Sports Hernia - Nonsurgical Approach

Nice work man. Please keep the updates coming and good luck!

Good luck with the recovery.

I've been dealing with this for a couple of years. Initially I tried to run through it and finally realized I couldn't.

I have not run since last July. Started jogging this week and managed two miles on the treadmill today. No pain but a little tight. Mostly I'm just woefully out of shape and 15 pounds heavier than I was at this time last year!

I doubt I'll return to competitive running (mid-30's road racing...if you consider that competitive) but would like to be reasonably fit for health and role model to my kids.

(I realize I didn't add much value to the discussion. Sorry)

Update #8

Progress continues.

Groin sensations are very rare now. I continue to do plenty of groin and hip mobility and stretching exercises. Check out

http://www.mobilitywod.com

for some really good hip and ankle mobility exercises.

I just started 3 min run-2 min walk. I do 10 reps with some walking to warm-up and cool-down. I am being very cautious. When you get into your late 40s, recovering from injuries takes 5-10x longer than when you are in your 20s. So I am taking it very slow. I would like to be running into my 70s and 80s.

Cycling is no longer a fitness priority. Too much sitting on the job and then "sitting" on a road bike results in terrible muscle length and strength imbalances. I have also cut back on swimming.

Recently started some TRX work. TRX has really challenged my core. I am starting out doing it 1x per week but plan to make it a 2x per week activity in a month or two.

I continue to walk 4x per week for at least 60 min. I have to do this to "unwind" the damage all the sitting does.

I am glad I have gone this route. Surgical outcomes can vary. I tolerate needles much better than anesthesia and scalpels.

The PT I used is Blair Green at One On One Physical Therapy in Atlanta, GA. She specializes in female pelvic conditions. Child birth can re-arrange the pelvic muscles. Although I am male, I think there are many similarities. Once your pelvis is out of whack, it helps to have a specialist. I highly recommend her.

Update #9

Had a setback last week. I had to do lots of sitting for work and that came after a couple of workouts in which I did burpees. It seems that burpees are too much at this point.

The eccentric load to the muscles of the pelvis that occur during the burpee exercise are probably too much at this stage in the recovery. I feel it while doing the run/walking sessions.

I would estimate I have gone from feeling 95% recovered back to 65-70% recovered.

PT did some more needling and some massage in the pelvic region. She advised me to continue with the stretching. One stretch in particular: Lay on your back on one of those exercise balls. Allow the hands and feet to contact the ground so that the body forms an arch. I hold this position for 5 mins 2x per day.

Physical therapy is essential, but it needs to be done by someone who has experience with sports hernias. In those cases that the surgery fails, they sometimes have to go in to do an adductor release, cut the inguinal nerve, or a platelet injection. Sports hernias usually occur because the front and back muscles of the hip are not balanced. The gluts and hamstrings are weaker and tight; abdominal muscles are stronger than the other core muscles; etc.

Mine was completely resolved after about 6 weeks of (sometimes embarassing) therapy and massage, strengthening exercises, stretching, etc.

comaboy - have you used a foam roller for anything? I have been using one and it has relieved much pain in the adductors and abdomen, just by rolling around my quads. I was stunned.

solofirst - would you be willing to post more details about your treatment? I'd also like to know how you went about finding a PT who knows about sports hernia. I get the impression that most of the medical professionals who I've talked to about it so far don't really understand it...

Update

I think the condition is improving. Slower than I had hoped.

PT says the adductors are staying relaxed and out of trouble. I still have discomfort when lunging forward on the left leg.

I have not run for several weeks. Keeping to walking and gym exercises without impact (other than some rope jumping). I would like to skip the bike riding entirely, but I have a multi-week bike trip to SE Asia in December and I need to be prepared.

I am doing some ab crunches on the physioball on a very limited basis. The TRX is helping too - but I have to concentrate on keeping the abs engaged rather than relying on the excessively strong and tight illiacus and psoas.

Agip-

Sorry for the delay. I don't check the site very often.

I have used and continue to use a foam roller. It is one way of doing deep tissue work at a low cost.

I have also been using a lacrosse ball in the inguinal area and the central abdominal area. I am thinking I need to move up to a softball of the size used in girls softball.

I usually move around on top of the ball (in the privacy of my own home), find the "hot spot" and then move slowly around in a tight circle.

Update

Improvement continues, but slowly.

The use of the softball has had some positive results. It is more painful than a mini basketball (size 3). I spend 5+ minutes rolling on the ball in tight circles when I get to a "hot spot." A hot spot feels like you are rolling over a "ridge" of tissue. It can be quite uncomfortable, but the pain is a good pain vs the nasty pain felt when the injury made itself known several months ago.

I have also continued with the TRX/Jungle GymXT.

I have added some brief applications of an ice pack for 10 mins.

Gym work continues. I have added a rotary/extension exercise starting at the low position of the adjustable cable stack.

Last PT apptmt went well with a focus on muscles of the trunk. Apparently I have pretty weak rotary coordination - which is a not unexpected result from too much sitting and bike riding.

At the current rate of improvement, I would expect to start running in late November.

Sounds like a long up and down process. Do you think you would have done better with the surgery?

You are exactly right. Up and down, better than worse, it is a moving target. Progress is inconsistent. Very frustrating.

The condition worsened yet again a couple weeks ago. So I have really cut back on working out. For past 10 days I have only done some walking, stretching and light cycling and swimming.

Actually have an apptmt to see a surgeon in early November. I wanted to have another set of eyes look at it.

I will do a follow-up post after the appointment. I may have to change the title of the original thread.

Actually have an apptmt to see a surgeon in early November. I wanted to have another set of eyes look at it.

I will do a follow-up post after the appointment. I may have to change the title of the original thread.

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Checking if you have a positive update. I'm also looking for any nonsurgical success stories. Anyone here with a successful outcome from the Holmich protocal stretches? Or the sportsherniaSouth.com protocal?

No positive update.

MRI in November showed partial tear in conjoined tendon on both sides. Also went to a nonsurgical specialist in sports medicine. He poked, pulled, pressed and advised that the surgery was my best option. He did say that the PT and self-initiated abdominal work with the ball was going to really payoff after the surgery.

I get the surgery Jan 9. I am relieved on the one (very small) hand that this wasn't anything else. But I hate getting cut.

Comaboy, did you ever have the surgery?I think I might have a Sports Hernia.

For two years I have had pain the matches the descriptions of a hernia but I really don't want surgery so I am managing it. it is undiagnosed, so it could be something else.

Just the past 4 months I have been working on strengthening my hip flexors and glutes and massaging my piriformis...and the pain is fading quickly, for the first time. Coughs and sneezes still hurt like the dickins, but otherwise things are getting better for the first time.

So might want to try self-pt on hips and glutes.

Found an experienced Sports Hernia surgeon locally. Had the surgery to repair the partially torn conjoined tendons. I took a few weeks off work for recovery. I was trying to avoid the sitting position which aggravates the cluster of sports hernia symptoms. I began some easy walking within 2 days of the surgery and continued walking daily working up to 2x1 hour. The months of PT prior to surgery sure helped my post-op situation. Many of the aggravating factors (muscle strength/length imbalances) were generally addressed during those months of PT.

I have been ramping up my running and embed easy running intervals into the walking routine. I am up to 3 weekly sessions at 30 min total running per session. No real issues. The sneezing can occasionally cause very slight discomfort. The surgeon cut a bunch of lower abdominal nerves so there is some numbness just above the pubic area.

I used the return to running to revisit my running form. My muscle strength imbalances (strong abdominals, hip flexors and quads) were determining my run form. I am moving more towards the Chi Running style and the one key tip, imagining you are running in sand and that your footprint is whole, not a divot, has made a real difference. Strength training continues to focus on hip stability, hip ROM, and glutes.

I have no regrets about the decisions leading up to the surgery. Yeah, maybe I should have had the MRI earlier, but the PT work may have set the stage for a more rapid return to running.

The result of bonking in a marathon, no doubt.

agip wrote:

For two years I have had pain the matches the descriptions of a hernia but I really don't want surgery so I am managing it. it is undiagnosed, so it could be something else.

Just the past 4 months I have been working on strengthening my hip flexors and glutes and massaging my piriformis...and the pain is fading quickly, for the first time. Coughs and sneezes still hurt like the dickins, but otherwise things are getting better for the first time.

So might want to try self-pt on hips and glutes.

Coopington wrote:

the way I crossed my legs when seated,

I just realized that this was contributing to mine. I sit funny while I'm at work programming and have a tendency to just cross my legs so my knee is against the underside of the desk. Bam, doubled over in pain out of blue. Whups. That's a tough thing to unlearn.

I have cured my sports hernia 95%. Just a mild occaisional ache now but not stopping me doing anything I did before. The secret was to NOT stop exercising. Two independent experts told me the worst thing to do is to rest up - if you do the scar tissue will form tight and then you've had it. The second surgeon told me to take ibruprofen for a month while exercising every day (certain pilates exercises, cycling, walking, and then gentle straight line runnning). This apparently keeps the swelling down and the exercising ensures the muscle doesn't heal in a contracted state. Makes sense to me and seems to have saved me going down the surgery route.

Oh, and the other huge thing...I got my SH after running with very tight and sore adductors. These were stiff and tight for several months after as well and the first 'leading expert' in SH surgery told me that I could get a series of injections or surgery to lengthen them. I was giving that serious consideration and then I came across a foam roller - and five minutes later (literally) the adductors were sorted. I've been foam rolling ever since and I'm never going to stop now. Proper sports massage is even better I guess but one session costs the same as a decent roller - so I'm going to stick with that. Give it a go if you have stiff adductors - you might be amazed at the results. And for me it was a crucial part of the healing process - if you have tight muscles linked to your groin then you probably won't be able to heal properly.

So sort the problem that caused the SH in the first place, keep the swelling down and keep exercising - that would be my advice. Good luck!