sports hernia/ athletic pubalgia

I had a pelvic floor repair and adductor release on one side with Dr. Meyers in PA 13 days ago. I thought he was first class. I can't believe how fast it was healing.

Unfortunately I slipped running in the pool yesterday (for rehab)while extending at the hip and now I am very sore in the groin. I'm worried I have done something bad or retorn something. Anyone had an experience like this?

Pain/tightness in upper left groin when running/walking going on for about a year. Every time I get up from sitting etc I seem to click in the left pubic area. Have been resting from running all this time and has not improved at all. However I am not getting pain in the lower abdomen region, or pain when coughing/sneezing. I have seen every doctor and they can't solve it. Anyone with simmilar experience or knowledge on this????? Would surgery help it? I am currently trying to read through the old thread to see if anyone had something like this but that is going to take ages. I still have my best running days ahead of me if I can get this solved!

Please help!!!

CB457 wrote:

You need to facilitate hip extension first (sagittal plane) before you make improvements in the frontal plane and transverse otherwise you'll maintain the same degree of imbalacne.

thanks a bunch for your information. do you have some links that describe the above strethces?

Just an update on my daughter's situation (soccer player with chronic groin pain heading off to college in Aug.)

We went to Ohio State Sports Medicine, and the doctor there thought she had a torn labrum. Then we went to NYC and saw Dr. Muschaweck. She looked on the ultrasound and did not think it was a sports hernia. Then she had an MRa (MRI arthrogram) and we got the results today--it is a torn labrum. Now she will be having surgery to repair it. The recovery time is 3-6 months depending on the repair that has to be done, and they won't know that until they get in there to fix it. There is an outside chance she won't have to red shirt her first season. This is a relief for her--now she knows what's wrong and can get it fixed. Thanks to everyone for your information and support. BTW, she did not have the classic sign of a labrum tear--no clicking at all.

Regarding proper stretching techniques here http://www.functionaldesign.com is an article that discusses the philosophy of stretching and need for proper stretching in functional positions.

What shocks me the most is that all of you went through months to years without getting it diagnosed. I think the biggest problem was playing through the pain initially until you COULD not play your sport anymore.

I currently have been diagnosde with the SH. It has been about 3 months now and 2 months since I went to physio for my injury. Instead of wasting space and re blabbling my story, go to my livejournal blog (don't worry it's not spam or anything with ads etc).

BTW, I am going through the conservative approach!

http://spidey9.livejournal.com/

Is this thread still functioning properly? (the other large sports hernia thread has essentially been shut down by the owners of LetsRun.com)

@ Bill in AZ -

look up Dr. Willaim Brown in Fremont, CA

or

also on the west coast, Dr. Kevin Pedersen in Las Vegas.

The price of the surgeries are:

The all-inclusive package price for Petersen is $4000

(This is the price he quoted me back in February 2009. I'm sure Mike can tell us if his price has gone up or not.)

Shouldice Hospital is approx. $3600

Muschaweck is approx 4600 Euros.

Fuerza!

I respond in this thread to your message in the other long thread since the admins have locked it or something. I suggest that it is this thread that wee should use and someone should write a message in that thread an redirect them to this thread. Can you do that admin (weldon)? Or is it to much to ask for? Really frustrating to write a long post and then not beeing able to post it.

Fuerza, thank you for your valid post! However in an forum you gave an american guy the advise to go to Germany and operate his SH and that post you posted the 20/2 just two days before you posted that you would have chosen someone else?

I am really not trying to be rude or anything beacause I understand you and how frustrating this injurie is but what made you change your mind in just two days?

I think you, Rem,, Monchi and Johnny the kayaker is the guys on this board with the most knowledge about this injurie and it is so hard do know what to do. You made a really valid point about calculating for the case of maybe needing to go back to Germany for more tests, operations when deciding to go their in the first place. Many of us I think is young guys who haven´t yet starting to make good money which mahe the financial situation really tough.

When you say that you have talked to more than a dozen people that have not getting cured by Muschaweck can you give alittle bit more info on what seems to be the problem in those cases? Is it for example that they have still adductor pain since she doesn´t adress the adductors or is it many that have the same problems that you have or is it someother problem like nerverelated or something? Would be really interseting to see a compilation of the data/info you have gotten from more than a dozen people beacause that is a large group.

And also alittle bit of what seems to be the common factor before the surgeries of those dozen people who hav not been cured. For example are they all soccerplayers did they all have this injurie for an unusual long time (like more then 2-3 years before surgery) and stuff like that.

On the other hand I think Mike in Vail was the perfect candidate for surgery with muschaweck since he only had have the injuries for a short time, it was a localized injurie an he seemd not so competitive in nature so I am sure he took it easy in the beginning.

Once again I will say that I fully understand your situation since I am in the same situation myself but I am not operated on yet thats the only diffrence. I can still function so well that I can keep my job but it is not fun at all and I don´t know how much longer I can take it. But going to Germany for surgery and maybe get worse so I can´t work and make money and then have to beg family and friends of money to be able to go back to Germany would be an absolut disaster. To be totally broke, not be able to make new money and to have seroius pain scares the hell out of me.

I am also really interesting to hear Rem:s current situation and symptoms since he seems to be a smart guy who do the right things it woulb be nice to see if he is doing any progress and exactly what is his worst symptoms now.

I spell like a 9 year old but don´t mind that.

Pain in the groin,

I didn't see a response I posted on 2/20/2010 so I'm not sure what you are referring to.

As for the people I spoke to, I didn't keep a log or compile any data when I spoke with them. I spoke with them through phone calls and emails. I began talking with them a month after my surgery and that is when I started to hear the stories of those still having pain months after they were supposed to be pain-free. I didn't ask if they were soccer players as it didn't matter to me what they did before the surgery, I just wanted to know how their recovery was afterward. I got the gamut of problems they were having: pain, burning, tightness, numbness, skin hypersensitivity, stinging from a variety of areas in and around the surgical area. I do remember some mentioning adductor pain but others had pain and pressure around the abdominal area. Some did PT and others did not.

Some were trying different physical therapists, some were trying to just live with the discomfort and others were seeking other surgical options.

If you're in the States, then I would try somebody here, that's all I'm saying. If you have problems when you return from the surgery, it will be hard for you to get her to look at you an ocean away. And if you are like me, trips back and forth to Germany will be hard to do because of the money involved.

Hey I have been trying to diagnose a similar problem but am very confused due to the wide varieties of symptoms mentioned. I have poured through these threads for hours and still have no conclusive feelings about whats wrong with me.

A few months ago i tweaked something in my lower right abs it felt about an inch below by an inch wide of my belly button. This happened during a decline sit up exercise. I stopped doing this exercise and continued all other training and soccer and got on fine for an extended period of time. Eventually after trying to include my ab routing a few more times this problem started showing symptoms during cardio (soccer). Well now i have alot of the symptoms mentioned i feel this dull "pain"(hardly hurts) about two inches above and to the right of my pubic mound and I have been resting for about two weeks and it just feels the same. I have seen a Hernia guy and he said it was a strain. I experienced pain while coughing/sneezing/laughing and now thats gone but i can feel that dull ache when i do the aforementioned.

What confuses me is i have no pain in my legs or hip/groin regions! Please help!

p.s. i have dealt with many nagging injuries and i stopped all activity as soon as i felt something was wrong.. this might be pertinent information as to why things aren't worse for me. WILL THIS HEAL!?

Using the base of your penis as the reference point, tell where this dull, achy pain is located.

If you have healed injuries before with conservative rest and you have had success, it would be fair to say that trying it again with this injury may work.

I would check out Mike Boyle's core strengthening regimen and the core strengthening exercises at the Hernia Bible site (www.groin-hernia.com/herniabible/) Yes, I realize you were told it was not a hernia, but these exercises are great to stabilize the lower ab muscles that feed into the groin.

Give them a try.

Also, the hernia doc you saw...was he a dedicated hernia surgeon or just a general surgeon? I ask because most times general surgeons miss incipient hernias or occult hernias, as they have no palpable bulge.

If rest and gently employing these exercise for 4-6 weeks doesn't resolve the issue, you may have to consider some tests for a sports hernia or athletic pubalgia.

I just got my hands on the latest research paper by Dr. Campanelli from the medical journal "Hernia". He is a surgeon in Italy that also focuses on sports hernias. It gives a good description as to what is happening with tissue tears in the groin area. If you want a copy, let me know where to send it.

MUSCHAWECK SPORTS HERNIA REPAIR - ONE YEAR LATER

An update on my condition after having surgery with Dr. UM.

It still hurts! There is something not right!

Several months into my recovery, which seemed to be going well, I started to get some minor pressure around the surgical area when sneezing or anything that would increase my abdominal pressure. Month by month this got worse. Now, anytime I lift my leg, whether it is to go up stairs, tie my shoes, get in and out of a car, exercise...anything...I feel a lump or a bulge being pushed up in and around the surgical site. When I reported this to Dr. UM, the only explanation I got was that it was a ghost nerve sensation because of the nerve being compressed prior to surgery. I had a hard time believing that so I ran it by my PCP and even he said that sounds 'iffy'. As the months progressed, more pains and problems showed up. Now, if I bring my knees together which subsequently collapses the center of the groin area, I can feel something squishy and loose moving around. It is a feeling that makes you worry because you have this gut-feeling that something is not right. I also get alot of burning and stinging when I sit down and the weight of your upper body naturally pushes downward to the center of your body - on the pelvis and groin area. When I laugh and clear my throat, I can feel this pulsing and outwardly pushing sensation where the superficial inguinal ring is.

Although I've communicated all of this with Dr. UM on several occasions, her intent with all the communiques is to tell me that there is nothing wrong and that nothing can undo her surgical procedure. Strangely enough, that is NOT the answer I got when I called the famed Shouldice Hospital and another pure-tissue repair hernia specialist. Both said without hesitation that any pure-tissue repair has the potential to fail or falter, even theirs - referring to Shouldice, which is the gold-standard when it comes to hernia repairs. I further asked about cortisone injections to calm the nerves and those places were quick to say, "Nooo, don't do that!" They explained that cortisone dissolves scar tissue and that is the last thing you want with a hernia repair. The scar tissue is what is binding the surgical site together and preventing it from breaking open again. When I questioned about its value and use in breaking up adhesions or scar tissue that could be entrapping nerves, again I got a big 'NO!' They both said that there is no way to direct the liquid once it leaves the syringe tip to a specific area to only break up some excessive scar tissue and leave the rest of it alone to continue doing its job as the binder for the incised tissue.

I did get an invite from Dr. UM to return to Munich for some testing and to see some specialists for the pain, since she continues to believe that nothing can go wrong with her procedure. She did mention that if a repeat surgery would be necessary, which she always says is highly unlikely, that I would already be there. (Didn't she have to re-operate on some athletes that had her procedure because they continued to have pain afterward? I thought I read that somewhere) Yes, of course I will already be there, but who is paying for all this?!?!? Excuse me for sounding like this, but I, like most others who have gone to Germany, had to pay for everything out-of-pocket. I used most of my savings the first time around to go to Germany because I thought I was getting 'the best'. Who is going to pay for all these tests and specialists if I return to Munich, not to mention another surgery...and airfare...and hotel costs...geeez!

I can respect the fact that she has helped many people and apparently they are doing fine as you hardly see them here once they are healed; but over the past months I have gotten in contact with more than a dozen people, mainly from this forum, who ARE having problems following her procedure. I'm sure there are more out there, I just don't know who they are. Again, I can respect that they may view her as a 'prayer from above', but you also need to afford some respect to those that are not healed and voice their opinions and tell about how their recovery has gone.

At this point, I feel 'kicked to the curb'. She has done her procedure, in her eyes the surgery that day was a success, so she is done with me. In my eyes, the surgery was NOT a success as I am still having pain and problems - oh, and for those that may be wondering, yes, I did do physical therapy and I even waited a whole month before doing PT to make sure that things were primarily healed and sealed internally before starting any rehab program. So, it can't be said that I didn't wait long enough before starting PT. Actually, I am guessing that this is an arrogantly common practice with surgeons. I have read similar horror stories here and at other forums where other SH surgeons operate on you and when you call them to report that you are still in pain, you automatically get,

'Hey, I operated on you and things went smoothly in the OR.'

I did months of research - reading this thread, reading other forums, even emailing many here to ask questions - before choosing her. In hindsight, if I had to do all over again, I probably would have chosen a US-based sports hernia specialist. At least that way I would have had better access to seeing him for follow-up care. Although many sports professionals may have no problem going to Germany whenever problems arise, they also have much deeper pockets than regular people, not to mention the financial resources of the organization they play for.

My suggestion - anticipate post-operative complications when planning to travel outside of the country for surgical care. Although you hope for the best, you often overlook the prospect that you'll be one of the unfortunate guys that has the problems - I know I did. Have even more money in reserves if you have to return to that doctor for her to address the problems you are experiencing.

My recommendation - find a doctor stateside that does SH surgery. There were many mentioned in this awesome thread, plus I have learned of 3 others that apparently have been 'training' with Dr. UM and know how to perform her 'minimal repair' technique. (which, by the way, is the technique she used on me, even though I requested her to do the Shouldice technique. She assured me that the Shouldice technique was overkill and that her technique would yield the best results. I'm now thinking that the Shouldice would have given me a stronger repair since it is a quadruple layer technique to compensate for intra-abdominal wall pressure)

I know price drives many people to see her, but do choose wisely when making the decision as to who is going to cut into you. You are the one that has to live with the outcome, not the surgeon.

My thoughts are with those that are still suffering after surgery and best of luck to those considering SH surgery.

I guess I'm not the only one having problems with her surgery. I read that Kevin Goldthwaite, of the New York Red Bulls, went to Munich to have her surgery in August 2009 and he wasn't doing well afterward; so, he ended up having a second surgery in February 2010 with a different surgeon. Not good...not good at all!

Wow, the more I search the internet, the more I am finding of people that are NOT doing well after Muschaweck's operation. Just read that hockey player, Clayton Stoner, who plays for the Minnesota Wild, had surgery with Dr. UM in January/February 2010. He wasn't getting any better so he had to have a second surgery by a different surgeon. So many people getting second surgeries because her repair technique is not working...this just isn't a good sign for Dr. UM.

adductor longus full release , to everyone out there you must read this it is crucial , dr meyers is a great surgeon he operated on me twice , his adductor releasse where he does his gentele slices is no good , the adductor eventually scars over and re tightens , you must have a full adductor release it is awsome , it really works , go to dr william brown in sanfrancisco web site , it detials it all about the full release he has done over 400 of them , they have been doing the full adductor release in europe and australia for 20 years , for some reason dr meyers doesnt do the full release , but i had his gentle releases and i kept tearing in the lower inguinal region , i had dr lylie micali at childrens hospital in boston cut mine and i cant tell you how much less tension i have on the inguinal region

dr brown in sanfran

dr tanndy freeman in texas

dr scott larson in minnesota

dr lylie micali in boston

these guy all know myers , thye send people to myers for his pelvic floor repair , but they end up doing the full adductor releases to his paitients if the adductors rescar up , save your self a lot of agrivation and have the adductor longus muscle cut fully right away , it wil bea huge help

dr scoot larson has done 45 of them on nfl players and they have all gone back and played

release all the tension , and stop the hernia tearing it works , i wish i had learned about this 10 years ago mylife would have been different

the best heria guy i have found is dr david grishkan ib cleavland , he specializes in re do and doctor screw ups he is the best that i have found and he is a great guy a great guy

dave from boston

I have just read through the threads on SH and have a few questions for all of you who are farther along in your SH "journey" First I will tell you where I am at.

- Lower left ab started hurting in November - dull ache not from anything specific - spread into my stomache and down left groin.

-GP says I don't have a hernia.

- ART - My guy was thinking it was a psoas issue and the ART was pretty effective in keeping me running for 5-6 months.

- Ran Boston and was OK - never got worse.

- Took 2 weeks off did a little jog - still there.

- Went to an Orthopedic doc and he did an x-ray - no bone issues. He tells me to see Boyarsky or Meyers.

- Boyarsky on the 12th of July. Left a message on Meyers office machine.

- Have not run since Boston - It feels better than it did when I jog after my daughter, but it is still slightly there. Riding a bike feels ok.

- My insurance, Oxford, will not cover the surgery if I need it.

Questions

Could it get Better?

Any opinions on Boyarsky?

I ran for 6 months with it. If I can deal with it should I run until I can see these guys. I am assuming I will not be able to see Meyers until Fall.

Anybody have any problems with cycling?

Anybody successfully get their insurance company to cover the surgery after they have said they don't cover SH surgery?

Thanks for all who have posted on this Injury. It has been a big help.

Bill