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

Hi, great thread and I though i would add my story in here.

12 years ago I had a mesh put in place for a sport hernia. I suffered for a few years and was mainly sent to the urologist (piriformis pain mistaken for prostate pain and ache in my tesitcle) Eventually i was diagnosed as having a sports hernia and they slapped a tension free mesh in there. The mesh was never particularly comfortable and there was huge scarring. The surgury didnt seem to help much so I rested and then had a lot of PT then a couple of years down the line I was back to full activity. I always could feel the mesh and scar tissue though.

Jump forward to 6 months ago. I was working in my garden breaking up a concrete path using a forceful downwards/cross body motion with a long crowbar when a felt a pain down the old scar. Only lasted a few hours but after the next couple of runs all the old symptoms came back in the right hand side (abductor pain, SI joint pain, piriformis pain and lower ab in the crease)

I found a surgeon who claimed to do be knowledgeable in this area and had the mri and cortisone injections and ant-inflammatories which are pretty standard protocol and then he recommended surgery to check it out.

I had an open op and he freed the nerve which was trapped and removed the old mesh, scar tissue etc (100g of material) He is happy that if there was any weakness, tear or bulge 12 year ago it is now gone. I felt far better than when I had the mesh put in at first op and was happily back to running (although gentle) in four weeks. I had a break from physical activity over xmas and that is when I started to feel pain in the scar tissue again. This was about 8 weeks after op. I decided to rest and see where that went but unfortunately the symptoms started coming back. 11 weeks out I had a cortisone shot in the scar tissue and Everything was brilliant for a week then it all came back. Looks like the nerve is not happy, probably due to reforming scar tissue. Perhaps if i had not took a break from activity ths would have not happened? Surgeon is out of ideas except time (I am only 13 weeks post op) and using lidocaine patches to break cycle)

My experience is this is an infuriating condition but I know eventually I will heal. My plan is plenty of PT and massage out as much of the scar tissue as possible. Ibuprofen and lidocaine gel daily. Work with foam roller and a sacrowedgie to loosen up si and hips. A program of light running, weights and rehab protocals up to the point that is comfortable. Most importantly get it to the back of my mind and stop worrying about it.

If anyone has any suggestions I would love to hear them also if anyone knows of a good surgeon in the UK please let me know. i will have a checkpoint in three months time and if no progress has been made I would like a second opinion and another MRI to be on the safe side. Probably go to Gerry Gilmore but not covered by my health plan so will have to come out of my own pocket (Probably should get a cheap flight to Germany)

Good Luck all

I went to Dr. Hoadley for sports hernia surgery back in May of last year. I couldn't be happier. I've played about six soccer matches thus far and feel pretty good. He also recommends the rehab protocol distributed by Dr. Brunt.

Den,

Could you post a link to the rehab protocols that Dr. Brunt uses? I googled it and found nothing outlining the exercises. Thanks...

Trigger599,

Yes, if you are looking for an expert, perhaps a cheap RyanAir flight (do you guys have RyanAir in the UK?) to Munich would be in order.

Now, I will tell you (and this may have no bearing on your decision given your location to Germany), long-distance follow-up care is nearly non-existent with Muschaweck; unless you are willing to hop a plane every time you need her to address something that she has done to you surgically. I am speaking from experience since I live across the pond. The only thing you will get is 'come back to Munich and I will look at you and run some tests'. Again, that may work for you since you are in the EU, but sucks for guys like me who are in the US. Oh sure, and don't get me wrong, she is very accessible via phone and email, but little good that does when you really need someone to examine you. And I don't know how the doctors are in the UK, but when I call a surgeon here in the States for an appointment and they learn I was operated on by someone else, they don't care to see me.

Monchi,

I don't think there is a link... Dr. Hoadley gave me a copy of it after surgery. It is the protocol used for the St. Louis Blues hockey team. I may still have a hard copy on another computer that I could email to you if you can give me your address. But I will say this... my opinion is that ART (Active Release Technique) may be the most important thing you can do as part of the Brunt rehab. I say this because I had a lot of compensation problems due to the injury itself. Meaning that I had a lot of tightness and dysfunctions as a result of the injury. I found that the ART helped free up some tension and allowed me to progress. Also, ART helps with relieving scar tissue and releasing soft tissue problems.

im in the middle of my last year of college eligibility and im pretty sure i now have a sports hernia. i have yet to go through all the thread but i was wondering how successfully i could run through this injury for the rest of indoor/outdoor (3.5 months). i run mid-distance and am in the best shape of my life (4:10 in my first mile) and would hate to take some time off now. would it be possible to keep running 70mpw with intense speed workouts to the middle of May??

Well, I hate to offer a wishy-washy answer as I'm certain you are looking for a definitive answer BUT...continuing to run is going to be up to how much pain you can tolerate for the next 3.5 months.

You could attempt to self-repair (if the injury isn't too far along yet), but that is going to entail rest and laying off of the speed running. You would also need to try and employ some of the Boyle rehab exercises if you have any hopes of rehabbing this injury.

If you haven't been properly diagnosed yet for a SH, you definitely will want to get that done as there are many other groin-related problems that could lead to a differential diagnosis. Find a good sports medicine doctor/orthopaedist, be aggressive with him, and request an MRI using standard athletic pubalgia protocols (Thomas Jefferson University has pretty much set the standard). You may also want to get a dynamic ultrasound (with continuous cine loop recording, and with color power doppler to look for hypervascularity and edema) performed by an experienced radiologist - not a technician - to see if you exhibit any posterior inguinal wall deficiency. Ultrasounds are highly operator dependent, so you need an experienced radiologist that knows what he is looking for. I would not rely on your local hospitals for these type of scans, unless you live in a metropolitan area that has better-than-average hospitals.

Best of luck.

thanks for the advice. its been hurting since monday so I think i caught it early. i could tolerate the injury if the pain stays similar to what it is now but im just not sure how much worse it will get.. ill try and get an mri as soon as possible.

The longer you try to run through it, the longer the recovery and the less chance of full recovery

I just got word that Dr. Muschaweck, the European guru for sports hernias, will be in NJ seeing patients during the first week of March, 2010.

For those that are suffering and want to see her, without having to go all the way to Germany, email her at:

info@hernien.de

and she will set up an appointment for you.

Best of luck.

Monchi and rem!

Monchi what is it that you still have problem with after your surgery with Muschaweck? Can you describe more in detail? It must suck to live in USA and have problem after a surgery done in Germany. Would you still recomend someone to do the surgery in Germany?

Rem- If I remember it correctly you had have some operations before you went to muschaweck so she had to deal with alot of extra scar-tissue and mesh.How happy are you with the result in a scale from 1 to 10?

What are the things that makes you feel that it is not a 10?

It is a very frustrating injurie with alot of contradictions so it is not easy to know what do to. Especially not if you have the adductors involved also as I do, it is very hard to know if it is just nerve-irritation from n.ilioinguinalis or if it is some structual damage on the adductors. I am at peace with the fact that I will never be able to compete att 110% of my ability again but right know I am at maybe 10% of my ability and that is not ok.

What is you goal Monchi and rem? How succesful must the surgery be to make you satisfied? What have you done post-surgery in terms of treatment? Nerve-injections/blocks, PT, massage etc?

And to the gentleman who are gonna try to run through the injury all I can say is good luck.

I have to admit I am a bit concerned about going to Germany for both difficulty in getting a follow up and also cost. I have healthcare for the uk but it will not cover Germany so it’s a big expense I really do not need. Problem being I don’t really believe the surgeon I have in the uk. He says he does these all the time but when pushed I am not convinced. After having op he says I have no tear but I wish I could believe him. My healthcare covers just about every surgeon in the uk except Gilmore which is also very annoying. He removed mesh and lots of scar tissue (as it sounds REM had done) I was great for 8 weeks but then I felt a sharp pain in the scar and then all the other symptoms came back. He says use lidocaine patches on it as its just an unsettled nerve. I don’t know why he didn’t just remove the nerve while he had me open.

REM do you have any advise on the pros and cons of having the nerve removed? Is it safe to have this done via laparoscopic op?

It’s the first day of using the lidocaine patches so I will report if they have any effect but I suspect it is clutching at straws.

Also I know this has been done to death but does anyone have a detailed PT routine that would be appropriate (I have read every page but can’t find one now) I am going to presume I still have a problem so looking for a pre operation type. Preferably something recommended by Meyers or Um

Any advice appreciated

I had the nerve removed.....twice. It was removed during the first repair a while back, but when Dr. UM went in the nerve had regenerated and sprouted back so she removed it a second time. I've never has a lapro repair so I wouldn't feel comfortale commenting, but I'm not sure how this injury can heal if the nerve is not taken.

At this point I can't see how I can possibly have another tear. But, I still have pain in my abs around the

incision(s), around my psoas, and any kind of exertional activity severely aggravates my adductors. I've resorted to soft tissue manipulation now - Graston, ART, and very focussed clinical massage.

Dr. UM doesn't recomend any PT. I think the one referenced previous in the Mike Boyle article is pretty sound.

Hi rem!

Do you think that you would have been better of not having any surgeries at all for your groins?

It is so hard to know what to do with this injurie!

Oh, one more question rem! What is it that Muschaweck does that the other surgeon did not do to prevent the nerve to grow back again? Does she cut it in some other way? Does she burn the nerve-endings or what? She must do something special...

I think the problem that I'm still trying to get over is an absolute butchering from the first surgeon who operated on me. In retrospect, I think he tried to fix an SH the same way he would a general inguinal hernia. Other than surgery, I don't see how rehab can get rid of what's essentially a hole in your abdomen wall. Just make sure you get a qualified surgeon.

As for how Dr. UM cut the nerve, I'm not sure if she did anything special. THe surgeon who cut it the first time was a qualified surgeon so I was surprised to hear it had come back.

Has anyone who had surgery for a sports hernia ended up hurting their knees too??

Update on my surgery. Finally, after a year I went to a clinic in Las Vegas on Feb. 2. Dr. Kevin Petersen performed my surgery. I would highly recommend him and his staff. I initially was diagnosed by Dr. UM in July 2009 as having an inguinal hernia on the left and a SH on the right. In October I slipped on some ice and therafter felt the hernia on my right bulge into my scrotum. Both Dr. UM and Dr. Petersen recommended no mesh for my surgery. Both Dr's told me that once they open someone up, they can determine the damage and what is the best procedure to do. After Dr. Petersen opened me up, he found a one inch inguinal hernia on each side. I am feeling no more pain in my groin and have started lightly walking today. Feel a little fatigued and sore at a couple areas, but the lack of pain feels great. BTW Dr. Petersen does not work with insurance companies. His website is noinsurancesurgery.com. His rates are very low and the care and professionalism from him and his staff was top notch.

Rick,

In retrospect, I probably would have tried to find a surgeon here in the US. Actually, I did find a surgeon that was quite knowledgeable about sports hernias and understood it to be an occult or incipient hernia. When I asked him how he treated it surgically, he told me he used standard hernia repair techniques - which is basically what Dr. UM is doing. Yes, of course, she has her new 'minimal repair' technique, but when all is said and done, it is still a hernia repair, plain and simple. And the good thing was that his price for the surgery was very close to the price for Dr. UM's surgery.

There was also another doctor, in California, that did pure-tissue repairs of sports hernias. He has been doing them for 10 years and works on alot of the professional teams in and around Los Angeles. He has a website and even talks about his approach and shows pictures of the actual surgery. I may have gone to him too.

So, in the end, there are alternatives to flying to Germany for a pure-tissue repair of a sports hernia. I chose her because I thought I was getting the best, but I did not count on complications after the surgery and the difficulties of getting follow-up care here in the States.