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

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  • johnny
    13 years ago 11/18/2006 10:03am CST
    re: johnny
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    oh
    what i didn't mention was the confidence of a couple of other docs i saw over here who wanted to give me nerve block injections, another wanted to do hip surgery, another wanted to put me on antibiotics for whatever in case of an infection, etc...lots of guessing going on, especially when each would see me for a total of about 5 minutes without even looking at the patient history.
    they could not put 2 and 2 together- sports accident with immediate groin pain = injury. not one of them until dr muschaweck. i knew what had happened- i felt the tears occur. it is a shame that some docs refuse to listen to a patient'm suggestion. i had learned about the sports hernia injury about 1 week after i had mine, and spent the next 18 months going from doc to doc asking about the hernia, and each was so self-confident in their assessment that they would not even referr me to a different doc who would acknowledge soft tissue damage.
    probably sounds familiar. just remember that not all doctors know what they are talking about when they step out of their tunnel vision of their speciality.
    dr msuchaweck is a hernia specialist, and a specialist in the sportsmans groin injury.
  • Lt Col. Ingus
    13 years ago 11/18/2006 10:10pm CST
    re: johnny
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    Johnny,

    I need to go back and read some of your earlier posts, to know what I'm talking about, but from what I remember, did you see a Dr Cattey, who I guess is doing things different than Meyers, and I also heard of a Dr Joesting in MN, and now that I think of it did you ever see anyone at Mayo clinic, or Cleveland Clinic which might be even more with it on this type problem. I don't think mayo works on this type injury? You can get a text book hip replacement at Mayo, but maybe not muscle and ligament pelvic work. That's strange isn't it? Let me know, and I'll look at your earlier posts and get back to you. Lt.
  • Lt Col. Ingus
    13 years ago 11/19/2006 1:27pm CST
    re: Lt Col. Ingus
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    Hurt Badley

    I know exactly what your talking about, but not from my own injury. If damage to one side throws pelvis, or better yet, pulls pelvis off balance, the problem will spread a little to the unaffected side with each step you take. I also know what your talking about when you go to MD and symptoms don't present well. If pelvis is off balance and I assume you have burning pain with movement, then first, the injury is best recognized under weight bearing conditions, and second, this is kind of hard, but the resuling damage is like putting a 1 inch heel raise in just one shoe for say a month. You'll be in extreme pain that may run up your spine even, but you can't push on just one spot to get a sharp pain response.
  • Hurt Bradley
    13 years ago 11/19/2006 3:19pm CST
    re: Lt Col. Ingus
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    Yeah, but I haven't been in extreme pain, and my pain hasn't been "burning," more like a deep, deep soreness right in the corner of my groin/leg. Then again, this pain is different then the pain I started out with, which was sharper and radiated all down my left leg. Now it's on both sides, more like a dull ache. On the other hand, I haven't really been pushing it trying to run. I'll try to run for a few days and it will not improve so I'll stop and get back on the bike.

    One thing I've noticed on the bike: While running, I don't really have any ab pain or irritation with this, just the groin soreness. But on the bike, my lower abs get more irritated too. What gives?

    Anyway, I started PT, so maybe I don't have any kind of hernia and that will help it, or maybe not, who knows.
  • johnny
    13 years ago 11/19/2006 9:26pm CST
    re: Hurt Bradley
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    lt, i never saw any other docs (cattey, meyers, etc) because i saw dr muschaweck before any other arrangements to see another doc ever happened. i was lucky in that i could travel very little to have met up with her.
    go see whichever specialist you live closer to. then take the next step if need be. much depends on what your insurance would cover. mine would cover nothing at all.
    if the meeting with muschaweck hadn't been so convenient for me i would have gone to meyers for the exam at least.

    bradly, etc. one thing that i have learned via my own injury, and studying the hell out of it, along with the treatments via my phys therapist- the psoas muscles play a large role in the twisting of the pelvis. tight/strained psoas can yeild bad muscular/musculoskeletal imbalances, which make one more prone to sports hernias as well as other groin/pelvis injuries. the psoas is the heart of your core. damage to that muscle and/or the tendons is very painful and may even mimic symptoms of a sports hernia without the full-blown sh.
    my psoas was damaged in my accident, never figured out how badly since my insurance refused an mri, saying it wasn't medically necessary (what a freaking joke). the tight psoas caused my pelvis to twist, thus the muscular imbalances, therefore the extra pains and long recovery. apparently the sports hernia takes place in the vicinity of the psoas. a very complicated area of the body.
    my psoas muscles on both sides (i had a bilateral sh) have been way tight for some time. it is a slow recovery. i recommend if you are having increasing pains then definitely go to a pt and learn about some exercises/stretches to start loosening up the psoas and see if that helps with your symptoms. make sure the pt has experience in trigger point release massage and manual therapy (not like lou ferigno with a weight room, in other words, if that makes sense, that is not the type of pt you need).
  • ozhammer
    13 years ago 11/21/2006 4:20pm CST
    re: I am going to germany
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    Going to Germnay -

    Did you go to Germany to have the operation done? I did not see ay follow up reports from you.
  • ozhammer
    13 years ago 11/21/2006 4:31pm CST
    re: Canadian girl
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    Canadian Girl - how long did it take for you to see him. I am in Waterloo and have just been requisitioned to see him. However, I have heard it can take months to get in to see him. If this is the case I may look to going to the US or Germany to have it taken care of.
  • went to germany
    13 years ago 11/21/2006 5:46pm CST
    re: ozhammer
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    Hello to all..I am sorry for taking so long to update for those who are waiting for a response...

    First, let me say that the care i recieved in germany was
    top notch. It took the doctors 5 minutes to figure out i had a sports hernia. She even said i have the beginning of one on my right side! However she said that i should not have any problems with it for now. Anyway i had the operation done on my left side on thursday oct 26 at 8 am.
    I was the first of 5 sports hernia operations that day!

    I was able to walk around the next day of the surgery with
    some pain and over the weeks the pain has slowely decreased.
    There is no longer any permanent pain in my testicles.But there is pain radiating fron a lump of swollen tisssue right along my inguinal canal. They tell you it will take about 6 weeks for the swollen tissue to heal into scar tissue.( I am on day 24.) they also say you are cleared to return to your sport in 14 days post op. I believe that this is only possible if you are in very good shape to begin with.I am not in good shape right now due to 6 months of not working out. I am a bodybuilder and i do not believe i can lift weights right now without hurting myself. I have not tried to test myself too much but i can walk up and down steps with only a little pain.

    I think i need a little more time to tell if the surgery is a complete succces. My guess is 6 weeks post op and i will try to lift very light wieghts.

    I will start riding a bike in a few days and will report how that makes me feel.

    If anyone has questions feel free to ask.

    Good luck to everyone
  • doublej
    13 years ago 11/21/2006 8:01pm CST
    re: went to germany
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    I was wondering how long ahead of time did you have to make appointment and what was the final cost for everything Plane,stay,surgery,Thankyou
  • Lt Col. Ingus
    13 years ago 11/21/2006 8:05pm CST
    re: johnny
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    johnny,

    I think you got that psoas by tail big boy. You know I wonder, how many of the people turned away by Dr Meyers because they didn't scream with pain when he pushed on the abdomen, actually had damage to the psoas? Psoas damage is hard to discover, because this muscle is in the center of your body, and can only be palpated in the pelvis through other tissue. You could have all kinds of damage that would not show up on MRI, just as Meyers will tell you sports hernia damage WILL NOT. I wonder if most sports hernias only involve the rectus abdominus, and how many involve the much deeper and extremely more complicated psoas? Abdominal and glutes act contrary to the psoas.

    lets start here, and see if we can't figure something out. How many of you had any work done on your psoas as part of a sports hernia repair, and what was done to the psoas exactly?????????????????????????????????? Lt.
  • johnny
    13 years ago 11/21/2006 9:26pm CST
    re: Lt Col. Ingus
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    plane costs vary depending on time of year, etc
    cost of surgery was something like 4,100 bucks per side
    i met with the doc in early june and had surgery in early august. i could have gone in end of july but had other things to take care of first.
    i am glad i went to her.
    hotels in munich are basically the same as in major cities in the states, depending on time of year.

    lt, i am not a doc, so i have no answers for you. i just know what i have been told about my condition and what has been worked on so far by docs/phys therapist.

    johnny
  • johnny
    13 years ago 11/22/2006 7:22am CST
    re: johnny
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    actually, now that it is morning and i am sober, i also wonder how many sports hernia people have/had problems with the psoas and iliacus muscles? anyone out there on this board?

    i imagine that dr muschaweck would have also checked my psoas muscles and the whole muscular structures within the pelvis during my exam and then during surgery, so i hope. all i know is that i am having pain and tightness in my pelvis/lower ab, and my pt tells me my psoas muscles are as hard as granite. she works on them and the sh scars basically at the same time. afterwards, i feel sore but quite a bit better. anyone out there have psoas tightness but yet have to be evaluated for a sh?
    thanks
    johnny
  • buckman
    13 years ago 11/22/2006 9:31am CST
    re: johnny
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    I think you guys are really onto something by bring the psoas into the discussion here. I’m 25 now and have experienced lifelong psoas tightness on my right side. I was a serious runner in high school, but was never very comfortable while running and always had a slight “hitch” in my stride. Looking back, I think I was on my way to getting a full-blown sports hernia—but the part of my body that was my weakest link was my left rectus femoris muscle as opposed to my pelvic floor, lower abs, etc. At age 17 I ended up gradually tearing my left RF over a several week period of running and I was forced to quit competitive running.

    I really feel that if my left RF didn’t fail, the massive imbalances and sheering forces caused by my uneven running motion would have torn my pelvic floor to shreds. And the cause of the imbalanced running stride?: my tight right psoas. Most doctors/PT’s will never mention the psoas, but this muscle really is at the core of good balance and biomechanics—and is also related to many injuries. For instance, does your right achilles hurt?—don’t treat just the achilles… also treat the cause which may very well be a shorter right leg and tight right psoas.

    I currently work on releasing/relaxing my psoas every day. I never run anymore, but am a Cat 2 road cyclist—so there is life beyond running. Looking back on running, my conclusion is that running is very bad for your body, and if you do not have good biomechanics and balance you run the risk of seriously damaging your body as you try to “run through the pain.”

    My suggestion to everybody experiencing sports hernia symptoms is to read up on the psoas and start becoming aware of your psoas muscle.

    Also, for anybody that wants to argue about whether cycling or running is the harder sport… the answer is that they’re different sports and are difficult in their own unique ways.
  • Lt Col. Ingus
    13 years ago 11/22/2006 11:36am CST
    re: buckman
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    How many of you went to a qualified PT who told you that you had an anterior ilium rotation? Some e mailed me an article called "Feeling the Pinch" on sports hernias. There is a passage in the text that says one of the causes of sports hernias is an anterior rotation. I HAVE NO DOUBT the article is right in that as the ilium is rotated forward by the tight or damaged psoas + iliacus the ilium is being pulled away from the abdominal or all core tissue above the injury. The psoas is a huge muscle and as it continues to tighten it's going to continue to pull the ilium toward the attachment point on the femur. The psoas isn't directly attached to the ilium, but rather the front of the lumbar spine, in the center of your body. Johnny the jet or big buck was right that the iliacus works in conjunction with the psoas and attachs all along the inner surface of the ilium at the top and it attaches to the femur at the bottom in the exact same place as the psoas. A few things. psoas + iliacus = iliopsoas or hip flexor. As the damaged hip flexor thightens all of this deep tissue and bone (ilium) is being pulled toward the attachment on the femur. As it does this it is pulling away from all the core tissue above, including all the abdominal layers and obliques on the affected side. It keeps pulling away or slowly tearing, and seems to have no real limit on where it will stop. This might explain why Sports Hernias don't show up on MRI? The injury is not an accute bleeding rip or tear, but rather a stretching to the point of micro tearing over a short period of time. NOW, this is only one variation of the sports hernia, as Bill Meyers will tell you. I think he identified 13 variations. The iliopsoas alone also does external rotation of the femur, because of how it weaves around the ilium and femur. This might explain the reason for the knee problem one poster mentioned earlier. If the femur is externally rotated your leg and foot are not hitting the ground right.

    I gotta go, so we'll start here later. Let me know on what was done during operation on iliacus or psoas and PT saying you had anterior rotation. Back soon.

    Lt.
  • johnny
    13 years ago 11/22/2006 12:19pm CST
    re: Lt Col. Ingus
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    holy cow!

    i am amazed to know that there still might be a problem to be addressed. i hope not via another operation (i have had enough).
    my pt, along with a medical masseuse and craniosacral specialist, has told me that my sacrum twisted clockwise. my left leg is the one with issues just as my left side is the one still in pain.
    when i think about the possible chain of events, i remember having pain in the left hemipelvis once in 2001 and again in 2002. i saw a ur since the pain radiated in to the testicle. they said i was fine, and i went ahead doing dangerous sports. then the accident happened. the left side was the one that really hurt. it advanced to both sides over the next couple of monhts. post-op, i feel someone better, but the left side is still bugging me. when i contract my abdominals, my left side buldges a bit more (in an out-of-shape, rounded kind of way) than the right. i also have a lump just above and one below the inguinal tendon. the bottom one is painful to touch but only sometimes. there feels like there is a vienna sausage on the left side that i can move around a bit, i just though that was the psoas, and i have seen so many docs that i figured i was in good hands. but the problem of pain remains. stretching of the psoas sometimes makes things worse.

    i am afraid that i tore some of these muscles in the iliopsoas and neighbors and they were never discovered. would a ct scan show those tears? i did have one just after the accident but it showed nothing. never had a pelvic mri cause the docs said it wasn't necessary and the insurance company rejected the requests from 2 docs that ordered the mri.

    this is complicated. i have no idea what to do. my sacrum is apparently back in order after a few adjustments via craniosacral manipulation. but who knows how long it will stay in place and what i can do for exercise that won't knock it out again.

    lt, if you would not mind, i would greatly appreciate if you could email me that article on the sh that you have. this is going to drive me nuts if i don't regain my ability to bend down without pain let alone get back into kayaking whitewater.

    would an mri or ct show the torn muscles?

    this sucks.

    thanks,
    johnny
    [email protected]
  • Hurt Bradley
    13 years ago 11/22/2006 12:44pm CST
    re: johnny
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    Somebody said that the psoas was not palpable directly, only through other muscles or tissues...so, what does psoas tightness feel like? How do you identify it?

    Another question for anyone who knows...do common adductor strains ever cause lower ab tightness, soreness or irritation...or is lower ab discomfort a sure sign of something else (most of my pain is in the adductors and deep in the high-up part of my groin on either side, but I do have some very mild irritation/tender spots in my lower abs).
  • Lt Col. Ingus
    13 years ago 11/22/2006 1:22pm CST
    re: Hurt Bradley
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    Johnny,

    The post right before this one begs the ?, the HB Beer House still around German town, Jet? Brad first. Good ? Tight or damaged hip flexor would manifest itself in alot of the periphiral symptoms in the groin that people have been posting from the beginning. You could also have a bad back ache because the top attachment is pulling the lumbar spine forward and down real hard. Concerning the adductor problem, this is what I think I figured out. Often times Meyers procedure includes abdominal/pelvic floor sewing and adductor release, and I thought to myself, why the adductor release? I think as the ilium rotates forward the adductors take up the slack created by this action, so they get toooo tight. When Bill sews you up, he has snugged up the core attachment to the lower pelvis, but the adductors are still tight because of the rotation, and with the musculature below the waist being soooo much stronger than that above, your best bet at recovery is to have your adductors released. I hear Billy's get'n a new Singer for x mas. Now, "What am I doctor????" How the hell do I know for sure. I have read this thread from the beginning and what it needs is an injection of MD assistance. We also need to get that Waves2ya guy back here, proper. Now, Johnny the jet. Try to cool your jets Johnny, as your probably not going to explode, right now. I have been hurt real bad and gotten NO operation. I hear good things about Dr Muschaweck, so not to worry there. I will scan and e mail you the "Feeling the Pinch" article. Let me think about your other stuff a little bit first. You know, I'm in South Dak right now and I met with doc's at University of Iowa in Iowa City. These doc's are heavy into internet and e mail. They LOVE IT over there. If anyone knows MD there in Iowa City, tell them about this thread and try to get them to post. Look, this post is all about tring to help each other out, but I can't operate and we need more actionable advice. Be nice if we could get Big Boy Billy to Bud Up. Back soon,

    Your Lt.
  • buckman
    13 years ago 11/22/2006 1:23pm CST
    re: Hurt Bradley
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    Symptoms of my tight right psoas include:

    functionally short right leg
    right side of pelvis rotated forward
    right side of pelvis rotated up
    low right shoulder
    lack of flexibility in right calf/achilles/ankle
    actual tightness right side when I move trunk laterally

    With daily exercises and relaxation I have successfully lengethened my psoas over the past year or so. As a result, many of the symptoms above have improved significantly.

    As for stretching-- do not stretch the psoas (or any other muscle!!) Stretching just leads to more tightness. Relaxation and specific exercises will lengthen the psoas.
  • johnny
    13 years ago 11/22/2006 2:26pm CST
    re: buckman
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    lt, thanks a lot for your excellent input!
    no worries about me being ready to explode or anything, quite the contrary as i am just fascinated with the human body and biomehanics (this injury has lead me to working on applying to grad school).
    i am confused if you were asking me if the hoffbrau haus still is up and running. for sure it is, very loud and full of cheer (or prost?) and blaring brass instsruments.
    i had a great time at the beer gartens and various ice cream places. not to mention i was lucky to meet some very cool people. if by chance you go to munich, i recommend paulaner haus, great food and excellent beer. the beer and brat combo at the cafe under the hacker-pschorr tents by the glockenspiel is the way to go for food, suds, and people watching.

    this is a great thread- i have learned more about the pelvis and lower abdomen from here than all my docs combined. i wonder how many sports hernias (or beginning of sports hernias) there are in the us. seems to me that it creates several varieties of pain and dysfunction symptoms. i am glad that i am way over the worst (i won't even bother with describing when i was at my worst in summer 2005). the surgery was necessary, but i have the feeling i have a way to go before i can be active again. the hangliding lessons will have to wait till later.

    i appreciate your sending me that article and keeping up with helping with everyone's curiosities about this injury and related syndromes. this info is pretty elusive...

    johnny
  • johnny
    13 years ago 11/22/2006 2:33pm CST
    re: buckman
    Forum Index
    lt, thanks a lot for your excellent input!
    no worries about me being ready to explode or anything, quite the contrary as i am just fascinated with the human body and biomehanics (this injury has lead me to working on applying to grad school).
    i am confused if you were asking me if the hoffbrau haus still is up and running. for sure it is, very loud and full of cheer (or prost?) and blaring brass instsruments.
    i had a great time at the beer gartens and various ice cream places. not to mention i was lucky to meet some very cool people. if by chance you go to munich, i recommend paulaner haus, great food and excellent beer. the beer and brat combo at the cafe under the hacker-pschorr tents by the glockenspiel is the way to go for food, suds, and people watching.

    this is a great thread- i have learned more about the pelvis and lower abdomen from here than all my docs combined. i wonder how many sports hernias (or beginning of sports hernias) there are in the us. seems to me that it creates several varieties of pain and dysfunction symptoms. i am glad that i am way over the worst (i won't even bother with describing when i was at my worst in summer 2005). the surgery was necessary, but i have the feeling i have a way to go before i can be active again. the hangliding lessons will have to wait till later.

    i appreciate your sending me that article and keeping up with helping with everyone's curiosities about this injury and related syndromes. this info is pretty elusive...
    i am curious, lt, how long have you been injured and has your pain been limiting you from doing normal activities, too? i know when it was really bad i couldn't walk. at all. but i must say i don't really have adductor pain anymore post-op, i think, i can stretch my adductors and don't have a pain reaction. my pains are localised mostly in the lower back like you say, and along the inguinal ligament, off the pubic bone, and a bit in the perineum. mostly on the left. most pains that are left seem to be the two lumps at the ligament, though. the problems assicated witht the pelvic floor seem to be gone.

    i too wish that dr meyers could give us all some input, he seems to be the expert in the states. 13 variations? holy cow! i'd be really interested in learning about those. fascinating stuff, really.

    johnny