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

mike
good luck with everything.
i also had the same pains in the pelvis, predominately on one side, the one that still bothers me more today. that was also the side which the sh started.
the manual therapy has really helped with the imbalances and the pain along the inner thigh/sit bones, and where i couldn't squeeze my knees together while sitting before (adduct), it doesn't bother me as much now. that inability to adduct while knees and hips flexed is typical of a sports hernia.
i was told numerous times to leave my posterior labral tear alone, take care of the sh issues (that would mean the imbalances, too) instead.
glad i did, i don't want to go through the labral surgery/recoup.

Thanks Johnny,

I will go with Dr. Meyers 12 week post surgery program that Marcia e-mailed me(7 ap packets of INFO and forms). I wish my first surgeon would have mentioned PT 20 months ago. I had no idea there are muscle groups that atrophy from the undiagnosed time of sh. Looking forward to a smooth, easy does it, PT this summer and fall.


Another interesting thing came up today, while talking to a friend he said his wife is benefiting from nerve pain blocks and prolitherapy shots for her neck after a car crash injury. She reported this week was the first time she could move her head easily. There is a pain center in Santa Barbara that has this therapy. So Johnny and others maybe you might benefit from this.

Off to Meyers, mike

hey mike
from what um says, no rehab program till the nerves calm down. so i guess that time frame between surgery and nerve irritation ceasing depends on how long the injury was around before repair.
when i did eventually find a doc who apparently understands ap, he said anyone who does pt within 6 months of ap surgery is crazy. after 6 months i did pt/pilates and it made me worse. that is when i discovered how much atrophy there actually was. the nerves would get tweaked every time i tried to stretch/work out those muscles. it will take lots of time
thanks for the tips, i am hoping to find out about injections tomorrow at my new doc's office. if it is offered, sign me up!
johnny

ps check out the blog mentioned above, it could evolve into a good thing for people. the more that people post the more people who have the injury but aren't runners can find info they are seeking...

Hey Johnny,

I can't believe that a doctor would tell you no PT for 6 mos following surgery. I realize the injury is complex, and made even more so by surgery, but to think of practically sitting idle for 6 mos post-surgery sounds counter-productive. And not all cases are the same, surely, so some people get up and go ager 4 weeks, others like you and me take much longer.

Can you offer any other insight or rationale as to why 6 months was the target date for getting into a rehab regimen?

And, I had prolotherapy about 5 months before I had surgery and I have to admit, it really did help with the pain. So, I believe that those very simple glucose injections did indeed mitigate some pain (although it wasn't enough to actual repair the torn muscle).

Talk soon!
Joe

hey joe
it took me 3 and a half months after surgery to finally find and get referred to a sports med doc that knew what AP is, so he said. he apparently did some sugeries with a dr boscano or something like that in boston.
after 6 mos he agreed to finally put me into a pt regimen. at that time i still had pretty bad pains with activity but better than at 3 months post op. i wish i knew what he was thinking, this whole thing with the doctors has been very frustrating.

i think that maybe i had a really bad case of sh, who knows, i had no one else to compare with. perhaps i made it worse through activity or maybe even the pre-op acupuncture sessions got those nerves more irritated.

dr um told me i could exercise right away, and i did try some but it made things worse. and i have a high tolerance for pain, so i have been told by many doctors and fellow sports enthusiasts alike.

i see a doctor tomorrow who is a pain guy that works in an ortho center. perhaps i can get these shots through him.

thanks a lot for the post
johnny

Yes Johnny I wonder if out of the 17 dif sh that dr. Meyers has performed if there isn't a direct relationship between PT right away and longer recovery PT programs. Instead of his weekly pt program I recieved(after week eight return to your sport) there should be a better way to get us back to the sports we used to love. Maybe his, 12 week you can do anything, PT e-mail I got was just a marketing ploy. Obviously a 22 yr old soccer player with a quickly diagnosed small tear will have a much different treatment than people like me a 51yr old-who walked around with hot pain for a year before UCLA diagnosed it.

Rereading this blog is great. Avoid deep stretching. Psoas management. Core exercising. Swimming. Therapies. I guess It is up to ourselves to pull back when it is painful and adjust our approach.

I bet my sh operation 20 months ago would have better healing / results if I found this great site then. Too bad Dr.s and PT pro's cannot get a definitive recovery set of therapies formalized.

So I will see Meyers 7-23-07. A pelvic MRI tomorrow. If my suspicions of additional tearing are correct looks like another year of slow recovery. But at least I have positive expectations of getting on my surfboard and playing basketball with my son again. Wish you all good healing. Thanks, Mike

Hey guys thanks for sharing all the great stories.

Hey Joe, I can really relate to your story.
I am almost 3 months out of surgery and my recovery has been pretty slow. Maybe If I pushed it like Will I would be better (maybe worse) but I am in no rush to get back to sports.
After 2 months I started jogging a little (about 1 mile).
A week ago I pushed 2 miles and I had some pain but general and not that acute spot we all know.
I have been biking about 10 miles or so and that hurts a little as well but after ice and a couple of days it seems to calm down.
Overall I feel I am getting better and stronger every week but it's very slow.
At this pace I guess it will take me at least 6 months before I play a real game.

Hey guys,
I saw my surgeon today, about 5 weeks post-op, and he told me everything looked good and to slowly work my way back into activity. I asked him if he had a sample program or anything, and he kind of gave me the run around. I was wondering if anyone had a pt/physio program they have used post-op with success. If someone could email me a copy I would really appreciate it. thanks!

Trevor
[email protected]

3 months post-op and Johnny (and everyone),

It's good to be in the company of non-immediate success stories. I do hope we rebound and get back to our respective sports.

I do think Dr. Meyers is extremely talented, but most of his surgeries compromise the athletic (paid) community, so they get the best possible treatment post-surgery. I know that has something to do with the protocol he hands out...but the fact is there is a more real-life scenario that I think he may not have considered. And Dr. um and others too...

What if you sit at a desk all day?
What if you just can't get to PT 3-4x per week?
What if you have a nerve issue that needs to be addressed?

A lot of cases, I'm sure, are quite cut and dry. Like those who feel pain, get diagnosed and have the surgery in quick order.

The lingering injured is a study unto itself that I think should be addressed.

How tough this is! And the mental impact of being sidelined for such prolonged periods of time, while attacking the issue from all angles with no results...we just have to really believe we'll get back, let the power of our minds heal us. I really think taping in to the most powerful healer (ourselves) is our next step. I can give more later on this via my chiropractor, who in her "rabbit hole" has helped many people heal themselves. It's fascinating and sustaining my hope that I will again emulate Roger Federer and win our backyard Wimbledon.

You are absolutly right. Surgeons don't take into consideration the healing time for normal people(not pro athlets)and the fact that people who have nerve damage from the sports hernia can't do all those exercises and that their rehab time is much much longer. I think that part of the problem of people who don't get diagnosed with sports hernia is that they are not pro athlets or are women. I don't think doctors think its possible for a women to get that kind of injury especially if she does'nt look like rambo. I have been checked by the former doctor of the maple leafs and he told me its an internal problem. A year after I was diagnosed by Dr. Meyers. I went back to the former maple leafs doctor with Dr. Meyers diagnosis and he started to do wierd things with his face, he didn't know what to say. He said wow.

hey i have a question for the long-term sports herniacs such as sher, mikel and shoelessjoe...
have yall been checked out by a GOOD osteopath/rolf/chiro and been told that your pelvis and/or sacrum is twisted, and/or your lumbar spine is rotated?

this will help me with my studies of this injury, part of my school "thesis."

i assume sher has, from what she wrote, but i am especially curious about mikel's situation...
thanks

I have read this huge thread with great interest and have posted elsewhere about what I dare say sounds like a saga, it feels like one. After racing well as a Master I began to develop a tightness on my right side in the IT band and also tension in my right SI... as I tend to train through things I kept plodding along and the muscle heaviness on the right side just got worse and worse to where I began to feel as though rectus femoris was shutting down 10 mins into a run, meaning there was a burning weighted sensation as though I had leg pressed to exhaustion which is not possible in such a short duration. I am weary of trying to find a solution as 2 yrs into this I can barely run without pain and for all the Dr help I have sough everyone seems to be in the dark.
I have had Chiropractic care, deep tissue massage, seen a pain management Dr and a Sports Med Dr and no diagnosis even.
My MRI from a year ago of the lower lumbar and right hip was "normal" and the PT I saw thought there was a possible labrum tear. In exploting that the Sports Doc ruled that out after he used ultra sound to pin point a cortisone shot to the hip capsule, it was totally ineffective. His next thought was to shoot the adductor/groin area with lydacaine, this was done last week and I have been in a considerable amount of pain since.... When he checked the area on ultra sound he could see inflamation in the pubic bone area and called the tissue around it "irregular." He then proceeded with a 6 inch needle to try and break up the calcifactions he saw in this vunerable area. I could not even attempt running for 5 days and had loads of pain near my right psoas when I did try it.
This is sounding like a broken record trying to get help for a problem with no name. This current Sports Dr now tells me he does not know what is wrong but thinks I may be one of the rare people in the world with compartment syndrome of the quad, it is more common in the calf area ala Mary Slaney back in the day. When I questioned him about a possible sports hernia he alluded to the fact he did not think that they existed and that they are very hard to diagnose even so.
I am hugely disappointed needless to say with the avenues for help I have sought with no answer. I have also tried extensive stretching and exercises through the Egoscue method and won't give up on those but this is pretty discouraging to say the least. I was hoping to be able to salvage something from my Masters running, but the longer I am fighting an injury with no name the more confusing it all gets.
I am considering seeing a Master Rolfer in the area who studied with Ida Rolf, who pioneered this form of structural integration.
If anyone reading this has any insights at all I would be glad to hear from you.

i would go see, only judgning from this thread and my own experiences...

1)dr meyers or um (but in munich) to see about a diagnosis and take it from there.

2)the advanced rolfer can probably help you a lot.

if you are near ny or maine, there is two certain si practioners that i can recommend there, just email me if you want the names.

Hello,
Well I recieved my non-dye pelvic MRI results today by the phone. My GP ordered it for me, per Dr. Meyer's request. Nothing frightening to report. Weak signs of a small hernia around my first sh surgery. Nothing on my left side. Interesting a month after my dyed, hip MRI from UCLA, which found bilateral labral tears, Labrum tears were not noted here. It was a 45 min MRI after the 25 minute one they kept looking when I told them I've had 4 previous largely negative MRI's for this injury. Now 5. Ofcourse I expected this and Dr. Meyers has this done as to rule out other pathologies. According to this thread only 20% of MRI's for our sport tears show anything. If we could only sit down- which I heard there is one in LA!

So I'm still in line for Meyers on the 23rd. I kind of wished I pursued prolitherapy injections like my GP mentioned. Although he wouldn't recommend any body here in Santa Barbara now that the two founders of prolitherapy have retired.

So I will send my questionaire(injury /recovery /history), original 18 month old sh surgery report and my two recent (somewhat conflicting) MRI's to Meyers.


Thanks to this positive and informative forumn. Johnny let me know if you need anything else.

Well, as of my last reply things were looking good. Not so fast.

About a week and a half ago something happened (not sure what) and I went relatively rapidly downhill and honestly I feel about as good as I did pre-surgery (May 9). The only difference is that before I felt it all over and now I feel it clearly on my left side. It spreads elsewhere but I can tell for sure that the left side is the source.

With Indocin, the pain is manageable. Without (and I know this because I forgot to bring it to work the other day!), it is totally unmanageable.

I have another appt with Dr. Meyers on Monday.

Regardless of my prognosis and forward course of action, I have asked twice if remaining as athletic as I can in the meantime is debilitating or merely a question of tolerance of pain (which with Indocin is OK but I don't think I want to be on it long term). No answer, I guess I will wait until I go to Philadelphia to find out.

I'm very curious as to what might have happened. I got to the point where I was 'back in action' for about two weeks with almost no pain and it went down quickly.

Will post again with hopefully better news.

This forum is great for commiseration, the worst part of this problem is that it's not linear (i.e. if you break your ankle, you need to do x, y, and z and then it takes x days/weeks/months to fix and then you're done). Everything with AP is to some degree unknown and now there is this innate fear that my odds of beating it surgically have gone down quite a stretch since one surgery didn't do it.

Hello, I've tried to read thru this thread, and I'm trying to figure out if this is what I have. First of all I am a female runner, in the beginning I had what felt like groin pain, and I could feel it when I would stand up, rollover in my sleep etc. Most especially I cannot run, it feels like a goosegg/cramp in my lower right abdomen, do these symptoms sound correct? I haven't run for a week, and it seems to be lightening up, but is definately still there - I also cannot do the piriformis stretch, if anyone is familiar with that. I went to the regular doctor and they ordered a CT Scan (with dye) x-ray of the pelvis and abdomen and it came up clean, but from what I read I would need an MRI for the AP to show up, is that correct? I'm trying to figure out if its something else, and I should run thru it, or if I'll do more damage, I'm going to see my orthopedist and hope he is familiar with this condition. Anyother info on the sympotms is greatly appreciated. Thank you

Mustrun,

Full disclosure: I'm certainly not an expert. I am merely a sufferer who is going through the throes of what is far from an exact science type of injury.

The two things I would say to you from my own experience (again take it for what it's worth):

1. What you're describing certainly sounds like it at least COULD be AP (which, according to the Dr. I see is really just a catch all term for at least 18 different types of abdominal muscle injuries).

2. The MRI 'for' AP is really only done to rule out other things in most cases. For some reason in my head I seem to remember reading that well over 70% of MRIs that belong to actual AP sufferers don't show anything wrong. The Dr. I go to specifically uses the MRI simply to eliminate other possible causes of the pain.

One other thing as it seems like you're certainly at the beginning of this experience (and hopefully it's not AP and you will not be on this blog very long :-), don't be surprised or discouraged if your GP, a hernia doctor, an orthopedist, etc. have no idea what you're talking about when you mention AP. It's happened to me and to many others on this blog.

Ultimately, there are really only two very 'known' names in the States and one overseas who have extensive experience dealing with AP:

Dr. William Meyers, Drexel University, Philadelphia - 'fixes' most major American athletes with AP (doesn't wear this on his sleeve, I found out by searching extensively on the net), utilizes open surgery and sutures. Claims over 5,000 surgeries. I am going to him.

Dr. Richard Cattey, Columbia St. Mary's, Milwaukee - utilizes a more minimally invasive surgery with mesh, claiming success with a shorter recovery time.

Dr. Ulrike Muschawek, Munich Germany - 'fixes' most major European soccer players (where this injury probably most commonly happens along with ice hockey). Claims over 10,000 repairs. Consistently on this blog seems to have an impeccable reputation.

There are also other Doctors who know and deal with AP with a variety of different methods including non-surgical, but the three above are definitely the most well known.

If it were me, knowing what I know through only my own experience, and again my 'knowledge' is probably not a whole lot greater than yours, I would give it a couple of weeks, cool off from activity a bit, see if you can resume your regimen without pain and if you cannot do your best to see someone who has specific experience with AP, even try for one of the above three if you can. They are all surprisingly accessible, of course this is relative to how far you have to travel.

Hope the above is at least a bit useful and that you get well soon.

WILL

I recently had bilateral repair for AP. It has been 7 weeks since I had the surgery and I think it was a success. My left side is still bothering me and Dr. Myers thinks there is an underlying hip issue with that side. Fortunately, I have always been able to play through the pain on that side. The right side was what stopped me from playing soccer. Right now I am able to sprint and run but I cannot maintain it for more than 20 minutes. I am 26 and was in good shape going into the surgery, so I think my rehab process might be faster than most. I'm looking to play in another 4 weeks. For anyone who has the surgery, just keep in mind that the pain does not end immediately. You will feel sudden acute pains that don't persist for more than 5 seconds and your groin area will feel sore but I did not feel the same pain I used to get preop. I think the surgery was a success and I hope this debilitating injury is finally fixed.

If you are having trouble making it to Dr. Myers, I would suggest seeing a sports med. guy who is a team physician. I saw one of Vanderbilts doctors and he referred me to Myers. I would have never known about this surgery if I was not such an avid soccer fan. I didn't know surgery was an option until I noticed that a lot of professional soccer players were getting it. After I realized that, I sought out a doctor who dealt with high-level atheletes. To be honest, I don't think it is a common injury for other players.

On diagnosiing yourself: take some time off and then try to rehab the area on your own or through rehab beforeyou opt for surgery. I went through rehab twice and a steroid injection and it didn't help. Surgery was a last option.

Also, my contact info for anyone who wants more information is [email protected]. Feel free to e-mail me and I will try to help you out.