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

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Surf

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10 years ago 05/15/2009 9:21am CDT
re: Albert

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Albert -

How does one work the adductors in the pool? Stand straight up in waist deep water and sweep the foot back and forth?

For someone like me who is trying to heal without surgery, would you recommend the pool adduction? I notice that my adductors are slowly but surely getting more and more troublesome. Mainly due to the fact, I think, that I've recently completed moving to a new residence, with much boxing and unboxing, stooping over, etc. Now I'm trying to avoid any activity other than walking, hoping the adductors will cool down.

Surf
Albert

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10 years ago 05/15/2009 9:45am CDT
re: Surf

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Surf-

the pool excercises entail just walking 5 lengths front and backwards and then slow adduction and abdution as well as flexion and extension.

Before the surgery I could not adduct without alot of pain. It would also set off my compartment syndrome. Posterior leg edema.

I think my tears were bad but I know when i tried to walk/run in the pool last year when i slipped on the botton I would set off the AP something fierce. I also could not swim without bad pain.

Today i am increasing my walking to 55 minutes at a time and am up to 3.1 m.p.h. Does not sound like alot but 3 days ago i was only getting up to 2.7 mph.

I am following the doctors rehab program to a T.
Albert

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10 years ago 05/15/2009 10:40am CDT
re: Surf

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According to Dr. Meyers the adductors get the injury because they are now left unopposed when there is a tear in the Rectous Abdominous. If you look at some of his clinical papers he clipped the RA in cadavers and the pelvis snapped anteriorly so violently that it almost cut the researchers hands with the bony processes of the pubis. So if you think about it simply it makes sense.

RA holds pelvis in neutral and when it is unopposed the adductors pull down even more on the pelvis. Your body will then try to compensate against this with all it has. This will include the whole pelvic girdle. THis is why many of us will have back pain, muscle tightness and then eventually the other side gets effected also. Almost like an old dresser drawer that you have to jimmy one side at a time.

According to the OR report i had calcium and fibrosis on my adductors and he debrided them.
Surf

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10 years ago 05/15/2009 2:02pm CDT
re: Albert

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Albert -

Interesting for sure. I guess to put it more precisely, the fascia attachment point at the pubic bone in a healthy person is fastened to the bone, and is being pulled upward by the rectus abdominis and simultaneously being pulled downward by the adductor, more or less balanced against each other.

Then in a sports hernia patient the rectus abdominis tears, and so the adductor is now unopposed, and when it works or contracts, it yanks the now unsupported fascia attachment point tending to pull it off the bone, damaging the fascia tissue (tendinosis).

So, what started out as one injury, a single tear in the rectus abdominis becomes 2 injuries: a tear in the rectus abdominis and a seriously damaged fascia attachment tissue where the adductor attaches to the pubic bone.

Does that make sense or am I missing something?

Surf
Surf

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10 years ago 05/15/2009 2:05pm CDT
re: Surf

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Test

bold

[url=http://f.imagehost.org/view/0930/275px-Rectus_abdominis]

http://f.imagehost.org/view/0930/275px-Rectus_abdominis

http://f.imagehost.org/0930/275px-Rectus_abdominis.png
Albert

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10 years ago 05/15/2009 3:23pm CDT
re: Surf

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Surf-

Please read the papers by Meyers I sent you. He explains it so much better than I do. What also happens if the tears are severe enough like mine were is the adductors get overloaded and can not do all the work. Then they shorten and scar. (IN fact mine had to be debrided of calcium). It also created a posterior compartment syndrome and that my friend is hugely painful. (leg pressure feels like it will explode through the skin and becomes hypersensitive to material and anything touching it)....

This is your bodies way of trying to brace itself.

My friend who was diagnosed last year by Meyers and decided to rehab himself is being operated in July. He has lesser tears than me and is in tip top shape. He has tried it all. Core strengthening, PT, Egoscue, Prolo and it continues to deteriorate. In fact now he is having SI issues on the other side as well as adductor tightening. It is only logical that the other side has to overcompensate. That also happened to me near the end. My opposite side would tighten something fierce from my hamstring to my QL in my lower left back.

When I asked Meyers what was going on and he said it is basically like pulling out an old dresser drawer one side at a time. Eventually it all gets weakened until the pelvic floor is stabilized. Go to a local NMT or someone who knows anatomy and have him show you on the skeleton the motion of the osteo pubis joint and its movement. You will be surprised that it is a functioning joint that effects alot of things. Especially pelvic tilt. if the RA is totally torn the effected side torques down anteriorly, yet the opposite side does not so now the sacrum is torqued so to speak. If you go to any therapist they may say any number of things to you such as you have one shorter leg than the other (which you do because of the pelvis being torqued), that you have SI joint issues (similar symptoms) Forward tilted pelvis and on and on.

I am amazed that as i progressed over time more and more symptoms were popping up. The last was Plantar Fasciatis and after surgery that was also gone. I think since my legs are no longer in hyper-spasm tightness the soleus and anterior peroneals have relaxed which many times is the cause of PF.

My friend was able to still do the resisted sit-up pain free which i could not.

It may be worth it to get examined to put your mind at ease.

Surf

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10 years ago 05/15/2009 3:42pm CDT
re: Albert

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One thing is for sure, sports hernia is a complex disease. Here's another outcome, courtesy of another poster, SND:

http://g.imagehost.org/0918/SND_Post.gif

Surf
Albert

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10 years ago 05/15/2009 8:47pm CDT
re: Surf

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Today I was looking at my rehab protocol and I am on day 2 of my pool walking which is coming along. i was feeling very good and upped my treadmill walk to 3.3 mph for 50 minutes. i was nervous but it felt good. when i was done my groin/adductor tightness was gone and 5 hours later is still gone. i do not know if i loosened scar tissue or not.

So i read the sheet and it said you can try light jogging. Let me tell you I have not / could not jog 10 feet for the last 4.5 years. Well off i went. I jogged the whole 50 yards of my driveway and then back again. It felt amazing and i nearly cried like a girl because i never thought it possible, especially at day 9 post surgery.

Well tonight I went to my buddies baseball game and they have a walking trail at the park and i did a nice quick 1.5 mile walk........and then i did it again....a jog. this time it was 1/2 the distance of the outfield fence. i could have gone further....but i am out of shape and i want to pace myself.

Man...i feel good. I can not believe this. the only pain i have is just incision tightness.

I am truly blessed.
Surf

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10 years ago 05/15/2009 9:29pm CDT
re: Albert

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Albert -
That's great news, and gives us all hope.

Remember to give yourself time to heal. For me, there is about a 33 hour lag from the time I perform any irritating exercise and the onset of the consequent soreness.

I haven't jogged even 10 feet in about 3 months now, myself. I'm going stir crazy.

Surf
Surf

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10 years ago 05/15/2009 9:42pm CDT
re: Albert

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SKIN SENSITIVITY AND SPORTS HERNIA

I went to a movie tonight and my adductors are more sensitive to little tugs and pulls of the velvet seat against blue jeans than are healthy muscles. The result was that my adductors were tense, unrelaxed the whole time.

I also notice that sometimes while walking the waist/belt of my pants can simply touch my groin and cause groin pain. All this suggests to me that there is a nervous system signaling element in the complex disease we call sports hernia.

I'm wondering if anybody has tried smoking marijuana to calm the skin/adductor over-sensitivity? I haven't smoked pot in a few years but I'm thinking of trying it to see if it calms my adductor irritation.

Does anybody know of anybody smoking pot while suffering from sports hernia? Probably a long shot.

Surf
Surf

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10 years ago 05/15/2009 9:50pm CDT
re: Mike in Va

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Mike in Va -
Notice in Albert's list of surgical items performed, the tear in the rectus abdominis is sutured (I think), and then some things are done to adductors.

I'm wondering if in Dr. Muschaweck's expected suturing of the "bulge", is that in other words, suturing a tear in the rectus abdominis?

Surf
Albert

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10 years ago 05/16/2009 2:12pm CDT
re: Surf

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Surf-

I do not know about that area. However, i can tell you that my posterior compartment syndrome made the skin behind my knee and upper calf very very tight. Some people said I had hypertrophy but it was from the edema. I chose to wear shorts as much as possible because the skin became hypersensitive due to its tautness. In fact I would try to avoid water spraying on it in the shower.

Instead of all this speculating why not just get it checked out and get a firm diagnosis and then formulate and attack plan.?

Surf

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10 years ago 05/16/2009 3:22pm CDT
re: Albert

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Albert -

When I have pain in my left groin I can usually get it to disappear for a while by simply stretching my left hamstring a little bit.

I normally sleep on my side, but I notice that that allows my hamstrings to shorten up. Then when I wake up after sleeping in this side/fetal I straighten my legs and now I feel my adductors tight too.

So I'm attempting to sleep on my back or stomach so as to keep my legs straight for those 8 hours.

I'm wondering how everybody else that has sports hernia normally sleeps (what position), and if they happened to have had any nagging tight hamstring before they came down with sports hernia.

Surf
Surf

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10 years ago 05/16/2009 3:25pm CDT
re: Surf

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Correction to my above post: My left groin pain can be made to disappear for a while by doing a gentle stretch to my right hamstring.

Surf
Albert

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10 years ago 05/16/2009 6:20pm CDT
re: Surf

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Surf-

I did notice if i slept with my leg straight it felt better...Not good, but better. I never had tight hamstrings. My quads were tight, my calves were tight, and my hips were tight. Hope that helps
JCsportsman

10 years ago 05/16/2009 8:32pm CDT
re: Surf

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Surf wrote:

Albert -

How does one work the adductors in the pool? Stand straight up in waist deep water and sweep the foot back and forth?

For someone like me who is trying to heal without surgery, would you recommend the pool adduction? I notice that my adductors are slowly but surely getting more and more troublesome. Mainly due to the fact, I think, that I've recently completed moving to a new residence, with much boxing and unboxing, stooping over, etc. Now I'm trying to avoid any activity other than walking, hoping the adductors will cool down.

Surf

Thought Id finally chime in since Im going for surgery on 7/15.......Im Alberts friend that also has the SH....If you have SH...its not going to heal.......Im going on 5 years and have tried it all.....the latest just recently even had 2 very expensive PRP Prolotherapy sessions in Feb and Apr........even been taking HGH daily injections......not working.....Im thinking MAYBE if you catch it very early, dont have a complete tear /detachment from the bone and you do the right things you might stand a chance to nip it...but if its been a long standing thing no way.....body will go into all kinds of dysfunctions...early on I only had the low ab/pubic pain.....over the course of the last 5 years all kinds of new stuff started popping up little by little not in any particular order...Hip, groin, low back, SI, Mid back, QL, Psoas, Glute, Sciatica, Hamstring, knee, shin, foot, shoulder pain or tightness...after 2 years I had some really good DMX xrays taken by a top Chiro ...heres the dysfunctions my body went into from this Damn SH....Slight curve in my spine to the right.....Sacrum/Pelvis was tilted down 7mm and rotated forward, to the right and down ...left hip was higher, short right leg..........when I sit it feels like my sit bone is going to come right out thru the skin it hurts so bad.....before this I never had an ounce of pain and I was averaging about 200 games of Softball year round....I remember the day I felt this sharp pain/ tearing feeling in my low left ab...and from that day on it was hell.....didnt get the correct Diagnosis until 4 years later..hence all the dysfunctions...thru all those years there were times I felt like I was close to getting to 100%.....things would change constantly from where the pain and tightness was and even sometimes swithcing to the other side...but that one spot in my low left ab/pubis always seemed to be there...and it could feel pretty good for a period where I could play 4 games in one day or it could give out to the point where I could barely take a step and would have to take 2 weeks off ...

But you really cant compare your symptoms to everyone elses since some may be the same and some may be totally different depending on what is going on.....there could be so many different combinations of what is torn etc...I think there slike 13 muscles/tendons that attach to that pelvis/pubic bone area...but most seem to all have the torn Rectus

I know for me and Im sure for Albert too I wish someone could of pointed me in the right direction 5 years ago instead of all the wasted tests, Docs, $$$, Diagnosis etc....would of loved to just have 1 MRI tell me what it was or wasnt and be done with it

All I know is I hope my rehab and luck goes as well as Alberts is going cause I too will go at it 150%....Looking foward to getting past this after 5 long years of chronic pain ...Right now Im sitting here and my left sit bone kills, my left groin is aching like hell and my low left ab/psoas area feels full of pressure and tightenss like water balloon is stuck in there......this morning it was my opposite groin that was all tight and locked up...crazy.....Good luck to all
Albert

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10 years ago 05/16/2009 8:58pm CDT
re: Surf

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Surf-

You seem like a great guy. However, you remind me of me my first few months after JC suggest i had this. I knew in my gut I had it, but i was convinced to find as many therapists and people to tell me what i wanted to hear. I got 5 people who were "healers/therapists/doctors" who told me now way i had it, i would not be able to walk. One of these guys is a world renowned inventor of a muscle lenghtening robot and he got me out of pain countless times and Knows the body like nobody else i know. He is amazing. Yet when he told me it was my ultimate validation to knowing i did not have it and my frayed RA would heal.....Yet I knew in my gut. My body also unraveled. Opposite sacral pain.....leg tightness...sit bone pain.....the list was expanding....

I know why....because I was afraid. I am sure you are too. I told myself at the least I would get a diagnosis. In fact I was still convinced I could heal it. So convinced that unlike ALL his out of town patients I DID NOT schedule the next day surgery.

However, after he showed me clear as day the tears I knew. He also put me at ease and gave me confidence. He did not try to talk me into anything or pressure me. He told me my options and he truly believed he could help me.

Do your self a favor my friend. Buy a plane ticket to Philly....(mine was $49 one way with Southwest)and I flew back the same night.

When I flew back i had a sense of peace and finality. I had been through the ringer....in terms of pain (i was now disabled for 2 yrs), emotionally after being to 19 therapists/docs/NMT's/CHEK/Egoscue and financially (i estimate it cost me 300K lost wages and 88k out of pocket for treatment....

Give yourself the peace of mind. It was the best thing i ever did. I know now that the healing is up to me and like Waves says we have to find the underlying causes and address those. Meyers built the foundation and now i have to build the new house.
Surf

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10 years ago 05/16/2009 10:00pm CDT
re: Albert

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Albert and JCSportsman -

I'm certainly considering going to Meyers. Don't forget that almost all the doctors surrounding sports hernia suggest treating SH conservatively with rest, and when that fails, go with surgery.

Another factor is that I have no insurance and no funds available. However if I become convinced that surgery is my only best way, I suppose I'll have to go into debt for the surgery if possible.

The other side of the coin is that anybody who carefully reads this gigantic thread at LetsRun, and pays attention to what they're reading, will come across many instances of surgery, by both Meyers and other surgeons, not working out well.

Although I want SH to be simple, it's not simple at all. I really appreciate everyone who comes to this board, like you guys have today, Albert and JCSportsmen, and share their experiences. Sports hernia is bigger than any one sufferer or any one doctor. But by collaborating and exchanging many experiences and angles of view, I do think that all of us together, our intellects combined by reasoned argument and discussion, will make progress against SH for ourselves and for future sufferers.

Even if you have surgery, your battle is only half-way over. One thing's for sure, sports hernia ain't simple.

Surf
Albert

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10 years ago 05/16/2009 10:30pm CDT
re: Surf

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Surf-

I am sorry about your insurance situation. I have been there myself. If you have an inkling you have it you are better off getting insurance for a few months and then going in. It will be far less expensive than going in right away and getting hit with a 20k bill.

The school of thought is NOT always conservative first. That is from doctors who can not make a firm diagnosis. It used to be that way because AP was a diagnosis of exclusion many times. If you look at the beginning of the thread you will see that the MRI's did not show anything but the clinicl exam was positive. However since the new 4 plane ? MRI was invented and put to use about 1.5 years ago the tears show. So if there are tears no rehab will make them reattach. When a tendon tears in that area...it is only a matter of time before other things hurt too.

Surf,

I wish that were the case.....if it were I would have healed a 100 times over because when it started I was hardcore....(a boxer in crazy shape)...as time and pain increased it sapped my will....

Anyways, only you know you. I can only offer my 2 cents. I was where you are sitting in October and then I had short term insurance (like having none at all....because my lumbar MRI was $2400 and i had to pay $2,200 of it)....It was that time that i knew I needed good insurance...just in case...

I think by reading things here also is that we are all different and there are 18 variations and over 120+ surgical combinations for repair.

Funny thing is most are left sided and mine is right sided. I read here that some people found it uncomfortable to drive for 4 weeks. Mine is my right side and driving pre-surgery always spasmed my adductors....Driving at day 3 was uncomortable and at day 10 is no problem driving an hour each way to work.

I can not believe how good i feel and judging by others my incision is 3x as large.

I am also 30 pounds heavier than ever before in my life. I can not wait to get in shape again.....
Albert

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10 years ago 05/16/2009 11:38pm CDT
re: Surf

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There are not many failures by Meyers and I would guess by The Munich Doc either. in fact their return to sport rate is in the upper 90% range. in fact i think it is 97%ish. I would suggest that will be even higher with the advances in diagnosis.

Is SH simple? I know it is understood by Meyers. I think anything new can be said is misunderstood by the medical community. I have to respectfully disagree with you (and I am a skeptic and cycnical by nature).

I think if you approach this injury with such a negative twist it can only be implanted in your mind that way.

You use terms like battle and half-over. Surgery for this allows us to get better so what you look at as a "battle" i look at as an opportunity....to get better.

Even the so called negative posts say they eventually heal so it tells me that meyers did his work. Most people expect surgeons to operate and wa-lah...all better. This may be true in many cases but live waves2ya says after meyers puts you together it is up to the patient to strengthen themselves.

I think why i am healing fast is prior to this last year I was in good shape and the basis for healing is there. also I have it in my mind i am getting better..PERIOD..
The mind plays a huge role.

I will give you an example. Prior to surgery I was in pre-op. I was one of the last to be operated on for the day....3rd to last to be exact. Anyways I saw 5 people in post op...Each one was moaning and groaning and 1 was actually crying and yelling. So much so the RN yelled at him to tell her what hurt...>He was incoherent and just yelled and yelled. NO dount this alarmed myself and the 2 young football players who were among the last 3. I kept telling myself I will come out clear and pain free....over and over to myself. When i awoke I was lucid and conversing with the nurse, even joking. I declined the pain meds and she insisted and gave me my shot of fentynal and morphine. I kept talking to her....got 3 glasses of water and graham crackers. She told me she would wheel me up to the room. We laughed the whole way up and she said it was fun to talk and joke. Also the youngest football player also came out laughing too. The Running Back came out crying/complaining. He was my roomate. We both arrived the same time. i was drinking asap and was up to pee in 1 hours time. I was walking the halls at 2 hours. At 9 o'clock i was changed and asking to be discharged. At 10 i was discharged. At 9 he was crying (really crying to his mom), had not been up and had not eaten. I told him that he should try to pee and get up. I went over and put the Celts game on for him and tried to coax him it was not that bad. I was able to help him up and to the bathroom. It was the fear of moving that is worse than the pain.

My point is that i set my mind to getting out that night and i was out. He was talking pre-surgery about how afraid he was and how much pain it is going to be. You manifest what you concentrate on.

We are not going to make any breaktrhoughs for SH sufferers. We are just a bunch of guys who have it......we can say what worked and what did not, but the speicalists are the guys who live this 24/7 365.

No disrespect but i will take what meyers says over what anyone on a forum has to interject on the topic. This man has dedicated his life to this cause. I really think you are making this soft tissue repair more than it is. Is it a pain in ass and scary because most of us have been through the ringer....YES.....but the diagnosis is simple....the surgery is simple.....mine was all of 47 minutes....My wisdom teeth took longer....

I would take this over my ACL surgery, my broken hand repair, my torn meniscus surgery, my back surgery (non-disc)....Each of those surgeries i did not hesitate because i trusted the doctor and they were common surgeries. I think you are confusing common with simple. I do not understand the comment about AP being bigger than anyone. What the hell does that mean? In my case Meyers was much bigger than AP i suppose. I don't know.

I will tell you this. If you do not have faith in the surgeon...regardless of what kind....do not get the operation. It is the wrong attitude to go in with.

I believe you are in a serious state of denial and are in fear. The more you research this....(real data not opinions of some posters...including me)you will find out MOST can not heal without surgery if it is AP.

Stay positive and keep your mind open. This is not brain surgery or life/death.