Sports Hernia vs. Althletic Pubalgia - there is a difference...although the line is thin.
Okay, you may be asking, "Who is this guy? How does he know this?" First, I am not a doctor, not even a once-medical student. I'm just a guy suffering from this insidious ailment like all of you. I have spent the last 8 months reading all 80+ pages of this forum, not once, not twice, but three separate times, from front to back - collecting data, researching it, cross-referencing it and sometimes emailing some of my fellow sufferers just to ask questions and compare painful notes.
Here is the conclusion I have reached - and if you would rather read something else instead of reading what I have to say, check this out:
There IS a difference with Athletic Pubalgia and a Sports Hernia. (I actually saw this evidenced in a publication by Meyers showing a flowchart of "how" to decipher a patient's pain, and there was a clear delineation between AP and SH - a fine line at that, but it was there.)
Cut to the chase:
Athletic Pubalgia - muscles tears or stresses at the insertion point on the pubic joint.
Sports Hernia - inguinal wall deficiencies and weaknesses, plus surrounding soft tissue disruptions.
There are countless stories here of everybody going to see any number of specialist across the globe, with a variety of procedures performed on them and with varying degrees of success. Some talk about tears at their rectus abdominus muscles and the adductor release - Athletic Pubalgia. Some mention how their posterior inguinal canal wall was shredded or the transversalis fascia was stretched or torn - Sports Hernia. More importantly, a Sports Hernia follows the more closely related track of an "occult hernia" - a true disruption in or around the inguinal canal that does not show a bulge. So for those of you who saw a regular hernia specialist and he did a mesh repair or pure tissue repair and you feel great, you more than likely had an "occult hernia" or "incomplete hernia". For those that had MRI's done and they CLEARLY showed tears at the insertion point on the pubic joint, you got the procedure that fixed that. Then...there are a few who are truly unfortunate to have both - muscle tears at the pubic joint that caused enough instability that the muscles and tissue around the inguinal canal got torn trying to overcompensate. Ouch!!! Those are the really tough cases. I bring this to light as it is ever so important to get a CLEAR and ACCURATE diagnosis. I have read how many have gone to see Meyers, and when his procedure didn't bring relief, they went to Muschaweck and then they had success, or vice versa. The same with any of the other SH/AP specialists that many have seen or referenced here - you go to one, get something done, it doesn't work, then you go to see another specialist and he fixes it.
From my research and experiences, it seems to follow these lines:
Meyers - Athletic Pubalgia. If you have tears in the pubic joint insertion-point muscles and nothing else - he is your man!
Muschaweck - Sports Hernia. If you have ultrasound verified disruptions directly along the inguinal canal - she is your best bet.
Cattey - Sports hernia. He seems to be more of a mesh man and that is clearly a hernia type repair. No amount of mesh laid on top of a torn insertion-point muscle is going to reattach that muscle.
Now, some of these doctors may dabble into the other areas that are not their forte, but I haven't seen alot of information here or elsewhere that they do that on a regular basis.
(Sorry if I didn't mention the great doctor that worked on you. I'm sure there are plenty of "hidden jewels" of surgeons out there that know exactly what they are doing, but for whatever reason their names have not been mentioned enough on this forum)
The problem that is often encountered is that the inguinal canal/myopectineal orifice practically sits upon the insertion point for the muscles coming into the pubic joint, thus, I believe, people often get some wrong diagnoses and a wrong procedure done and find that they are searching out the 'other' specialist months or years later to correct the original problem. I'm sure there are quite a few at this forum who can attest to that.
What I am saying is this...ASK ALOT OF QUESTIONS...to whomever you choose to see. After all, it is the ONLY body you have and more than likely you will be paying the bill. Also, get that second opinion. Yes, I know you are in pain and what relief now, but it is even more painful to go with the first doctor that sells you on his procedure only to find out - "Hey, I still feel like crap, nothing has changed" - and then you have to find another doctor to go back in and operate again. Ouch!!
Where am I in all of this? I have already seen one of the big names mentioned here (I may post more about that experience here later) and I feel I need to see the other one now. I still am in pain. I can't do many things in my daily life now but any operation for me is going to be a one shot deal. It has already been determined that any procedure I get will be a nearly 100% out-of-pocket expense, so I need to choose the right one the first time around.
I hope this information proves useful to anyone who is starting to research things or just needs a little boost to continue the fight to find more information or to find that right doctor that will bring peace and relief back into your life.
Here is to a better tomorrow!