I think reading that Meyer's et al. paper above touches on why it's really a crapshoot with the laparo-mesh. In addition, like most medical outcome studies, patients for whatever treatment the study's focusing on, are held within a restricted, specific criteria that usually misrepresents the general population. Most laparo-mesh studies include professional athletes with symptoms prior to surgery for under 4-months who most likely have superficial damage to the transversalis fascia. Also, you can't rule out the placebo effect since almost all studies don't include a wait-list control group. That being said, maybe the laparo-mesh is legitimate for a select group of patients (1 of the 17 variants of SH observed by Meyers). This is just my cursory observation as I too sit with a failed laparo-mesh attempt. Good question. Maybe others can elucidate this further. Chris
Back home in VA, drugged up, walked 1 mile (per Dr's orders), sore as shit.
Here's another thing I came across that day that I don't think is in prior threads:
"Celebrini believes that just fixing the problem through surgery, without addressing the underlying cause by going over each athlete and his individual body concerns very carefully, can lead to the injury recurring..."
You can go back off the cliff again, so after you get fixed you must figure out what went wrong in the first place (best of luck w/ that one...!).
i just had surgery w meyers and i was wondering at how much walking i should be doing?? i'm getting shooting pain in my incision site...could that be a nerve?? Also should i be recovering lying down or in chairs?
I also just had my surgery three days ago and i was wondering if i could get some advice on the rehab process. Meyers is telling me that I should walk a mile a day but I feel that I am not ready for that. This seems excessive, what do you think? A couple of questions: should i be in bed for a while, what activities should i be able to do the first week, should i have trouble getting up from a sitting or lying down position, how long should i wait before rehabbing? Is it strange that I am in more pain today that I was yesterday? I keep thinking I have reinjured the area.
I had surgery at the end of November, about 2 weeks after surgery I was in a lot of pain but Dr Muschaweck told me this was down to the nerves being damaged. I am now 6 months on and have no pain at all.
I didn't walk a mile a day after surgery as it would have been impossible, I just let my body tell me when it was ready, by the end of January I was back playing competitive football.
For those new to the thread or those still suffering, the best bit of advice I can give, is get seen by a specialist as soon as possible, the longer you leave the injury, the more related problems you'll have and the longer your recovery after surgery.
Good luck all !!
Sportshernia and Jay:
Good luck guys. I keep thinking "I hope to God I didn't mess myself up" since it still hurts pretty bad. I'm just trusting Dr. Meyers about the walking part since he emphasized that he feels people should be aggressive about rehab.
My 3 and 6 week rehab plans are at work and I am not. I talked with Trish yesterday and she emphasized not to do more than 1 mile/day walking and not to lift more than 10 lbs. in the first 3 weeks.
To those who have recently gone under the knife with Meyers: The first two weeks are really painful. Yes you feel pain when you stand, move and sit down. Only natural. Listen to your body, but certainly don't walk a mile the first week...that's really pushing it too hard. Just make sure you do stand up and walk around the house a bit.
It took me until about week 3 to finally start moving around better. You're dealing with not only the repair by the incision site as well, in a very sensitive area. I can only urge you to listen to your body.
I would also highly recommend seeking counsel from a good physical therapist. I tried pilates at week 5 and wasn't ready. Others will be, it really depends on how you heal and it's different for everyone. The therapist will take you back to square one so you can learn how to move again. Getting over surgery without this type of guidance would only hinder your progress, I feel.
So take it easy for the first couple of weeks; just don't sit on the couch the entire time. Get up, walk around a bit and sit when you think you should. Your body is very good communicator. Remember, you just had a pretty significant surgery...it's completely normal to feel pain..old pain, new pain, etc. Give it time...and just be positive, eat well and imagine yourself back playing your sport and you'll get there.
Thanks, Joe. I'm hoping I'm not making a mistake in listening to Meyers about walking. I felt pretty good doing my mile yesterday, though I still hurt in general. I'm young (24) and was fully active until just over 3 months ago. So I'm hoping that I can follow the plan.
Is every generally pretty swollen for a while? I don't have the "apple" Meyers warned me about, but the area that was operated on is rather enlarged.
I am 25 year old male. I am having this problem for the last 12 weeks. It all started 3 months back when I felt slight discomfort in my left scrotum. After 2 such weeks it slightly increased when I was driving car for hours together .The pain level I would say was 2 in the scale of 10, 10 being the highest. And immediately after that I visited a emergency medical clinic. The doctor took a testicular ultrasound scan and said that there is nothing wrong with the testicles. The doctors ruled out any testicle abnormalities like torsion, cancer etc.
I visited a urologist after this and he again read the scan reports and did tests for hernia and also took a urine test. He ruled out urinary problems and also hernia. He suspected a muscle strain and prescribed me alleve for next 2 weeks. After this the discomfort had been intermittent for following 6 weeks. The symptoms did also change. In this period I started to feel the discomfort get into the left inner thigh. I would call these discomforts (rather than pain) pulling sensations. But I had these once in every 2 to 3 days.
I drove a car afterwards and the symptoms got pretty constant. Again I visited the urologist and he referred me to a sports medicine specialist. The Sports medicine specialist took X rays of my left abdomen and thigh and said that the X rays were fine. And looking at my symptoms told me it could be a muscle stain or a sports hernia. And gave me muscle relaxant medicine for the following two weeks. But as I didn't get relieved of these symptoms I had an MRI for any possible muscle pull and nothing showed up on the MRI scan. The doctor told that it could be sports hernia and would refer to some other doctor.
And now Whenever I do any work like walking or bending twisting for some time I start to feel the discomfort after few minutes and when I just relax by lying down or sit on a couch the discomfort just goes of in minutes and also warm and cold pack compressions in the groin region also helps me get rid of these discomfort quickly. Now I could feel the discomfort sometimes even in my perineum area. These are no swellings or visible changes in the area. Also the discomfort not always occur in all the three regions together - inner thigh, left scrotum and perineum area. Sometimes it happens in all the parts, some times in just one or two part. Its just random.
I haven't been involved in any regular sports of late for the last 5-6 months and I didn't have any injury that I could recollect which could have caused this. The long duration of this problem without any known exact reason so far is bothering me a lot. I am currently away from my home country and it still make me worry. I know the answers here are not a substitute for a qualified medical doctors diagnosis, but your answers could help me consider my further actions to diagnosis my problem and treat it.
Is this a sports henia or anything else is possible for these symptoms?
Can a person with no active sports activity get a sports hernia? But I do a lot of house hold work like cleaning, moving things around etc.
Is surgery the only remedy for this. Can this be cured using medication and may be physiotherapy am a student now and I am joining a company in another 2 months. Is it possible to get this resolved during this 2 months.
Please I would be really grateful if somebody can help me with this.
I had surgery with Meyers 4.5 weeks ago and he is definitely into working through the pain. I know it is hard because a lot of the pain is like the pain you got from the original injury. I have had 2 flare-ups already and I have trusted his judgement and worked through it gently and have come out alright.
It is definitely not an easy recovery for everybody!
For those of you concerned about how much to walk after Meyer's surgery, I can related my own experience (I had bilateral PF repair in Oct. 2007). The first few days do suck, I walked as much as I could/ needed to but quickly found that I was extremely more tired than usual (which makes sense). I remember getting up out of bed was nearly impossible (since I couldn't sit up at al) and that I was walking with little shuffle steps for awhile. My whole pace of life slowed down but that's just how it goes. I also had sharp pain at the incision site a couple of times- namely, when I laughed too hard (it was painful to laugh hard at 2 weeks PO) and once when a cat jumped on me while laying down and I contracted my stomach out of reflex. That was very painful since it happened like day 2 PO but I am happy to say that I recovered relatively quickly from the surgery (back to full sports activity by week 8) and still feel good at over 6 months PO....
You can develop a sports hernia from any activity with a core imbalance although it tends to happen with athletes. The prognosis for healing on its own is not real good -- if you have a sports hernia. From what I've learned, surgery is usually the answer for most. So, to heal in 2 months, is very unlikely. While I have gotten better through physical therapy, it has never completely gone away. I've had almost every X-ray with the exception of a CT Arthrogram, and doctors still can't find anything significant.
My advice would be to start doing core exercises for strengthening, possibly some stationary biking, and a lot of walking to stay in shape. But honestly, if you think you have a sports hernia, you need to go see a specialist.
Thanks Den for your reply.
I have an appointment with the sport medicine specialist tomorrow. But he said that he will refer me to a specialist. Is there specialization for Sports hernia?
I am also concerned about the time and money involved in the surgery. Once I join the job I should have insurance coverage. But usually how long does one have to take off from normal work for the surgery, I mean how long should I wait after the surgery to get back to office work (a software job)? .How much does the surgery cost? Is this surgery a normal one. I mean how common does doctors in various states and cities perform this. Or does one have to go to some place for these?
I am really worried about these.
Like Janet, I also had surgery 4.5 weeks ago. Felt pretty good for 10 days, with no problem walking a mile or more. But day 10 I walked too far going to and from a lacrosse playoff game, and also had to push up too much when crossing through the bleachers, so I had a real bad flare-up and was sure I had screwed up Meyers good work. Five days later I was OK but on day 17 I was hooking up a sprinkler and it came on and I instinctively tried to outrun it. Bad Idea! I felt something really give in the adductor region. Again after five days was somewhat better, but continued to feel that sometimes. Meyers said that it was probably just scar tissue letting loose and that after three weeks it was time to push it. So, after a week in the pool, today was my first attempt to run on the road. Just an alternating half mile walk, half mile run for three miles. Didn't feel great, but not terrible either. Bottom line-I live in fear that I screwed things up by doing too much. (I think a five gallon paint bucket weighs 40 pounds, and I moved a couple of those in the second and third weeks) My main pain now is straight up from the bottom of my groin, starting on the very bottom of whatever bone that is. But I can handle it, mostly because it doesn't feel like a pain that implies structural weekness, so it doesn't make me worry like the occasional pain and minor swelling I get in the incision area after heavier use. I'll try and ramp up the running over the next two weeks and see what happens.
One definite improvement is that since immediately after surgery I could squeeze the adductors without much pain for the first time in years.
That's probably more detail than anyone needs to hear, but I'll be curious to hear how all of you who are a few weeks behind me do over the next six weeks.
Good luck to everybody.
how hard and where am i supposed to massage the adductor region?? meyers said i need to do that 7 days out and im now 11. Also, at what point should i start the pool walking and rehabilitation?? im not even walking to the end of my driveway...should i be pushing myself more? my dad is trying to get me to walk the mile..
The massage therapist told me to massage my inner thighs in a circular motion stating at day 10, but that was because I had the adductor release. I wasn't sure about the woumd area so I called her but didn't really get a clear answer. I am now doing that (started vey gently around three weeks)and it seems to help.
I would definitely try and do what walking you can, because it will help you feel better after a day or two.
The six week rehab protocal has you start walking in the pool after three weeks. Marcia will email you a copy if you don't have it.
It seems as though most people are either recommending Dr. William Meyers in the U.S. or Dr. Muschaweck in Germany to do the actual surgery. They are probably who you want to see in the effort to get an accurate diagnosis. Otherwise, I think you would be wasting your money and time with a doctor who doesn't have as much training in sports hernias. These doctors appear to be the experts in the field.
I've been to several doctors and orthopedists, which really didn't help me that much; and I spent a lot of money. However, my orthopedist has diagnosed me with a athletic pubalgia (sports hernia). I just need to get an appointment with Dr. Meyers. I haven't done that yet because I've shown some improvement with therapy, and I don't have much pain right now -- other than heavy exercise.
I've heard the surgery is fairly expensive and not covered by some insurance companies. I haven't had the surgery so I don't know how long it takes to recover. But I'm guessing you would need at least a full week before going back to work.
Den, once again thank u so much for ur reply.
I read in the forum that Dr Meyers operated only on half the number of patients he attended. Does this mean that others got back to good health through conservative treatment.
The only thing that makes me feel that I wont need a surgery is that my pain is not that much and is not constant too. I would call them discomfort than pain (1 in a scale of 10, 10 being the highest). Is the degree of pain related to the amount of damage done to the groin?
How about u? You said ur pain had decreased through PT. Did u have severe pain before that? Is it possible to delay the surgery for 3 to 4 months. by PT and other treatment.
Please, if any others also have any suggestions regarding this please post them.
I had bilateral pain in which the pain was more intense and frequent on my left side. Surgical findings correlated with this in that the surgeon found more extensive tearing of the transversalis fascia on the left than the right.
PT helped only to a point before I plateaued. My suspicion is that PT helped the unaffected compensating muscle groups as well as helped with misalignments and imbalances. Though, maybe the increased bloodflow from exercise can aid healing in those with minimal damage and a short duration since onset.
Per Meyer's paper in the above link, most candidates for surgery have extensive damage not just in the transversalis fascia, but in more anterior regions which together would be almost impossible to cure through rehab exercises.
Your symptoms sound typical for sports hernia. There are many other pathologies that involve diverse areas of the pelvis that could cause similar symptoms, however, I'm not going to speculate on them. Find a specialist who is knowledgabe on the latest diagnostic and surgical techniques for SH. For instance, Meyer's and a few other across the US are now effectively employing MRI to detect sports hernia which wasn't the case a few years ago.
Good luck. Chris