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

Andrei,

I wouldn't get too concerned about fleeting pain on both sides yet... I think the imbalances create that in some cases. I had some short term pain on my right side that went away. The problem was on my left side (surgery side) to begin with, but when the pain got really bad on the left, I was getting pain on the right and throughout my pelvis, in part I think, because of all the inflammation. This was all prior to surgery.

This is very encouraging Den. I hope you're right. I'm going on with my core workout and stretching. Thank you very much.

I've been following this thread for quite some time as I am in a similar spot as many here. I've always had some minor groin tightness and atrributed it to lack of hip flexibility. Fortunately it never stopped me from participating in all kinds of sports until May 2009. The pain on my left side groin and lower ab has made any sort of strenous exercise (especially running) very painful and difficult. I ran through the normal channels fairly quickly and realized I need someone specialized to handle this, which appears to be fortunate given some of the long-standing battles of many posters. I travel to Europe quite often for work and went to see Dr. UM, who diagnosed walnut-sized inguinal hernias on both sides with only one side showing as symptomatic. My question for those that have gone through this before is should I get both fixed if I am going to be going for surgery anyway or only do the symptomatic side and hope the other side holds up? Dr. UM left it as open since both need to be fixed from a medical perspective but only one is symptomatic. Thoughts?

Where do you live Munich_Bound? If you live in Canada then you should check the shouldice hernia clinic (shouldicedotcom). They do a wonderful job and what is important is covered by OHIP. They do pure tissue repair which is the operation with almost no side effects and almost 0% recurrence. Hernias do not heal themselves no matter what you do. After everything I've read, there is a very small window of opportunity to heal it through conservative measures but in your case is more than 5 months. Have you tried PT yet? Did you stop any sport activity?

Give us please more details about what do you for living, daily physical activities etc so we can evaluate a little bit. Me personally I have no medical knowledge whatsoever but all of us from here we read a lot about this so maybe we can pinpoint you into the right direction.

Hey Andrei - my understanding is that Dr UM does a Shouldice-based procedure with very similar results. Please correct me if I am mistaken. With regards to treatment, I tried the PT route, manual therapy, ice/NSAIDs, electric stim, ultrasound and virtually everything I could get access to. I didn't completely stop sports until it became unbearable to run (about 4 - 6 weeks after occurence). The treatments would make it manageable until exertion made it progressively worse. I live in Pennsylvania and typically, I work out (weights, running, sports) on a daily basis each morning for 60 - 90 minutes. For obvious reasons, that has been dramatically reduced and I've been just focusing on mobility and trying to maintain as much strength as I can given the limitations. I am 34 and work in a business management role so I am at a desk most of the day. Any insight or perspective is greatly appreciated.

Munich_Bound,

Drop me an e-mail at jb_alphamaleatyahoo.com and I'll send you a doc written by Dr. UM in which she says that since 2000 she is not using anymore the Shouldice technique. Anyways I do expect that if you live in PA than your insurance is not going to cover the shouldice /canada costs. Check with them the costs and compare them with Dr. UM's. Shouldice clinic do not operate SH so in my case my best option is Dr. UM/Germany so I biased to her. By the way I just remembered that there are guys from US in this thread that had the operation with Dr. UM and had covered most of the costs through their insurance. Depends on the insurance company and type. In the other hand if you can afford the operation with Dr. UM I'd go there considering that she put the diagnostic and her world ranking related to SH and inguinal hernias is among the 1st. At the end is your choice.

Munich_Bound ....NO BRAINER....Get both sides fixed........also why not see Dr Meyer .....hes right in Philadelphia

Munich_Bound,

I'm a fellow Pennsylvanian. I went to see Dr. UM and had surgery with her. I also saw Dr. Meyers - no surgery with him. I also checked into Shouldice.

Send me an email and I will give you my home phone number and will gladly answer all of your questions, if you're interested. There is just too much information to share to type it all.

fuerza,

rahenry42@yahoo.com

JCsportsman,

I have actually already seen Dr Meyers as I don't live far from Philly. His MRI indicated a high-grade tear on the left (symptomatic) and low-grade tear on the right with a diagnosis of left athletic pubalgia with an adductor component. Based on our conversation, he recommended only fixing the left and doing an adductor release. I certainly felt comfortable with him and his recommendation but think my injury is more abdominal/inguinal and wanted to get the Dr UM perspective before making a decision. Interestingly enough, the MRI report from Dr Meyers indicated no inguinal hernia present and Dr UM found and showed me two through ultrasound.

I am certainly going to get it fixed surgically as I believe that no amount of rehab will resolve this to my satisfaction given the physical evidence of muscle detachment and the lack of improvement with rest, rehab and hope. Everyone's injury and situation is a little different but I am just trying to determine whether or not to get both sides fixed. I have scheduled for both with Dr UM but keep going back and forth about the best approach (1 vs 2 at the same time).

Munich_Bound!

Your situation is EXACTLY what is bothering me!

There is no consensus between doctors about this injurie.

If we take your situation as an example:

You go to the guy who is by many regarded as the best doctor in america when it comes to this injurie. He sees two (rectus abdominis?) tear on your groin. BUT NO HERNIA.

OK, if this superdoctor says that to you and also is very good at treating this tears then ofcourse you should let him fix you!

BUT, then you go to the best doctor in Europe, and she doésn´t see any tear and adductor-injurie. SHE SEES TWO HERNIAS instead! WTF??

One of them must be wrong! This is so ridicolus. And the sad part is that you are not unique! I have heard of so many guys who have meet both Meyer and Muschaweck and gotten the exact same confusing answer as you have.

It would be interesting to meet both Meyer and Muschaweck at the same time and let them do all there tests and then talk to each other before they together gave you there

joint statement.

Rick

Dr. Meyer's diagnostic didn't specify RA tear. He said athletic pubalgia which in my understanding is his similar to SH.

This confusion that Munich_Bound experiences made me to cancel the appointment with Dr. Myers because reading everything around I decided that Dr. UM's expertise is closer to my injury so 1 diagnostic and 1 fix.

I perfectly understand others reasons to have more than 1 diagnostic but hey, everybody is different as this condition (SH or RA tear etc) is unique from person to person.

Munich_Bound whatever decision you take get it fixed and return to real life. Anyways this is my intention. :)

I agree that it would be really interesting to hear them together but clearly that will not happen. As crazy as it seems, I actually don't necessarily think either is wrong. I think they view this kind of injury through a specific lens. As one of my friends, who happens to be an orthopedic surgeon, said - when you have a hammer, everything you see is a nail. I think my role, as a patient, is to determine which approach works best with my circumstances. For me, I wanted minimally invasive and I think Dr UM is really good if you catch it early enough, like many of the athletes she treats. If not, Dr Meyers is likely better as he does a more extensive repair and can fix the collateral damage that often occurs. I would be curious to hear from anyone that did a bilateral with Dr UM - did you consider doing just one side, how was the recovery with both, how is the two days of surgery, etc.

Munich-Bound,

I had bi-lateral repair with Dr. UM six weeks ago today. I just did my favorite 3 mile lunch time trail run a few hrs ago. I am only a few minutes slower than I was one year ago. Having a bi-lateral repair by Dr. UM was not bad at all. The only thing I didn't like was having surgery on one side one day...then the other side the next day. Seems like they could do it fairly easily all at once. Never got a good answer as to why they don't do bi-lats on the same day. BUT, i had very minimal pain on either side so I am not going to complain about anything. I had my symptoms for about a year, that included mostly burning in my upper thighs, and very harsh pain in the testicals. I never had any pain in my lower abdominals or in my pubic area. I went to a Sports medicine where I did a bunch of movement tests that she said showed I had no tears or strains. So knowing that my injury was 100% inguinal canal related it was very easy to make the decision to go to Dr. UM.

Dr. UM, and the medical staff she uses are top notch. It was a great experience that i would do over if i HAD too. I suggest taking someone with you if possible. That made it much easier for me. Also stay as long as you can in europe. I didn't get on a plane to come back here until Day 10 post op. I walked 3-8 miles a day up to getting on the plane to come back.

I'll be happy to answer any other questions.

garrettdelmas@gmail.com

garrett

well not sure about the early enough thing as i have heard from more than 1 ex UM patient who had been in serious pain for many years who were 'fixed' by her.

I think it all depends on where you are injured, if you mainly have inguinal canal issues that are compressing nerves and causing the pain then i think UM is the route to take, if its more RA seperation and adductor related then maybe Myers is better but for me i clearly have pain radiating out from my inguinal canals so this is where i am focusing my investigations and treatments.

Basically any repair of a tendon is going to be a longer recovery and more painful.......If its just an inguinal hernia repair recovery is very quick.......Dr Meyer does check for Direct and Indirect inguinal while hes in there.....plus after his repair he double checks to make sure one will not form...if weakness occurs he will reinforce it further.........all this was in my O.R report........

I think these 2 Docs do close to the same thing just in totally different ways ...from my understanding is DR Um looks for inguinal hernias thru Ultrasound then while doing her repair may correct any torn tendons she comes upon ???...where as Meyers looks for the torn tendons thru his MRI then will fix anything else while hes in there.......A lot of times you just never really know what is really going on until the surgeon is actually in there

i think the hernia tag is confusing and thats why UM does not use it and instead goes for sportsmans groin. She may or maynot find a 'hernia' but what she often does discover is a weakness of the abdominal wall causing compression within the inguinal canal.

Have you seen her pdf?

london sufferrer

No I have not seen her pdf!

It would be great if you could share it with us!

this is the one

www.leistenbruch.de/fileadmin/docs/UEFA_engl.pdf

- Similar

Based on my conversations with both doctors, you are absolutely correct JCSportsman. Dr UM focuses on the inguinal hernia, often indirect with no bulge, or abdominal wall "weakness" and reattaches any detachments that are there. Where they differ, however, is that she does not feel that it is necessary to do the pelvic floor repair or address the adductors. She indicated to me that adductor pain is most often nerve pressure radiation. I'm not completely convinced but the pain I have is primarily abdominal (low) so I believe she's right for me, although my MRI report may indicate otherwise. Here are my findings:

There is an 8 mm detachment of the lateral right rectus abdominis/adductor aponeurosis with grade 1 adductor

lungus tendnosis. There is a 15 mm detachment at the lateral edge of the caudal left rectus abdominis with interstitial tearing or grade 2 tendinopathy extending into Ihe left adductor longus tendon origin. Midline structures are intact. No distal rectus abdominis muscle atrophy is present. No inguinal hernia is identified by MRI.

Thoughts?