To clarify, never had a full-blown sports hernia—but in the past 2 years what I have overcome is a severely imbalanced pelvis, pain in the pubis symphasis, pain in the testes, never-ending pain in the adductors, sciatica, achilles issues, popping/releasing in lower back/abs/sacroiliac joints, pain in shoulders/wrists/elbows. What I have in common with SH runners is that 1) the whole problem was self inflicted due to an endurance sport and 2) I had nasty pain and discomfort in my entire pelvic region and I had no idea how to fix it.
My torn left RF from 1999 was surgically repaired in 2000, but the surgery was not entirely successful or even needed. The RF is still functional and I can extend my knee, but it simply does not bear weight or generate power when I cycle. I think it’s my body’s way of protecting it form further damage. My surrounding quad muscles in my left leg have adapted and learned how to take the work load of cycling and my spin scan shows that my left leg does 48 or 49 % of the work during cycling.
To answer the question: “did your pelvic floor hurt, and experience tightness?”---
In October 2004 I was climbing in the saddle and I felt a massive “pull” of my right adductor and a heart-wrenching pain in my pubis symphasis. When you feel a pain in your symphasis you know that something is horribly wrong and you wonder if you’ll ever be normal again. I remember that my symphasis would hurt when getting into a chair and I could feel it ache at night. My testes also hurt. My right adductor also hurt nonstop for literally a month. I was extremely bound up and tight in the whole pelvic region and I felt dull aches everywhere in there—but there was no single injury or sharp pain that I could identify.
Looking back, I had gradually rotated my pelvis forward and up on the right side during thousands of miles of riding and that one day I literally blew out my pelvic integrity. I think this is similar to a running SH where you run for thousands of miles and one day you “blow out” a weak link and experience pains everywhere from the compensatory muscles kicking in and tightening and pulling on things and being pulled.
Another question: “i have all those phantom pains in the hip, buttock (like sciatica), groin, rectus, etc... come and go throughout the day, and never hurt all at once. the pain near the scar does coincide with si joint-area pain, though, and often referrs to pf.
sound familiar to your case?”
During my recovery I felt sharp “electric” pains in my pubis symphasis probably 5 times in total. I would also occasionally think I pulled my right or left groin. So- yes- there were some weird pains that scared me but I think as things “shift” you are bound to activate some nerves here and there.
As for my imbalances being genetic—I would say they are. I remember that I could never kick my right leg correctly during the breast stroke during swimming lessons when I was 9 years old. I was also unable to ski using the parallel method as a kid. Even as far back as 1990 I was definitely imbalanced.
More questions:
“However, can you tell us what kinds of things you did to overcome this?
What are the exercises?
What wieghts did you do to strengthen?
What stretching did you do? Yoga?”
First you have to believe that you can recover from the injury. This took me about 6 months to do. I began seeing a chiro about 2 months after the injury. That helped to slightly loosen up my joints. I was extremely bound up and tight in my entire lower back and pelvic region. In the summer of 2005 I started doing various stretches. I basically had to loosen everything up. At that point I could still hardly walk. Imagine walking with your right shoe on and your left shoe off. That’s what it felt like. The problem with stretching is that your muscles often become tighter as a result. It would often take me several weeks to loosen a muscle to the point where it would not tighten up to worse than before. This general stretching got me to the point where I could ride a bike gently.
My major developments beyond that can be attributed to relaxing, strengthening various muscles, and recruiting the right nerves. I actually stopped stretching in mid 2006 because it would simply make me tighter than before. I learned that relaxing produces the best results in trying to achieve symmetry. The main relaxing position is the “active rest” position. This is where you lay on your back and have your knees bent at 90 degrees with your feet touching the ground. This takes all the pressure off your psoas and helps it relax and lengthen. From that position I then do various yoga and ab techniques—things like lifting you bent knees off the ground and side to side.
My most recent major development has been starting from my toes and feet and re-teaching my body what muscles to use when walking and supporting body weight. It’s a bit hard to explain but one of the things I am working on is sitting in a chair and contacting the ground with my right foot at the proper pressure points. When I do this and slightly lift the arch, my whole right glute and ab area starts twitching because these are the right muscles to use, but they are extremely weak and have never been used.
Forget going to chiros and PT’s—what you need is somebody who makes you strip down to your underwear and do various movements so your biomechanical flaws can be pinpointed. I think you can get an acute SH in a sport with lots of twisting and turning (hockey, soccer) but as a runner you will get one by gradually breaking down an important supporting muscle. I guess it’s possible that you have perfect biomechanics and you truly have a weak link, but I think that improper biomechanics and hundreds of hours of uneven shearing forces is what leads to SH’s in runners.
Anyone ever had a "Sports Hernia" aka: "Sportsman's hernia", "Gilmore's groin", or "
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Dr. Brown uses the mesh technique. I've heard only 2 names that deal with sports hernias in north america - Meyers and Brown. I've consulted with several sports doctors (including one of Canada's national track and field doctors) and from what I hear Dr. Brown is the real deal. This is all he does. He's performed hundreds of procedures on professional altheletes and hockey players including claude lemieux, peter forsberg, and darcy tucker (i developed my sports hernia from playing hockey). I only have a phone number for him (514-935-4888). He consults out of the Montreal General Hospital along side the Montreal Canadiens physician (Dr. Mulder).
I'll be sure to post my post-surgery progress. -
thanks for the info.
i am strongly leaning towards going to germany for surgery with dr. muschaweck. my insurance won't cover the operation, and if i'm going to pay out of pocket i want the best there is. in terms of experience, success rate and speed of recovery, i don't think they get any better than dr. M.
best of luck with dr. brown - it certainly sounds like he knows what he's doing. and yes, keep us updated.
by the way, is it $3000 per side, or is that the total cost (even if you have surgery on both sides, which i think is called bilateral surgery)? and is it canadian or US dollars? (fyi dr. M charges appx. US$5000 per side) -
osaru,
just fyi, the cost of just over 5k is for each side, and includes the stay in the hotel-type clinic the day/night of surgery. also includes the food (if i remember right), and the food is actually pretty good. good beer in the minifridge as well.
dr m and her husband are truly a dynamic duo. you will see when/if you meet them.
since you are already paying out of pocket, i recommend staying a few days extra before and after to see a bit of munich, it is an awesome place to have fun and meet people.
john -
Someone asked to keep posting updates. Well it has been four weeks and I am totally good to go. Other than a very small amount of tightness from the scar tissue I am basically 100%. I ran 3x last week, biked 4 - 6 hours and swam 11km - no problems. This week has been much the same. In addition, I played ball hockey last night and had no problem. In fact, I notice that my strength in my groin is back and I have complete confidence that the injury is healed.
Only minor complication I had was my left side became infected. However, that can happen to anyone. Took some anti-biotics and I was good to go. -
I've had two hernia surgeries and one was good the last was bad. Needless to say the last has ruined my running career and now I suffer from serious side effects like constant pain, overcompensation effects from the pain, and other testicle pain that at times is a low throb to an acute pain. Anyway, someone aware of my situation saw something about hernia surgeries gone bad and told me about a class action lawsuit against the maker of the mesh some doctors use.
Do a google search for "class action lawsuit hernia surgery" or "kugel mesh recall" and you should find some information if you've had some problems. I'm still doing research to see if I am included in this group.
Anyway, thought some of you should know!!! -
What is the difference btw sh surgery and an ordinary inguinal hernia one?
Bill will cut your adductor loose, some won't, like Joesting. So Joesting's operation sounds exactly like a inguinal one, put some mesh around the canal.
Open up, fix anything you think is wrong. Wonder what are the chance just fix sh by pretending there is a inguinal one. -
looking for "JAPANHERNIA", who posted a few months ago on this thread (http://www.letsrun.com/forum/flat_read.php?thread=559820&page=14) about having surgery in japan.
if you see this (or if anyone else knows how to reach "japanhernia") please shoot me an email at yleeper at gmail dot com. i also live in japan and am very interested to see how your surgery went.
cheers -
Well, people, just chiming in, I used to post on this thread last year fairly extensively. I guess I didn't have a sports hernia, but just a bi-lat inguinal hernia. So, had surgery 2 wks ago, too early to tell results, but i'll keep everyone posted. But, I guess i did have the bulges of a more traditional hernia once I got it finally looked at, they were fairly subtle. So, don't think i'm clear yet, but i'm hoping this cures what had ailed me. It was a long road.
Cheers, and best of luck to everyone goin thru any of this.
ROC -
My daughter had sports hernia surgery by Meyers last March and is still in a lot pain. Can you tell me how you rehabbed if physical therapy didn't work? I need a new direction. Thanks for any info.
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Sorry, I don't have any answers. How old is your daughter? Seems like an unusual injury for a young girl. Does Meyers have an opinion as to why the surgery didn't work with her?
Meyers claims he returns 96% of his patients to 100% activity level. I may be one of his patients very soon. I worry about the surgical option, but I'm running out of ideas. If surgery will work I figure it's better to go with Meyers than a military surgeon.
Good luck. -
from my own experiences, so far,
check for pain caused by irritation/compression of the nerves involved in the injury: ilioinguinal, genitofemoral, iliohypergastric, and also the obturator nerve.
also be treated/checked for muscle imbalances. i worked with a pt for over a year and got some success, but now have moved on to a Rolfer. first session yeilded great things.
chances are, with me, my obturator nerve is compressed. the emg may not properly diagnose this. i have had enough surgeries, so i am going to treat this with alternative therapies, then down the road perhaps an injection in the tendon insertion sites (of the muscles most affected by the injury). the dr who did my surgery suggests this, and i will get the shots in march if the other therapies haven't done it for me by then.
hope that helps -
Great post. I am in total agreement about the biomechanics involved when you are injured. I have had two AP surgeries in the last year. Both by CATTEY. 1.5 X 1 cm tears of my external oblique where it meets the lateral border of the rectus. Still in pain and it really feels as if something is digging in me. I am an avid weight trainer and do a lot of cardio and play/coach baseball. This problem has been a 3 year ordeal that was never diagnosed.
AP led to a hip labral tear surgery a year and a half ago. At the time it was thought that this would solve my ab, hip, and groin pain.
I actually had two things going on on the same side, because I was all messed up biomechanically for so long. It has really been tough. Not only did it not work with CATTEY, he has horrible follow-up protocol. Never returns calls. I spoke two him 1x after surger 6 months ago. Probably doesn't want to hear how bad i'm doing.
I am going to see Meyers this week in hopes of finally correcting the problem. I am a strength coach and gym teacher. Anyone know how long it would be till I can walk well enough to go to work. Sorry so long.
I would like more on Meyers if anyone can share anything.
So far there office staff has been great by sending me all kinds of information. The way I see it it seems Cattey patches a tire and Meyers kind of rebuilds the front end. -
Kozy,
I had surgery with Dr. Meyers and can share my hospital bill. $40,000. Not sure how much of that will be reduced by the insurance company as they need more info from the hospital before they process the claim. I shouldn't be surprised because i have seen estimates on this forum as high as $30,000. I guess the price has gone up.
I'm almost three weeks out of from surgery and the numbness in my pubic area is starting to go away. The most uncomfortable aspect of the recovery is the scar tissue. I have two huge lumps under the incisions.
I start rehab in a week or so and i'll know more about how the area feels once i start doing more than just walking.
On a personal level i thought Meyers was great. Gave me all the time I needed during the physical exam and answered all my questions. I haven't had to call him post op so i don't know how he is about follow up questions or concerns but they give you his cell phone and tell you not to hesitate to call. I haven't had the best experience with his assistant. She wasn't very helpful when i was trying to get information about my insurance coverage. She wouldn't return my calls and seemed put off by the three or four emails i sent her. Glad i don't have to deal with her any more.
The most comforting thing i heard while i was waiting to go into surgery was from the operating room nurse who told me Dr. Meyers is "such a perfectionist it is almost sickening." I remember thinking that is not such a bad quality in a surgeon. You will definitley be in good hands should you go into surgery with him. -
I went to see Meyers yesterday and thought he was great. I expected to see much more of his assistants than him but that was not the case. He did a pretty thorough exam and then told me I should have the surgery. Contrary to the first opinion I received, he said I do not have an inguinal hernia. He was very confident in his diagnosis which was a bit disarming. He ordered the MRI but not to confirm his diagnosis only to rule out other possibilities.
So now I'm confused. Do I have an inguinal hernia or not? Will the MRI rule out an inguinal hernia?
He did write me a prescription for a pretty strong NSAID and told me I might want to try it but that it is not likely to cure the problem. I'm going to have physical therapy too. Anything to avoid surgery. -
I've had two inguinal hernia surgeries on the same side in the past two years. Everything is much better, Except my adductor muscle on the same side. At the attachment to the pubic bone the tendons are/have been inflamed constantly for almost a year now, with the last 7 months having been w/ no running whatsoever. I'm considering heading out to see Meyers because I have read that he deals w/ adductor pains and does the ad release. Has anyone had this? and if so what are your thoughts? Rest has done nothing to heal my problem, at least not in the last 7 months.
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my opinion, for what it is worth (or not), is to avoid any invasive procedures if you can. adductor tightness and pain may be caused by the nerve that feeds that area, it is also injured in the sports hernia. that might be why the adductor hurts, notice that the surgery/injury is not near the adductor, but is not too far from the nerve path where the injured nerves/tissues are.
my dr who did the surgeries is suggesting injections ( i think cortisone and/or lidocane) onto the points where the tendons insert. i will get them in march if i cannot delete the pain through alternative therapies first.
my first 3 sessions of acupuncture (with a "western" approach to locate and release tight muslces and trigger pts) has been VERY successful and since the first session i have seen massive improvements in both pain reduction, tightness around the scars/injury sites, and mobility.
the sessions can be painful but i think better method than having a tendon sliced in order to reduce tension in the muscle.
there are other modalities that can help as well, at least to be considered and perhaps tried before going under the knife again. -
Johnny, Yeah, I understand what you're saying and thanks for the advice. My problem doesn't feel nerve related to me but of course I could be wrong on this. The pain isn't a shooting pain like I've had w/ sciatica in the past, but something like a really bad case of tendonitis right at the insertion to the pubic bone. I'm going to be seeing a local Chiro to see if alignment might be the root of the problem. I'm interested to know how the injections work for you. I've looked into the Prolotherapy and wondered if that might be a good alternative also. Thanks again for sharing.
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Jhonathin,
I have an exam with Dr. Meyers scheduled next Thursday. Surgery on Friday if necessary. I have been dealing with this problem for about 5 months and am pretty convinced it's AP on my left side. The military did an MRI and didn't see anything, but they did rule out an inguinal hernia. My worry is that Meyers won't find me a good surgical candidate. I'm 42 and very fit. I don't think additional rest is going to solve this problem. Did you get the sense that he is very selective with his surgical patients?
I saw a second Army surgeon today who referred me out to Meyers. I now just have to hope Tricare Prime approves it. The surgeon I saw today had heard of Meyers and had read some of his literature. He also told me he had recently attended a conference where physicians debated whether AP really exists and whether Meyers' surgical procedure (and others like it) are really necessary. There are strong opinions on both sides. But, he preferred I see Meyers as the Army would not operate on someone with AP symptoms. -
RunDaddy,
I met with Meyers on Monday. I was struck at how quickly he arrived at his diagnosis after only a few minutes in his office and without the benefit of an MRI. He said the MRI was generally just a tool to rule out other problems. He was confident in his diagnosis. I'm 39 and fit so I doubt he'd rule you out if you present like I did.
I'm going to pursue PT just b/c this has only been going on for 6 weeks for me. I want to be sure surgery is the only option before I go under.
