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

Garrett and everyone who is coming to Denver.

There is a coffee shop in the Brown Palace Hotel. How about if we all meet up there at 8 am? That makes it easy and we won't have to go far for parking or re-park.


Mike in Denver

Works for me

Good luck everyone when you see the doc in Denver. I hope she gives you the diagnosis to put this behind you once and for all.

My torn MCL is healing very well and I am back to walking 5-7 miles per day. I am also religiously doing my excercises that were specifically designed for me by the results of my FMS.

I feel real good while walking....Sore muscles...remember I was out of shape. However, i push on and workout 2x per day.....The new excercises/stretches seem to be strengthening my adductors but at the end of the day they are shaking....sore.....weak...while driving. In fact the past 4 days my pubic area seems to be very swollen with fluid and when I sit i get the leg pressure again. (my worse symptom). It is not bad at all, but the pressure from the edema/fluid gets forced downward when I sit. It all makes so much more sense when I talked to Meyers. This is the inflammation battle I am fighting. I am not backing off my rehab...I will fight through this. I am taking Indocin, but if it is not gone by week 12 I will get a shot there I suppose. However, i think because I was injured so long that my complete recovery will be longer also. I am pleased with things.

Here is how I would grade things

ROM - adductors A (prior D)
hips A (prior F)
Strength - adductors B- (prior F)
- RA B- (prior F-)
legs B+ (prior F)

Pain - Adductors B (prior D)
RA B+ (prior F)

Tightness - Adductors B- (prior F)
RA (pubic area) B- (prior D)

Muscle Endurance is about a C-....I walk for 2 hours per day hard....but in terms of the specific excercises I am very weak and shaky....However, i am getting stronger and the compartment is getting more stable all the time..

As soon as I get over the inflammation I am home free.

I started lifting light weights in an effort to do a circuit for elevating my heartrate. No problems there.

Tonight I played 3 games of 6 man beach volleyball in my local league after sitting out the first 5 matches. I played as the main setter and was all over the court. I felt fabulous. I had no pain whatsoever. I was diving, digging out shots and moving all over the sand. I never thought I would get there again. It would of hurt just getting my shoes off to hit the beach for the match before the repair. I did my standard core rehab and some light weights in the morning, then volleyball this afternoon.

For those of you seeing Dr. UM on the 4th here is how the meeting with go.

She'll bring you in and fill out a form with your standard information (name, DOB, how you think this might of happened, what sports your play etc....) She will then check you for an inguinal hernia. After that she will have you lay down and do the ultrasound. You will be able to see her laptop screen during the exam, if you can't see it then ask to see it. She will ask you to flex your muscles when doing the ultrasound. Make sure you flex both your lower abdomen as well as you leg muscles at the same time as hard as you can. You'll see the injury clear as day on the ultrasound if you have it. She will do this several times and measure the injury with still shots and save it with your info. Then she will check your other side. If you have a bi-lateral injury she will show it to you. If your other side is fine, you will see the wall of your abdomen completely in tact on the ultrasound when you flex. After the test she will talk to you about your options for repair based on how much pain you are having. If you are having a lot of pain, tell her. Getting in the queue for a surgical repair is really based on how much pain her patients are in and how it is impacting their life/job. Ask her as many questions as you want. She absolutely will not rush you out of the examination room. Have her draw a diagram of what SH is and where the pain comes from. She will do it. She is the best, but I'm biased. I can guarantee you will feel a huge mental relief after her diagnosis (negative or positive). I know I did. That was a huge turning point for me. The next day I began my rehab and haven't looked back since. It feels good to be out there competing again. You will get there too...

Mike in Va.

Greg,

Dr. UM's limits for lifting are for post-op. Nothing over 44lbs for 14 days. I didn't lift anything over 20. I got some dirty looks at the airport when my wife was slinging the bags around, but what can you do. I just had a knife in my groin.

As far as nerves go, my Genital branch was pretty much destroyed and she removed it. She will examine all of your nerves during the operation and remove what is severely damaged if you allow her. There was no way I was putting any handcuffs on what she could do to me. Whatever it took to get rid of my pain I asked her to do.

Mike in Va

Thanks for the info Mike in VA.

Sorry I won't be able to meet up in Denver (will be in the air at that time). Good luck everyone.

Mike in Va and everyone on the board.

I just left the Hotel after meeting with Dr. UM. I also got to meet Garrett and Teri.

I was diagnosed by Dr. UM with a Sports Hernia on the right and an inguinal hernia on the left. The consulatation went almost exactly how Mike in Va. mentioned how his ultrasound went.

Dr. UM said that I have a 1.13 cm tear in the abdominal wall causing pressure on the nerve in the groin canal.
This is what has been causing the pain I have been experiencing. She did not have time to go over the surgical procedure or the costs. She also didn't have time to do any drawings to show the difference between the sports hernia and the inguinal hernia.

However, I did get to speak with her husband Leonhard.
He explained to me that a sportsmans hernia, as they like to call it, is a precursor to an inguinal hernia. He also said that both hernias can put pressure on the nerves and cause the pain. No two hernias are exactly alike and they can affect people differently because of where the hernia lies and what nerves are affected.

Obviously, the inguinal hernia is the one that needs repair first since it clearly showed a loop of bowel protruding into the inguinal canal. Dr.UM said that the sports hernia may not need surgery unless I continue to have pain on that side. She felt that I was overcompensating for the pain on the left side, and if that was repaired, the bulging at the groin muscle on the right side might subside. We just have to wait and see.

Unfortunately, we had to leave to go pick up our son from the babysitters. I would have liked to spend some time asking her more questions. She explained that she is here for a week and then has to go back to Germany.

It was great meeting Teri and Garrett. I know their experiences with Dr. UM were very rewarding.

Now that I know what my diagnosis is, I am now curious about what comes next. I won't find out until next week what her recommendation is and what the costs will be. I have a feeling they will be close to what Mike in Va costs were.

Mike in Denver

Mike in Denver,

I'm glad you finally have some answers to your pain. Sorry you didn't have more time with her, she must of been seeing a bunch of people today. Now that you have been seen you can establish a relationship with her online like I did.

Happy Independence Day to all of you.

Good Luck.

Mike in Va

Mike in Denver, I have one word for you...Shouldice! Since you have been diagnosed with a clear inguinal hernia that shows a loop of intestine in it, I would go to the Shouldice Hospital in Ontario. The are closer to you than a Germany trip and they have set the gold standard on inguinal hernia repairs, so much so that Dr. UM does/copies this procedure on clients in Munich. They will not touch anybody that has a sport's hernia, also known as an incipient hernia, because they only deal with true bulges and especially ones that show looping. I, like many here, tried to see them but when I told them it was a SH, they told me that they didn't work on incipient hernias. Yes, Dr. UM is damn good, but they are the experts on the Shouldice technique. They do the 4-layer repair and have less than a 1% recurrence rate. It is a pure-tissue repair so no nasty mesh implants to ball up on you years later. From my research, they do the 4-layer repair on everybody to make damn sure that it doesn't break down as you age. Overkill? I don't believe so. That is like you painting a room in your house and you say, "let's put one more coat on the walls just to make sure it is nice and strong and resistant." The price will be about the same as Dr. UM, in the $5000 ballpark area and they say that they accept most American insurance plans. Check them out and do some research at www.shouldice.com.

For those of you that like to hear about Dr. UM's level of involvement in American sports medicine, check out her listings at the 2009 American Orthopaedic Society for Sports Medicine conference in Keystone, Colorado - the reason she came to Denver in the first place. She is giving a talk at the conference. Put in her name and do a .pdf search. They use words like "pioneer" and "renowned" to describe her.

Hey, is anyone in Denver able to go to this and sit-in on her sessions to learn about her technique and whatnot? It would be great to be able to see these on a webcast or hear them on a podcast. Perhaps Mike in Denver could spin a story and tell the gate people at the conference that he has been diagnosed by her and is just there to learn more about her technique and surgical approach. That may get you in the door just for that session, Mike.

http://www.sportsmed.org/secure/reveal/admin/uploads/events/Annual%20Meeting%20Preliminary%20Program.pdf

Monchi- What did she say about your current situation? Was it nervepain or a "new SH"? It is so important to know what she do with the few people that are not cured in the first surgery.

If you havent seen her already I wish you good luck!

My visit...

I explained to Dr. M that I was diagnosed with a sports hernia based on an MRI. She reviewed the results and said it was pubalgia. I thought pubalgia was the same, but she said no - pubalgia is caused by the sports hernia or in my case an inguinial hernia.

In 2 seconds she diagnosed small inguinial hernias on both sides. Something 3 doctors (two of them surgeons) and 4 hernia checks (two that had me on my toes even) couldn't tell me. I can't believe it - what a waste of 7 months. I still don't see the bulge that Dr. M says she sees, but she showed me on the ultrasound what was going on. She said that the pubalgia is caused by tension in the pubic area due to the expanding of the inguinial canal and that if I fix the hernias that will correct itself.

She said this repair almost certainly can be done without mesh and also mentioned the Shouldice clinic that monchi mentions.

A few other things I took away from the visit...

Laporoscopic requires mesh and a mesh larger than would be required by open surgery. Open repair in the States is almost always done with mesh as well as far as she is aware. If you do have a mesh repair it should be the Lichtenstein repair if possible, which is easier to correct later on if needed because the mesh is on the top side. There is a doctor or clinic in LA that does this repair. She said absolutely stay away from the plug and patch repair where they use a polypropylene plug. She didn't go into too much detail, but said it is just terrible. The shouldice clinic only does the shouldice repair. She tailors her surgery to the patient and often adjusts as needed once you're opened up.

She really soured me on mesh repair. I guess that means a trip for repair. Good thing is an inguinial hernia will be covered by insurance. I'm going to check out Shouldice, but keep her in mind as well. There's really not much difference between Toronto and Munich as far as I'm concerned (coming from Houston and will use frequent flier miles anyway).

Greg - ahh, yes...my visit and diagnosis. When I arrived I first saw Dr. Leonhard, her husband, and he immediately recognized me from when I was in Munich back in February. We chatted for quite some length of time before Dr. UM saw me.

I explained to her what was going on with me and the low grade pain and ache I was now feeling on a consistent basis. She did her standard finger invagination of the scrotum (http://www.fotosearch.com/bigcomp.asp?path=LIF/LIF139/NU106003.jpg). This was, like always, unpleasant and a bit tender. She did not sense any new bulging on the operated right side, but she did, once again and without consulting my file, feel the very minor bulging that she diagnosed on my left side back in February (I did not get that side operated on, btw, because I have no pain there...yet - and I pray that I never do). I demonstrated for here the moves I do with my right leg to illicit the "puffy" and bulging sensations. She watched and listened. She then had me lie down on the make-shift examination table and proceeded with the ultrasound. She scanned many different areas, while showing me the results and concluded that there was no new bulge and that nothing had torn or come apart. Her feeling was that my nerve was coming back too full sensitivity and it was giving me a 'ghost' sensation of a bulge. After me pinpointing several areas around the groin that seemed to be very sensitive, she proceeded to hand evaluate those areas as well. The areas that were tender were all adductor regions, according to her. She thought that since I had decreased my exercise regimen quite a bit that the trauma from the surgery was causing the adductors to shorten up and get tense as a protection mechanism against further pain in the area; thus pulling a bit on the surgical area and probably adding to the pain I am feeling in the ilioinguinal nerve as it continues to heal. And as we all know, nerves take a long time to heal. She did point out that everybody heals at different rates and that it may take me up to a year to have full nerve resolution in that area. When I heard that I was somewhat skeptical. A year??? - to get rid of a ghost sensation. I was scratching my head on the inside without giving any visual indication of my skepticism. Her prescription was for me to continue with NSAIDS therapy and start taking larger doses of B12 - all of which I heard before the day after my surgery. She suggested that I re-energize myself in starting to exercise more again and wanted me to see a physiotherapist for deep tissue massage in and around the adductor region - this sounded more in tune with a PT friend of mine that said that my pain sound like scar infiltration of the nerve area and deep tissue would help to break up any possible scar tissue that was causing the nerve irritation.

So, what is my next move? I'm not sure yet. It wouldn't hurt to start the pills again, but I don't see that being a long-term solution. I will also start taking my Wobenyzms and Zyflamends again, in earnest. I haven't ruled out second opinions or corroborating scans to help me feel more at ease with what she thinks the problem is.


ARenko - yes, she is right. The plug is absolutely the worst. I have spent nearly a year researching my ass off on all types of hernia repairs and some repair moves are just horrible. From everything I have read, the Shouldice Hospital in Canada is the place to be for normal hernia surgery if one is looking to avoid having a foreign material implanted in the body. Pure-tissue repair is definitely the way to go. The only problem is that so many younger surgeons have not invested the time to learn the tried and true old-school techniques to hernia repair so they just learn the 'quick and slick' mesh repairs.

Hockey Player and Tiff......Good luck this week!!!!!!.......I think the hardest part is waiting for "the day" to come.....Im scheduled the following week and am starting to think about it 24/7.....Hope all goes well for the both of you

monchi,

Do you have any good references regarding mesh repair and its failure rates, complications, etc...? My wife is skeptical since so many doctors use the mesh. She can't believe that I could potentially have to go out of the country to get a hernia repaired when repairs happen all over this country every day.

I guess that most patients with mesh hernia repairs may not have the same issues that younger or athletic patients have and therefore mesh repairs are good enough for them. From what I gathered from Dr. M mesh can shrink over time (so if you're younger you have more chance of needing repair eventually) and mesh results in loss of elasticity in the area, which is needed by athletes. I also guess that young athletic people are a small portion of the hernia repairs performed by general surgeons in this country.

Mike in Denver,

So you are planning to see Dr. M f/ the inguinial repair? Did you ever notice a bulge? I still don't see one in mine. Did anyone else diagnose you with an inguinial hernia? Really damaged my faith in doctors that it took 7 months and me going to Denver to see a surgeon from Germany to find out.

Just found this article - http://www.herniedatabasen.dk/downloads/ehsguidelines.pdf - that seems to favor mesh repair. Haven't really read it yet though. I think the deal with Shouldice repair is you need someone who really knows how to do it (i.e. Dr. M or Shouldice Clinic) otherwise the recurrance rate is on par with mesh.

Nice to see Hamilton playing double A ball 3 weeks out of surgery....He plays triple A today and then may be back in the bigs tomorrow!!!!

Hamilton on way back from surgery
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Associated Press

ARLINGTON, Texas -- Texas Rangers slugger Josh Hamilton started his comeback from abdominal surgery by going 1 for 4 with a walk and a run scored for Double-A Frisco on Monday night.

Hamilton
Hamilton

Hamilton, who led off as the designated hitter, started with the walk. He also had an RBI single and stole a base in the seventh inning. He appeared to be running with no problems, even sliding into second base.

"Everything felt OK physically," Hamilton said. "Sliding's fine. I stole third so the media wouldn't think anything was wrong with me."

The Rangers said Hamilton, who has missed all of June, will work out with them Tuesday before their game against the Los Angeles Angels. Hamilton will then fly to Des Moines, Iowa, to join Triple-A Oklahoma City and play multiple games there, including in the outfield.

"What I have to do is just see pitching. There's nothing like game experience," Hamilton said. "I need to make a progression, make some adjustments."

Hamilton, who had surgery June 9, got hurt when he crashed into an outfield wall making a catch May 17. That came less than a week after he came off an earlier stint on the disabled list because of a strained ribcage muscle sustained when he crashed into another wall on another catch.

General manager Jon Daniels has said Hamilton could be back in the lineup as early as this weekend. Hamilton said being back for July 4, which is Saturday, was realistic.

"My legs are sore. I'm getting into the swing of things. But I don't see it being a problem." Hamilton said.

Hamilton, who hit .304 with 32 homers and an AL-high 130 RBIs last season, is hitting .240 with six homers and 24 RBIs in 35 games this season.

ARenko,

Haha...I, too, read that publication when I started my hernia research. Then I stumbled across many more websites that said to avoid mesh or suffer the consequences later in life - namely post-herniorrhaphy pain syndrome. Check out this forum as you will find many people talking about their complications with mesh - http://hernia.tripod.com/ (on the left hand side there is a link to the discussion board). I actually went to see the doctor that has this site and he did detect a very small bulge but would only do a mesh repair - that is what he believes in. You will see many doctors names tossed around at this website for hernia repairs, both mesh and pure tissue repairs. Also, check this out if you are interested in learning about the technical aspects of pure-tissue repairs - it does talk about and show actually step-by-step procedures on how a Shouldice repair is carried out. (do a google search for "pure tissue repairs robert bendavid". it's a google book article)

Hamilton is amazing even though he only had a minor RA tear. Regardless it was an open surgery and the RA has to heal. Swinging a bat is a lot of torque and he has been doing that at least a week.

I am getting better also. Inflammation is still the enemy and my opposite side lumbar area gets sore. My cook therapist says because that side was stretched because the bad side was torqued. Also many muscles are out of condition. I walked 9 miles today. Feel fine. I am sore at end of day...but no searing pain like I lived with.

I do think this is going to be a long haul to where it is a memory. My general conditioning is getting there but I was so out of shape that it will be until October until I am at fighting weight.

My bad days are further and further apart. Also my definition of bad is not real bad anymore either.

I want to wish Tiff, Hockey Player the best of luck this week and JC next week. Stay focused and get through the first week. I was so happy to get it behind me I was out walking everyday...even though it hurt like a bitch. Hindsight...I may have stayed in and chilled a little more.