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

this is to johnny i just had the surgery with dr muschaweck here in germany and i was wondering if she also had to cut your nerve during the operation? because she had to cut mine and i was a little feaked out.
It amazed me that i started walking on the day of the surgery. today is the second day after surgery and i am walking. yeepi

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willg wrote:

RunDaddy, if you're back from North Africa (or anyone else reading):

I had my surgery with Dr. Meyers exactly two weeks ago. Bilateral pelvic floor repair, no adductor release, and they found an inguinal hernia on my right side while they were in there so that too.

Recovery so far has been, more or less, as expected. A lot of pain the first two or three days and gradual subsiding thereafter.

Having said this, it's still not easy. I seemed to regress a couple of nights ago (pain in my groin, particularly on my right testicle, enough to wake me up at night) and it's been off and on the last 48 hours, enough so that I'm working from home today in "the chair" (a recliner).

The only habits I changed that could have brought this on were driving to and from work (which might have contributed to it, as stupid as it seems using my right leg for gas and brake seems to require a bit of exertion) and sitting on a regular chair for more or less 8-9 hours.

According to Dr. Meyers, I'm going to start my three week (most say it's more like 5-8 week) rehab program in a week but I wonder if I'll be ready by then.

Does this mirror, more or less, similar experiences after the surgery? I am not concerned enough to start bugging the good doctor with every little hypochondriac-al thing that comes up but am curious to know about any others' experiences.

Thanks a lot.

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hi sher,
glad to hear you are walking around dr m's clinic grounds, not too bad, huh?

no, she did not cut my nerve but i wish she did because i am still having pains. she has had to do that with patitnets before, so it is not so unusual. one patient had several regular hernia ops before he met her, all those repairs "popped" or whatever, leaving tons of scar tissue to entrap the nerves. when he finally got to dr um he also needed the nerves freed and he was finally without pain after 12 agonizing years.

in my case, i was doing things such as deep stretches via the advise of my pt, which turned out to be damaging the muscles more.
in my final sh blowout accident, i also tore the left hip labrum (or maybe before or after, but who knows for sure). it does not need surgery but combined with the muscle imbalances the long-term painful sh injury yielded, more muscle imbalances occured in the hip. my hip joint became locked up, which makes the imbalances and tension in the groin worse off. all in all, there is more nerve irritation, thus a viscious cycle begins.

i imagine you will be fine sooner than you think. just don't overdo things like she says you can right after your surgeries. i think that is the case for pro athletes, who usually get the diagnosis almost right away, thus get surgery much sooner.

be well and keep us posted!

by the way, a bunch of pages back, "buckman" posted something about stretching vs not stretching with regards to recoupertating from ap surgery. i think it was geared more towards those who had the injury for a long time before surgery.
i learned via a very well respected doc in phys med/neuro/acu/pt/rolf/pain mgmnt that when muscles are tightened due to nerve irritation (such a thing that can happen with ap), it is best to not stretch until the nerves learn to relax, thus relaxing the muscles and setting their tension settings back to the normal default. i *think* this is why some people dont easily recover from the ap surgery- when a muscle is in pain, the autonomic reaction is to tighten up to protect it. stretching this muscle in this state will only cause more microdamage, and the pain->tension->nerve irritation->pain cycle starts over again.
in other words, "standard" pt protocols of stretching and whatnot should be avoided in order to create more of a custom, individualized format of rehab. that just might be a determining factor of healing time.
i was told to stretch by a pt, and i never seemed to be getting past a certain point. when i stopped stretching on my own, about 1 month pre-op, i felt a lot better. post- op, my pt said to stretch. in the long run it made things worse, or perhaps just delayed the rehab.

just a thought. notice how many athletes such as dominic hasek went a long time with this injury, in and out of the sport, until it became intolerable. he actually had to retire. then he finally got surgery, stayed retired, and then all of a sudden, he's back. his groin injury started in the 90's!! i'll bet he continued to injure his groin via playing for years, in and out, with the injury. and now he is playing strong.
so a story to build confidence for those such as myself who are having issues getting over this injury and perhaps surgery, thinking they cannot get better.

Slugworth,
Your slow recovery without surgery seems very similar to mine. As I've already posted, after a visit to Meyers I am on anti-inflamatory meds and a regimen of exercises designed for soccer players. My initial symptoms were a bit different from yours-my pain was centered between my penis and my belly button, and was usually worst the day after exercises, and, if I then rested, always lasted five days. My improvement, however, seems nearly identical-eight weeks off, still unable to run, then a very gradual return to running with cycling mixed in. The cycling seems to cause no problems, except for once when I really hit some steep hills two days in a row. For now, I'm limiting my runs to four miles, but will try increasing again in another week. Like you, though, the big improvement is that normal activities are finally mostly pain free.
Bottom line-I probably have a frayed (Meyer's word) connection between my abdominal muscle and the pubic bone. If I give up soccer (what the hell, I'm almost 56) and running races, I probably can nurse it along without surgery. However, I always run the risk of re-ingury at work lifting something.

It would be great to get reports from anybody else out there who has had any success without surgery, or anybody who has had the surgery and is now pain free.

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jeff55 wrote:

Slugworth,
Your slow recovery without surgery seems very similar to mine. As I've already posted, after a visit to Meyers I am on anti-inflamatory meds and a regimen of exercises designed for soccer players. My initial symptoms were a bit different from yours-my pain was centered between my penis and my belly button, and was usually worst the day after exercises, and, if I then rested, always lasted five days. My improvement, however, seems nearly identical-eight weeks off, still unable to run, then a very gradual return to running with cycling mixed in. The cycling seems to cause no problems, except for once when I really hit some steep hills two days in a row. For now, I'm limiting my runs to four miles, but will try increasing again in another week. Like you, though, the big improvement is that normal activities are finally mostly pain free.
Bottom line-I probably have a frayed (Meyer's word) connection between my abdominal muscle and the pubic bone. If I give up soccer (what the hell, I'm almost 56) and running races, I probably can nurse it along without surgery. However, I always run the risk of re-ingury at work lifting something.

It would be great to get reports from anybody else out there who has had any success without surgery, or anybody who has had the surgery and is now pain free.

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I've had similar symptoms to what everyone is posting here, but they don't seem to be quite as bad.

Here's my experience:

1) I ran consistently for about 2 years with milage between 20 and 40 miles per week. During this time, I never really ran any speed work. I just generally jogged anywhere from a 6:40 per mile pace to an 8:00 per mile pace.

2) About 3 months ago, I began to do some speed work. I would run 400's and 800's twice per week.

3) During the speed portions, I wouldn't notice any pain at all in my lower abdomen.

4) During my second week of speed work, when I would begin running, I would be surprised as to how sore my lower left abdomen would feel as I began running. Then, after about a mile or so, the pain would go away.

5) During my third week of speed work, I noticed that by lower left abdomen would begin getting sore in the evenings, and it would be difficult to sleep. As I would turn over in bed, by lower abdomen would cause sharp pain. It would be sore for another day, and then go away, mostly. I would notice it occassionally such as when I would twist suddenly.

6) At week 4, I took a week off from running.

7) At week 5, I went out for a "test run". I made 3 miles, but noticed soreness in my last mile. This time, in the evening, my lower left abdomen became very sore. I took off for the rest of the week.

8) At week 6, I wet out for a "test run". This time I felt soreness at 1 mile, so I stopped and walked. Walking seems to cause no pain.

9) Now I am taking off two consecutive weeks, to see if that helps.

Does this senario sound familiar to anyone? Any advise to help me get back on track to running everyday?

Thanks,
Mark

Test

JPL, thanks for the quick response. I just received the letter from United Healthcare denying the pre-approval. They say "The clinical evidence in published peer-reviewed medical literature is insufficient to show that repair of torn rectus abdominus muscle is a safe and effective treatment for athletic pubalgia. Therefore, repair of torn rectus abdominus muscle is an unproven service under the plan and is not a covered benefit".

I received a PDF "Anatomic Basis for Evaluation of
Abdominal and Groin Pain in Athletes - William C. Meyers, MD, FACS, Robert Greenleaf, and Adam Saad" from 'Operative Techniques in Sports Medicine'. Another document the doctor's office sent was "Management of Severe Lower Abdominal or Inguinal Pain in High Performance Athletes - William C Meyers, David Foley, William Garrett et al." American Journal of Sports Medicine - in 2000.

If anyone has references for other peer-reviewed material that i can use to substantiate i would appreciate it. My wife is scheduled to see Dr. Meyers next thursday. She was initially scheduled to undergo surgery the following day - now i am thinking we'll wait to appeal the insurance and see how that goes. Meanwhile, i have been reading about experiences with Dr.M and if im paying out-of-pocket most folks recommend seeing Dr. M as it is minimally invasive and faster recovery.

Any help would be much appreciated.
thanks

https://www.oxhp.com/secure/policy/surgical_treatment_athletic_pubalgia.html further elaborates insurance position -- this is a different provider than mine - mine's united healthcare PPO Plus.

hello, i am a women who suffered for 2 years with ap and finally got diagnosed by meyers. I just did the surgery with Dr Muschaweck and still in germany recovering. The treatment here is amazing. I feel better already, i still have nerve irritation on the injured leg but my leg is now moving normally. I am 5 days after surgery and walking better. I suffered so much at one point i couldn't even walk. I chose this doctor because she is minimally invasive. This week i am going to see doctor mullar he is the top sports speciallist in germany i will post his recommendations to me.

Johnny, i am going to see dr mullar here, he is a top sports specialist and i will post his advice and exercise routine for healing. I am now 5 days after surgery feeling better but still have nerve irritation on the injured leg. I agree that stretching is not necessary, massage is not good as well. We have to let the nerve heal but itself, take a lot of b12 and dont do any aggressive exercise.

hi sher
thanks for the info. i wish my pt had knowledge of how to heal this beforehand, i went and was told to do straight leg lifts and crunches and the like, and it made me worse.

finally got to the right manual therapists about 4 months ago and am sort of on the mend.

i was like you, could not walk, for a long time. severe pain most days, all day.

i'd be very happy if you can give me a full report on what that doc tells you since it'd probably apply to me as well. can you email me if it is too long to post?
[email protected]
that would be great!

i still have nerve irritation on the one side (also on the other but i can deal with it more). and my hip is waaaay tight in the rotators/flexors.

glad you are healing.

hey johnny, why do you think you have more irritation on one side than the other? are u able to function normanly? did you start jogging?how long after the surgery did you start your physio? I am asking you this because, for people who are not pro athlits they can't just start jogging and doing crunches. I saw an orthopedic surgeon today for my other leg which also got injured. He told me that for people who are not pro athlits, they have to start their physio by only walking for at least a month to let the nerve irritation relax and to establish correct balance and only after to start with simple physio. I phoned Dr. Muller and am waiting for an appointment. I will keep u posted.

Always have the doctor check for 'osteitis pubis' a condition not many know about. Essentially this is stress fractures of the pubic bone from impact sports. It's chronic and it hurts like hell.

Bryan,

I've posted here a few times. I've had SH issues for a few years and I will say they are totally under control at this point. I have no pain whatsoever. However, it's been a long, long road to get to that point. It has taken a dedicated program of lifting to strengthen key areas. I also gave this program to someone else that goes to my gym and he has improved to the point that he is racing again. He just raced Memphis in May Triathlon. This Spring, I have not missed a race due to this injury. I am back to runnign about 5:00 pace in races; injury free.

I don't want to retype all the things I've done so search for old posts by 'not a doctor' if you want something to try other than surgery.

It certainly is not the American way but if it were me starting all over again, I'd try anything before I let someone cut my core muscles.

i can walk and light hiking. but some things such as bending over to move something over 15 pounds is bad.

i didn't start pt until january, 6 months post-op, cuz the docs wouldn't order it.
but i did see a pt on my own time and $ about 3 weeks post-op. i started doing the exercises and stretching as recommended. that irritated the nerves more (now i know).

my left side always hurt more. didn't even know my right side was torn as badly until the ultrasound confirmation in um's clinic.

my current physio consists of taking it easy, walking, and amnual therapy, about to change back into light yoga and hiking in a week or so, under the correct (finally) guidance.

i think i was thrown waaay off by dr um claiming that i'd be back into sports within a week. she insisted, but i needed to trust my gut feelings instead (and they hurt a lot so i was confused).

johnny

hey johnny,i just came back from dr muschaweck she recommended me to take it easy for a while maybe because i am a women and the body heals differently. Did u e-mail the doctor telling her that you still have pain? I am still here in germany because i have a problem with the other leg as well. I will be seeing dr.muller on monday for that. I wanted to tell you about a new method here for fast healing injuries its called: fitvibe. Have you heard about it? can you still do core strenghtening execises
after this surgery?

Hey guys, I just had laparoscopic repair for my SH 45 days ago and I am feeling much better.

The doctor told me I could run and play sports 30 days after the surgery, but I didn’t feel like risking it. I just now started to bike and jog very slowly and I feel good.

I suffered for almost 2 years before finding out what I had on my own and "explaining" it to the doctors. I thought I would live forever with that annoying groin pain!

My advice is: try resting completely for about 3 months and then slowly go back to biking, running, etc. If the pain comes back, surgery is probably the way to go.

Thanks Johnny and Sher for the valuable posts