Just double checking
Wejo...thanks for keeping this very important source of information up and running for SH/AP sufferers. We all appreciate the fact that you continue to make sure it lives.
johnyboy...based on your description, it sounds like a regular hernia (i.e. the visible bulge) My suggestion, based on all of my research, is to seek a pure tissue hernia repair. Although mesh may be a wonder of modern medical science, it can cause alot of problems years down the round. I'm not sure where you are from but here in the USA, even the FDA has posted patient warnings and advisories about the potential harms in man-made (non-biological) meshes. Even my PCP admitted, if you are even remotely healthy, get a pure tissue repair and then rehab the inguinal canals. The human body doesn't like have inert materials in it. I would suggest the Shouldice Hernia Center in Canada ($4000 repair w/o insurance), they have been the gold standard in pure tissue repair for the past 40 years (but they don't do sports hernias, which is a type of incipient/occult hernia) or Dr. Muschaweck in Germany. She knows the Shouldice technique, plus her own minimally invasive technique ($6000 w/o insurance). If your options are very limited, then do try and search for a doctor that knows the 'old-school' pure tissue repair techniques. Some of the better repair techniques are Bassini, modified Bassini (it is best if they open up the posterior inguinal wall and repair that too), Halsted, McVay, Cooper's ligament...or any combination of the five.
Testing 1 2 3
Hey all - hope you can be of some assistance. I hurt my groin suddenly Nov 2007 playing Ultimate. I was sprinting around with some mild but bearable pain and then all the sudden the sharp pain started. I have not recovered since.
I had been diagnosed with OP and a hip labral tear in Feb 2008 due to MR Arthrogram. We tried the typical conservative treatments including steroid injections, ultrasound therapy, physical therapy, LOTS of rest, etc. So the labral tear was fixed in early December 2008. The pain is just the same.
With everything ruled out it's an adductor strain requiring surgery (tenotomy?) or a sports hernia requiring surgery. Or both...don't know. I am most tender with a deep pain where the adductor tendon inserts into the bone. My adductor hurts stretching, walking, running, crossing legs, etc. about halfway down to my knee with the pain decreasing as it gets further from the groin. It also hurts radially a few inches into hip, abs. It sometimes hurts sitting up in the morning.
I have had two groin injuries before that required 4 weeks of rest/rehab to get back to playing. I feel that the tendon may been weakened those first two times the point of basically rupturing. So I am leaning towards a serious adductor strain but would like to know if someone has key differences to point out that would discern between the two.
I'll check this frequently to see if there's anything new. Thanks!
I'm almost positive I have a sports hernia and was wondering if theres any Dr in the Denver area that can properly diagnose and repair a SH?
I believe Dr. Muschaweck will be in Colorado late spring/early summer. Call her office to find out her US schedule. She often sees potential patients while in the states.
monchi - would you be interested in speaking to me off line at joebshoe at hotmail.com?
I just read your post and am intrigued (to say the least) and of course have a litany of questions. Well, a few to start.
Hey guys, sorry for the long-winded message but please bear with me :)
I am suffering from pretty strong left-sided groin and abdominal pain, radiating down into my left testicle and also into my left kidney. A hernia has been rulled out by my Gp after physical examination and ultrasound, although after seeing a private urologist he suspects I might have gilmore's groin. The pain came on after lifting a piece of heavy machinery, rather awkwardly due to someone else's carelessness. It comes on during exercise and forces me to stop from the pain. This happened about 2 months ago.
Now rewind a year, and I was about to undergo varicocele embolization for left-sided varicocele. Having experienced intermittent bouts of groin, left testicular and abdominal pain previous to this, the varicocele was seen to have been the probable cause of the pain in the groin. After the operation the groin and abdomen pain was a lot worse, with a gradual move back into exercise possible after about a month, then full recovery about 2 1/2 months later. However the varicocele still remained!!
I suspect that I might have had some sort of abdominal muscular weakness, which the embolization temporarily aggravated, and now has been majorly exacerbated by this incident of improper heavy lifting. I am almost 20years of age, and a very active person usually, doing mainly cycling and swimming. The pain does not seem to be getting any better, only with fluctuating periods of improvement/ worsening pain.
Can anyone please offer some advice??
Thank you very much, Georgy
Monchi, I think your analysis is spot on. I have been to see Meyers and then went for a second opinion with Dr. Andrew Boyarsky, who is a disciple of Dr. Muschaweck. Meyers identified me as a good candidate for the surgery he does because his MRI shows I have rectus tears on both sides. Boyarsky did the finger/ultrasound exam, which focuses less on the rectus/nearby soft tissue and more on the inguinal canal, and found no reason to operate.
After seeing both of them I have been trying to slowly work back up to my normal athletic activity, in a last-ditch attempt to avoid surgery. I consulted Meyers prior to doing this and he was fine with it. Said there was a slight chance i could make the injury worse but he could still fix it afterward. Started with elliptical and stationary cycle, then moved up to some ab work and finally tried to skate again yesterday. Until I tried skating it was just mild to moderate soreness. Today I have much more acute pain at the site of the left tear (interesting as my symptoms first presented on the right side almost 2 years ago) and I'm thinking I'm probably going to go back to Myers and have the procedure in the near future.
Good luck to everyone else who is suffering from this ailment and thanks to everyone who has contributed to this board -- and to LR for hosting. A great service to the AP/SH community.
I just wanted to let everyone know that I have been talking with Dr. Muschaweck over email about a recently diagnosed Sports Hernia I have had for the last 90 days. She is going to be in New Jersey in early April to do Dynamic Ultrasound exams. Contact her secretary if you would like to set up an appointment to get examined by her in the US. She has been very thorough and replied to all of my emails in less than 24 hours. I am very impressed and have already scheduled my appointment.
Hello there. This is my first post.
About 4.5 yrs ago I was bent over throwing logs. Felt a pop in my low abs and sacrum. 2 days later i could feel sacral pain, groin pain and calf burning/tightness. I have large legs and big upper body. Power athlete.
Went to doctor after doctor and MRI's for lumbar were clean. Therapy consisted of Pilates excercise and that is when i noticed my testicle killing me and ab pain. I had this before but i never linked the 2.
Went to more doctors, NMT's, therapists and more MRI's. All strength tested positive yet nobody tested my groin.
Now along with my back pain I had unbelieveable groin tightness to the point of it feeling jammed into me. This also was combined with my calf and behind my knee being so grossly tight that therapists could not believe how tight I was and was not loosening. I also noted my right foot was everted and not straight forward.
I decided to keep working out even though i wanted to cry and had zero relief in any position. It felt as if I was being held in this locked position. If i sat indian style with my feet together my right knee would not lower.
I continued to walk 6 miles per day and it killed me even though i looked good.
I hated to lift my right leg or adduct it, yet i still thought it was aback injury since i had it checked by my doctor at least 3 times and no hernia....duh
So i went to a Pain specialist in NYC who has a device that detects injured muscles. He tested all my back muscles and determined they were healthy. he then put this probe in my crotch area and it felt like a cattle prod and i wanted to jump. He then put a cream on my leg and asked how i felt. THe calf pain was gone. He then injected over the next 2 days my adductor magnus and pectineus muscle. Instant relief and my everted foot returned to neutral. I figured I was all better. however a week later the tightness was back, but not as bad and the calf burn pain is just tension which i only feel if i am laying on my left side and my right leg is dropping on top of it.
Thinking i was fine i raked and my testicle and ab and groin were on fire for a week. I now realize since my body/muscles are not bracing/spasm to protect me how painful my groin area is. Over the next few months i go back and forth...feel functional for 2 days and then inflame it. Now my main complaint is not back pain or leg pain....but this SH pain.
My NMT massages the area and hits the insertion of the rectous abdominous and it is very tender and it hurts to roll over, get out of car, raise knee or push off. In fact slipping on ice has set this off alot.
I am seeing MEYERS this month and i assume i have this and would assume since i had such bad leg pain from the magnus (only adductor innervated by the sciatica) that i have a tear there or hopefully since my RA is torn my powerful quads are pulling down unresisted causing unbelievable tightness. Now the other side (healthy side) adductor/pectineus are tight as a mother and this in turn tightens my QL in my back.
When he releases the adductors does he have a view of them all to see which ones are injured since the magnus is back a little.
I'm going to try to allow my sports hernia to heal without surgery, hopefully with a scientific understanding of the molecular mechanics of healing described in an article by Roger Cole, Ph.D., not about sports hernia, but about hamstring tendons for Yoga practitioners. Here is an excerpt:
When a student first tears a tendon, many of the tiny blood vessels (capillaries) that feed it are destroyed. During the first 72 hours after injury (the inflammation phase), the body?s main job is to stop bleeding, clear away damaged tissue, prevent infection and lay the ground work for later repair. Stressing the area with stretching or strengthening exercises during this time will only further tear the tendon and its capillaries, undoing much of the work the body has done and making the injury more severe.
If the inflammation phase is allowed to run its course without disturbance, the body will enter the repair phase, which lasts six weeks or so. It begins this phase by setting up a delicate molecular and cellular matrix that serves as the framework for reconstructing capillaries and connective tissue. It then starts the initial stages of filling in this matrix.
A healthy tendon is made of collagen fibers arranged in an orderly way, making it strong and somewhat flexible in the direction of pull applied to it. However, at the beginning of the repair phase, the body lays down new collagen fibers haphazardly. This is a crucial time. If the student systematically applies very mild force along the lines of the healing tendon (by practicing extremely gentle strengthening and stretching asanas), the collagen matrix will become aligned in an appropriate way. The body will then lay down new fibers of the right type and connect them to one another in the optimal orientation to produce a strong, slightly flexible tendon. If, instead, the student does not apply any stress to the tendon after the body lays down the initial collagen fibers, the body will continue to lay down new fibers haphazardly, and connect them randomly. The result will be a weak, thick, inflexible scar.
Here's useful site dedicated to sports hernia (athletic pubalgia):
Sports Hernia Forum
I agree totally. Surgery is gonna be an absolute last resort for me. I'm no pro athlete and still have little confidence it would solve my SH completely. I'm hoping the Dynamic Ultrasound with Dr. Muschaweck will allow me to understand how big my tear is. If I can rehab this in a year, then I will go that route. Over the past 10 days I have reached a point where my groin/testicle pain has subsided, along with the feeling of the "fold" in my lower abdomen. This has been done with rest and consistent 20 on / 20 off icing. I walked for 20 minutes the last 2 days and did quite a bit of stretching and still feel good. My next phase will be to start a core-x and abdomen stretching routine after my visit with Dr. Muschaweck. It took me some time, but I have come to grips with what has happened. Mentally I am in charge now.
Mike in Va
Hey Mike in VA,
I like your surgery-free approach, but worry a little about your stretches.
Check this out from Sports Hernia Forum to compare notes:
Mike in Va...just so you are not mistaken about Dr. Muschaweck's technique with the dynamic sonogram, she is not looking for tears but for bulges. She is traditionally a hernia doctor. Her theory is that SH sufferers exhibit an incipient or occult hernia, a pre-hernia, if you will; and the pressure placed on the nerves in the spermatic cord from the weakened posterior inguinal wall is the culprit. If she finds this evidence, she will suggest her 'minimal repair' surgery on the affected area ONLY. Much like German car makers, she seems to embrace the theory that 'less is more'. In a traditional hernia operation, the entire posterior inguinal wall is incised and layer-sutured back together. She does not do this unless the entire posterior wall is shredded or obliterated. Just a little clarity so you are prepared for your April appointment with her.
When I had my ultrasound done by her, I took a friend with me and she was easily able to see the 'looseness' and 'over-elasticity' of my posterior inguinal wall when compared to my good side. Plus, I was somewhat proactive and had the same dynamic sonogram done by an American radiologist PRIOR to seeing Dr. M just to see if someone else, other than her, could see a problem with my posterior inguinal canal...and he did - identical diagnoses: weakness and/or deficiencies in the posterior inguinal wall canal.
Thanks Monci. Did you have the Minimal Repair Procedure? Going in for an MRI this morning, knowing they won't find much but just following the process. Been off NSAIDS for 72 hours, sore. I hate this injury!
Mike in Va.
Thought it might be helpful (or not) to post... I was monitoring this thread religiously last year and I even posted a couple times...
I was diagnosed by Dr. Muschaweck (during her US visit) as having a bi-lateral SH. One worse than the other. I was thrilled to finally have a diagnosis. For 2-3 years I've had discomfort and multiple bad diagnosis (eg osteitis pubis, etc). I schemed and planned to get the procedure in Germany paid for by my health insurance, even got a second carrier through my wife's work, but was never satisfied I wouldn't have to pay the majority out of pocket, so I never scheduled the surgery (Dr. Muschaweck's office was awesome in trying to work with me)...
All the while, I was inching my way back into health. First, I took 4-6 weeks off anything that aggravated the injury. Then I started working back, limiting my running and doing more swimming and cycling. The whole time I did a lot of core/ab work and introduced abductor/adductor work (which I never did before)... Also some yoga on my own...
Little by little I got back to playing basketball. And running (although I kept the miles way down)...
Now, a year after the diagnosis, I'm training for my first triathlon (Olympic) and I'm playing basketball once/week. I still feel the SH, but it doesn't limit me any more than being 37 years old limits me. Just another injury from my past...
I'm not sure I know exactly what worked what didn't. I'd also think that maybe I didn't have a SH after all, but being diagnosed by Dr. Muschaweck herself seems to say otherwise. Maybe it's just a matter of time before I get reinjured? Who knows. I'm definitely more careful now in terms of overtraining...
Hope that was helpful...