Yes, I think I would be going to get a diagnosis from Dr. Muschaweck, too.

Wishing you a speedy recovery.

Den -

How are you doing on strengthening your core muscles? Any luck?

Albert/JC

I\'m setup for surgery with Meyers 2wk of sept. Bilateral tear with detachment on right side and adductors appeared good on MRI, however my hamstrings/adductor feels pretty tight and my back/lumbar pain changes day-day, but as you know, its horrible most days. I\'m hitting the gym as much as possible. I have a good core routine thats feels good without causing pain etc. I have access to foam rollers, bosu, reebok core board, pool, cycling.

You guys have any suggestion on particular exercise or stretches that may be helpful for the next 3 weeks? I\'m going to stick to my core workout which includes lowerback. I\'m curious if it best i strengthening or stretch my psoas/glutes/adductors/hamgstrings before the surgery?

Surf - yes its a long time to suffer with this but saying everyone is addicted to pushing themselves is not true, as i for one was not that active when this hit.

What is perhaps interesting is that i was VERY active in the years upto this, but not a gym monkey, i used to live in the mountains and so ski/snowboard all winter and hike all summer. Go from that to a desk job and a couple of years later and this happens, so yes i think these things might show up when people get 'weaker', i think Albert was similar, but i think this is basically something i was born with that showed up later in life.

london -

I think yours is an unusual case compared to most of the stories posted in this long LetsRun thread. I think you're maybe the only non-addict (of exercise).

I wonder if you may have only a simple inguinal hernia? Dr. Muschaweck will be able to tell you.

Another thought, london, is that when I first came down with sports hernia I tried some rehabing by an exercise list, and also tried just no activity. Neither worked. I became so afraid the make the tear worse, that I slept mostly on my back, and got in/out of my car very carefully with protected movements. But what I now realize is that by not sleeping or moving normally, waiting for things to get better, my muscles began to atrophy almost immediately.

Even the various muscles that humans use to turn themselves over at night atrophied on me. Subsequently, turning over at night without tensing my core muscles (out of fear) as a normal human would, became more dangerous to me, in a sort of vicious cycle.

You mentioned sitting at work. I'm guessing that one reason for the large number of people with sports hernia and groin pain is that the whole world now is spending so much time sitting, hour after hour, day after day, staring at a computer screen.

But now, thank the heavens and knock on wood, I'm making real progress by simply strengthening my core muscles, patiently retraining them, bringing them back to life. I'm steadily moving towards sleeping normally, and am already getting out of a car normally. All without surgery or drugs.

Whether Dr. Muschaweck diagnoses you as a sports hernia or inguinal hernia, it seems to me that you'll want to have some good strong core muscles: front (abdomen), back, left side and right side of your torso. Even if you don't plan any sports and expect to spend a lot of time working at a desk.

Wishing you a speed diagnosis and recovery, london sufferer.

PS.

Also, here's by someone else having sitting problem.

http://www.sportsherniaforum.com/index.cgi?board=general&action=display&thread=16

thanks for the words - Yes Dr UM's diagnosis is eagerly awaited.

My core is pretty strong as it is as i can do a plank for about 2 mins before it really starts to fatigue me so hopefully i am OK there but i have found that my glutes are totally weak in that if i stand on one leg and then lift my leg out to the side its really taxing on me so that is something i am working on.