Mike in Munich
Anyone ever had a "Sports Hernia" aka: "Sportsman's hernia", "Gilmore's groin", or "
Mike in Munich
Have any of you guys tried Active Release Technique before? It is listed as part of the therapy on the rehab program I have. I get the feeling has some similarities to rolfing, but was curious if anyone had any experience with it. I'm trying to find a therapist in my area...
What is extensive trunk extension. I know one day when i woke up and stretched to yawn with arms over my head it hurt.
I have been shooting baskets so i wonder if that is extensive trunk extension upon release. No jump shots....just shooting. Does not seem to bother me.
However, i am inflammed today after 3 great days. i think I am still not in good enough condition to be doing all the running I have been doing. However, he says to push it. But today is change in barometric pressure and it seems to coincide with my inflame days.
We'll see how long this lasts. Usually 2-3 days.
Hopefully will feel better tomorrow. I have had ART. It is very good.
Mike in VA,
That is GREAT news!! Thanks for keeping us informed! I also have an appt with Dr. M on July 4th. It can't come soon enough!
Not completely sure, but I would say it relates to this video... I actually thought it was referring to a "lean back" but it is probably more related to this because of the pulling motion.
I was watching TV last week on my stomach up on my elbows for a few days...Hours at a time. Oooops!! Funny thing was a friend of mine told me this was a no no if you have tight hip flexors. So I stopped. No wonder why I got tender.
Thanks Den....Great Info
What a thread!!! Here's my story...
Dec '08 woke up with some slight discomfort in right groin that radiated to my testicle. Got up and felt normal. Played soccer that morning and started to feel the discomfort again until finally really doing damage while running to the right and kicking back across my body towards the left. The pain wasn't too bad, but enough that I knew to stop.
Next morning I had difficulty walking. Went to the doc on Tuesday - walking was no problem now, but situps and right leg adduction caused minor pain. Diagnosis - groin strain. Two months rest and I felt pretty good. Went back to play soccer, but it still wasn't right - I could play, but not accelerate, twist, or kick hard.
Rested 1 month, but went back to the GP after minor progress. Adduction and situps no problem now though. GP still thought groin strain and referred me to Ortho surgeon. Ortho diagnosed groin strain. Two more months rest - minor progress (kicking not painful, but accelerating and twisting still an issue).
Went back to ortho who referred me to general surgeon, who ordered an MRI.
"There is minimal increased bone marrow signal seen in the medial superior pubic rami regions. There is a small focus of increased signal intensity noted at the inferior aspect of the left superiour pubic bone/ 'cleft sign', with a tiny focus of abnormal signal seen inferior to the right superior pubic ramus bone. These findings are consistent with a tear of the left rectus abdominous/ adductor longus aponeurosis, with possible tiny tear also seen on the right. There is no abnormal signal seen in the abductor longus muscles or rectus abdominis muscles to suggest muscle strain. There are no discreet tears of the recuts abdominis muscle seen."
This was not a groin strain, as I'd always suspected it wasn't. The doc says it is a sports hernia, but he wasn't so knowledgeable and he doesn't know where to refer me.
The strange thing to me is that my initial pain and most pain was always on the right. When sprinting I do feel a weakness across the pubic region, but most pain appears on the right. MRI says tear on the left and possible tiny tear on right. I also occasionally feel discomfort (extremely mild, just noticeable) on my right when sitting for a long time.
One other thing that is a minor annoyance is my right leg where the inside upper thigh connects with my body is tight. I can't really find a good way to stretch it. The tightness is especially noticable if standing I lift my leg to where my upper thigh is parallel to the floor and then rotate my leg out towards my right side. I suppose it's related.
I have so many thoughts/ questions right now I just don't know where to start. I'll try to gather my thougths and formulate some questions later. For now I just wanted to introduce my story. If anyone has any comments or ideas on my MRI results I'd love to here them.
First, a warning -- do not do any hard abdominals work, especially not tricep pulldowns, because it could make your situation worse.
I'm 59 yrs-old and was playing basketball once or twice per week for years before coming down with sports hernia. I had noticed out of the blue last summer that when I went to do situps I had minor pain an inch or two below navel. So I simply avoided situps, continued to play basketball, and everything was fine for about 5 months. Every so often I would try a situp and noticed the pain was slowly getting better.
Then, in about February, like an idiot, I did some tricep pulldowns (on a pulley), and with each rep I could feel the little pain below my navel, but no big deal. But then the next day or so, I really started getting sore, then had to stop basketball.
I'm thinking I was probably very slowly healing with each passing month while playing basketball, but by doing the tricep pulldowns, I though myself past the tipping point, and over the cliff into the abyss of sports hernia.
I'm thinking maybe you, ARenko, are actually slowly healiing now, and with another year of light sports and no heavy abdominals work, you'll heal up completely.
On the other hand, if you live near Colorado, you probably have an opportunity to be examined with ultrasound by German surgeon Dr. Muschaweck for free when she visits there July 4.
But remember my mistake of doing the tricep pulldowns. Just a few reps can do a lot of damage.
As you can see by reading this thread, my belief is that any surgery, and sports hernia surgery certainly, has risk associated with it.
A final warning: Do not under any circumstances allow anyone to inject you with a hydrocortisone type drug until you have personally googled hydrocortisone and spent a lot of time reading about its permanent effects. Yes, hydrocortisone type drugs have worked miracles since their invention. But they've also cause enormous damage. It is a huge step, with irreversible consequences.
I've zero credentials so take everything I say with a grain of salt. But it seems to me you are a candidate for avoiding surgery and avoiding drugs, and letting yourself heal over this next 12 months.
In your story, an important fact is that you situps and adduction improved with time. Your body is busily repairing itself better than any surgeon could.
How old are you? What is your current most noticeable symptom? Is it affecting your everyday life, or just your soccer?
Again, ARenko, I have zero credentials. I'm just another sports hernia sufferer. So take everything that I say with a grain of salt. I'm simply telling you how it seems to me.
ARenko, your symptoms are very, very similar to mine. My pain was initially concentrated on the right side but MRI showed a bilateral tear that is actually a bit worse on the left side. More recently I've had pain on both sides. As you can see from the thread, Drs. Meyers and Muschaweck are the preeminent surgeons in this field but there are others that have fixed people, too. It's also possible you will get better without surgery, and you should definitely try conservative therapies first like rest and PT. Good luck!
Thanks for the response. To ease your mind - I'm not doing any abdominal work. I've just done a situp here and there as a test. Literally I've probably done 5 situps in the last six months. I'm not doing any weight lifting since the injury.
I'm 38 years old. My most noticeable symptoms now are that when I try to sprint or when I do a major twisting motion I have pain across the pubic region. The twisting motion is a warmup I've always done before soccer - jogging sideways, crossing one leg over the other, while rotating my upper body in the opposite direction of my lower body. If I do it at a decent speed it is mildly painful.
Both symptoms seem to be getting better, although I need to test them out more consistently. I've not been excercising regularly - I need to test more frequently to see if it's getting better or just seems to be then flares up again.
Only soccer is affected, although it is a large and important part of my life.
If I understand the MRI report it is an aponeurosis tear. This attaches muscle to the bone and gets little blood supply. How can that heal without surgery? Which doctor is it that specializes in that?
How do I go about getting an appt w/ Dr. Muschaweck? I am in Houston.
Interesting you mentioned the hydrocortisone. A friend was diagnosed with SH and got a hydrocorisone shot that put him back on the field that same day and for the last 9 months.
My most noticeable symptoms now are that when I try to sprint or when I do a major twisting motion I have pain across the pubic region. The twisting motion is a warmup I've always done before soccer - jogging sideways, crossing one leg over the other, while rotating my upper body in the opposite direction of my lower body. If I do it at a decent speed it is mildly painful.
I'm guessing that this drill is what caused you to get sports hernia. I'll tell you why.
I'm 5'10". Last summer for basketball, I took a notion into my head that I wanted to improve my ability to drive up the middle to the basket, through tall opponents, keeping my dribble very low, and my running speed very high. So I made up a drill, much to my later detriment.
In my warmup to playing, I would find a vacant court and try running very quickly across the court keeping the dribble very low, maybe a foot off the ground, but trying to run as fast as I could. Rather than keeping my torso erect, I would bend forward, almost like a hockey player, with the ball out in front of me. It was kind of fun. I did it for maybe 3 or 4 minutes before every session, which usually consisted of maybe 2 or 3 games. This is pickup basketball.
I did that drill probably once or twice per week for about 4 months I guess, no problems. But after I came down with sports hernia and started reading about its causes, it all clicked. My drill was putting the body in a very unnatural position and movement. In the evolution of the human, probably no cave-man fighting with animals or other cave-men ever did that type of movement over and over.
Yet with each step I took, bent way forward, my dribbling hand (either one) way in front of me, and then, most importantly, my legs moving forward quickly, coming up under me while my pelvis is still straining to support my leaned-over torso, it puts too much strain on the tendons attaching at the pubic bone in the groin.
The leg moving forward, over and over and over, maybe 50 or 100 times. It's a repetive stress injury, not a normal injury.
The fascia tissue is what gets damaged in an unusual way. It's not cut but rather frayed to hell. It still works, but it now fatiques easily and is more easily damaged.
That's my theory at least, and your warm up drill for soccer sounds unlike anything a cave-man or monkey would do repetetively. Your body is designed to run, to hunt, to fight, to swim, and to do almost any movement once in a while, or even several times. But your drill of running and sideways with body back and forth, if done over and over, starts shreding the faschia tissue that is under enormous physical forces.
That's only a guess, of course. And could be totally wrong.
But I'm pretty sure about my own drill being a huge mistake and the cause of my sports hernia.
I suppose that drill could've contributed. I've been doing it for more than 20 years. I've also seen many professional soccer players incorporating that in their warmup.
It's just a few steps going one direction, then the opposite. I like it just to crack my joints. It's not real strenuous - at least I never thought so. I probably do it more aggressively now when I test out the injury - maybe not a good idea although I have noticed pain has lessened since the injury. It just happens to be the motion that causes the most pain (again, mild pain) and I've been using it as a barometer to gauge my "healing."
I'm guessing you're catching things earlier than I did, thank goodness. I'm guessing you have a real good opportunity to heal naturally if you can keep relatively active and healthy without incurring serious soreness, and do that over a year's time, you'll be mended better (by nature) than if you had surgery.
But best to hear some other perspectives too, of course.
By the way, three interesting things I learned in this message board in the last couple of weeks:
1 - When Den had surgery, his doctor observed during the operation that Den's conjoined tendon had widened or splayed in response to his injury. This makes me realize that Den's body had been busy trying to repair itself before surgery.
2 - During Rem's operation in Germany to correct an earlier operation in midwest US, it was noted that his nerve on one side that had been removed in the prior surgery had generated new sprouts. This makes me realize how active is the body in trying to repair itself.
3 - Dr. Meyers, the best known sports hernia surgeon in the US, said in his medical article that there is credible evidence from a doctor in [Yugoslavia?] that serious sports hernia will heal itself if given 3 to 5 years.
Dr. Muschaweck will be seeing patients in Denver, Colorado on July 4th. You can email her office (near Munich):
Three active members here have recently had surgery by her. Rem, MeLLoDrama, and Mike in Va. They can tell you more than I can. It's my understanding that her examination, including ultrasound, is free.
Today Friday 6/12/2009 is day 25 for me since I began my rehab plan by taking my surfboard to the beach on a dead-calm day.
I've been doing it on a MWF (Monday Wednesday Friday) schedule.
I spend about 30+ minutes in the water. I wade into the water, paddle the board a couple of minutes, then get off the board and do some on-back flutter-kicking, propelling myself through the water backwards, the board following me attached to my ankle by its leash. Towards the end of the last 30 minute session, I noticed small pains in my lower abdomen that I'm guessing are due to fatigue, so I stopped immediately.
I've done a total of 11 of these sessions now. With each one, my abdominals, chest, arms, and back muscles are getting stronger, so I'm a little more aggressive with each session. Also, my inner thighs seem stronger from the flutter-kicking, which I've become more aggressive about. But I think I've maybe reached a limit on the acceptable duration of the flutter-kick, as my adductors are still prone to inflammation from too much of that, I think.
Day before yesterday, I did the ocean session at dawn, then in the afternoon I mowed my yard on a riding lawnmower. Getting on an off it several times was the only thing stressful about that. Today, after no activity yesterday except walking, I'm a little more sore that I expected, and I'm planning to henceforth put 2 off-days between exercises instead on off-day.
My current symptoms
When I've been sitting down, perhaps for a meal, and then stand up, I have to give myself a few seconds before I step away, or I'll get some groin pain for a step or two.
Getting out of a car, I need to use both feet next to each other, or it irritates my left leg adductors, the irritation manifesting itself later.
Pain in lower abdomen or groin when turning over at night.
Pain in back of legs, especially left leg, triggered by bending and stooping.
Note about pain
ARenko made me think about the nature of my pain. I don't know about you guys, but the nature of the pains I've encountered in sports hernia is never excruciating. It's main attribute, I think, is worrisome. Like everybody here, I can remember many times in my life and youth being very, very sore from an especially intense game, or especially gruelling day. But because I was absolutely certain my body would be healed up the next day, the pains meant nothing.
But with sports hernia, even smaller pains in new places like the lower abdomen, strike fear in me now. Just when you think your getting better...bang. I think there's a psychological aspect to sports hernia.
My hopes and expectations
I'm hoping a regimen of exercising every 3rd day, or twice per week, will be something that works for me. My main strategy now is to heal without surgery as follows:
1. Somehow get myself physically capable of dealing with the everyday demands of living without being sore. If I can achieve this without surgery, then I think if I can stay active (light exercises) for a full year, I can consider myself
2. Do some agility movement twice per week, but only for a minute or so, so that my fascia tissue will learn the directions of forces to expect.
3. Turn my mind from sports hernia to business so I don't end up in the poor house.
4. Do the above 3 things for one year.
Basketball played an important role in my life, a major source of pleasure for me over the years. For the last 10 years of it, it was almost surreal, because I was always the oldest player. I used to thank the heavens for such a blessing. In my 50's and still running a good full court game! How can this be true? What could be more fun?
But I've decided that I won't undertake the risk of surgery in order to continue to play basketball. You younger guys can see my logic, can't you?
So my objective is to simply be able to live the life of a normal, healthy, active, non-athlete. If I can get in and out of a car normally, jump down from a dock into a boat, etc., I'll be satisfied.
Also, I don't have insurance. If I have surgery by Dr. Muschaweck I'll have to put a mortgage on my house. And if I keep spending all my time thinking about sports hernia and posting to this message board, I'll be completely broke.
I wish everybody here a speedy recovery from this cursed sports hernia, and will try to post progress reports here regularly.
I wish my AP was just irritating. It was downright fiercely painful. My lumbar...my groin...SI joints....hips....leg tightness....addcutors....
Nothing annoying about it. And when it is like that it wears you out....day by day....week by week....month by month....year by year...
My pain was so strong that i could never determine what made it worse. It was always bad. It was not until i went to a pain specialist who told me it is my groin...not back was when i realized that any type of push off flared it dramatically. I could semi-function but needed to lay down several times a day. My lower leg hypertrophied so much the skin was shiny. (means the skin got so tight)....I know this is a rare compartment syndrome but it is from the 2 addcuctors being rock hard and forcing the magnus/rectus to do too much.
After i am done walking for 60 minutes the leg has minor symtpoms but they dissipate. i imagine this will happen until my muscles get strong. After a workout while driving my inner leg is still shaking from the muscles relearning their job.
I just got back and my scar infection is gone. It was very minor but nonetheless a bother.
So far here are my results
I am week 5
I am working out twice per day...(1 hour walk...fast) (1 hour in pool...plus stretching)..I do this 4x per week...other 3 days just the walking and excercises
My opposite side tightness is completely gone
Hip pains are completely gone
Groin pain comes and goes but more discomfort now
RA pain is more discomfort now
Leg pressure is there after a long workout...but resolves
No low stomach pain when getting up
I also notice my glutes are working harder than ever. Prior to this I was told by a therapist I had glute amnesia...common for someone with tight hip flexors and lower crossed syndrome.
This is a good sign for me because it means my posture and core are strengthening. This is real slow.
I have also lost 17 lbs since surgery. I envision being pain free at 6 months. I am still waiting on my CORE X system. Marcia says this will do wonders.
Some days i overdo it for sure. I really have no business running but i have. I am way too out of shape for that and i had too many dysfunctions. I will run again but i will be 45 pounds lighter and my legs will be strong.
I will keep updating until July 1st. Also, remember i was severely injured for 5 years. i would imagine if someone had this and was in shape it would be much easier. However, i think i am doing great....but when you have 3 days of pain free you get selfish and when it comes back it pisses you off. This is what i think many people who rehabbed say it tests your emotions.
Surf I know I said I wouldnt comment on your post but just had to on this one...I think your doing yourself a disservice ....Rehab involves working out 1-2x a day, part of it is for muscle memory.......2-3x a week doing some flutter kicks on a surf board isnt much.....If your going to commit yourself for a year to trying to strengthening your core get a good program and do it the right way.......You use your core everyday so it can be exercised everyday....I myself do take a day off every so often and have even done a every other day one...but we are talking 1-2x a day for 1-2 hours of serious core stuff....Look at Alberts post rehab routine....the man is putting 150% and lots of time into with 2x a day workouts and look at his results in only 5 weeks........Professional athletes are even more insane putting in 4+ hour days in rehab........If you are feeling pain with the little amount of stuff you are doing I honestly dont think you will get anywhere.....I have 3 areas of known tears along with known Edema and known Tendonosis on top of the tears all found by the MRI....My Core/body although dysfunctional right now is pretty strong because of about 3 years of core strengthening and I think that is the reason Im pretty functional even with the amount of damage I have which in the last 4 months I have a feeling is now on the other side to which isnt a big surprise cause I have had this for 5 years and remained very active playing sports thru it all (probably not a good idea)....so I may be looking at a Bi-lateral repair...SOme may think Im crazy but Id actaully prefer to ahv ethe other side sliced open and looked at reguardless so no stone is left unturned...but thats just me
Renko there are 2 doctors in the US.....Dr Meyers in Philly and Dr Brown in Arizona...close to you......if you look up sprots hernia or Dr Brown you should find him...if not let me know and I will get his info for you
My advise is to act on this soon as possible....the longer you let it go the aches and pains will start spreading over time due to your body getting into dysfucntions from this...Me personally It took a good 9 months for me to notice other symptoms popping up besides the basic groin/pubic/ab pains......stuff that started popping up in pain were hips, SI area, sacrum, low back, mid back and shoulders...due to he unsupported Pelvis on one side...my spine developed a slight bend to the right, sacrum/pelvis rose up on the weak side and the pelvis tourqed to the right side and down.....Rehab probably wont work and can put you into dysfunction quicker due to the fact that the stronger side will take over even more ......Good luck to you
I don't know if your program will work or not. But in my opinion, taking two days off will make it worse. If you take two days off, then you should walk or do concentrated, light stretching on your days off. I have paid close attention to this, pre-surgery and post-surgery. I think rest is needed, but I define rest as not doing intense workouts. Just during the last few days, I rested more than usual and I felt a little bit more stiff than when I was working out.
I stayed quite flexible prior to surgery despite my problems because I dedicated myself to stretching. Honestly, my condition was manageable prior to surgery; inflammation was more of a problem than everyday pain. I didn't have any serious pain anymore, but I couldn't jog or do anything strenuous without aggravating it in some way. I got back to a manageable level through physical therapy, which was controlled. I doubt you have any control over what the ocean does -- even if it is calm. I wish you well, but I think you should at least see a physical therapist once or twice if you are dedicated to getting better without surgery.