Mike in Denver,
I suspect you definitely have a SH. Here are some classic actions causing pain a lot of us have felt and now avoid.
Racking Leaves
Pushing Pulling a Lawn Mower
Riding a Bike
Walking in Water or Swimming
Sitting in the car for long periods of time
Getting in and out of the car/bed
Any kind of jogging/running or lateral movements with sports
Walking uphill or downhill (steep grades)
Sitting for long periods of time at a computer
Bending over and lifting objects over 20 lbs or moving boxes
Kicking a soccer ball with the injured leg
Maintaining balance on slippery surfaces like ice or on a slick floor in socks
Situps
Leg Flutters/Kicks while lying on the back
All of these actions put substantial stress on the lower abdomen and pelvic region where the tear or bulge along the posterior wall of the groin canal is located (in my case). The resulting areas where you will feel pain after these movements include the lower abdomen, the adductors, nerve pain down the inside of the injured leg, and the testicles. Some of this pain is the actual tear and a lot of it is nerve pain caused by the compression of the groin canal where some of your main core nerves are located.
Keep in mind that there are many different types of SH injuries, which is why diagnosis by one of the top doctors is essential before starting Rehab. Albert is a prime example of this. His knowledge in the diverse types of SH injuries through his diagnosis and surgery is a source of great information.
In my case, the injury is limited to the tear on the lower abdomen along the groin canal. Dr Muschaweck diagnosed a 1.6cm (cherry sized) bulge/tear in this area via ultrasound on April 16th of this year. After her consultation I started rehab, but it never got better. As soon as I attempted one of the above mentioned movements, the pain always came back. The lower ab pain is pretty much persistent 24x7.
Any PT you do should avoid stress to this core area and I think should be started only after seeing a doctor for a firm diagnosis. 90% of my PT that I have been doing for 6 weeks is done on my back lying down. Here are the exercises that I have done in order to help reduce the pain while awaiting surgery. These were acquired from Michael Boyle's site and Herniabible.com. These are the first 4 days of rehab. After 10 days I started to feel some relief from the harsh pain. I believe this is because I was able to tighten my lower abdomen and lift the bulge area just slightly off the nerves, but there was still pain..just reduced. I am continuing the routine until I leave for Munich in June.
Links:
Mike Boyle Explanation of SH and Rehab (2 articles)
http://www.sbcoachescollege.com/articles/UnderstandingSportsHerniaI.html
http://www.strengthcoach.com/public/1606.cfm
Hernia Bible Exercises
http://www.groin-hernia.com/herniabible/exercises.html
-------------------------------------------
1.6cm Bulge on Left Groin - Diagnosed April 16, 2009 by Dr. Ulrike Muschaweck in New Jersey
Day 1 - April 17th, 2009
Cook Hip Lift- single leg bridge holds - 3 Sets of 10 reps - no pain
Quadruped
Hip Ext (McGill Bird Dogs) - 3 Sets of 10 reps - no pain (back and arm suspension only, no legs)
Side Bridge- short lever - 2 Sets of 10 reps - no pain
Supine or Side Lying Adduction- 2 Sets of 10 reps - no pain
Bodyweight Squats- - 2 Sets of 10 reps - no pain
Reaching 1 leg Straight leg deadlift - 2 Sets of 10 reps - no pain
25 Minute Walk - after core exercises - no pain on walk
Stretch afterwards
Day 2 - April 18th, 2009
Pillow Squeeze using a Tennis Ball - 3 x 10
Cook Hip Lift- single leg bridge holds - 2 Sets of 10 reps (5 sec holds) - no pain
Laying on Back - arms above head (move opposite feet and hands up and down while moving abs side to side to stretch the core) - no pain
Quadruped Hip Ext (McGill Bird Dogs) - 3 Sets of 10 reps - no pain (back and arm suspension and legs, but not arms and legs together, legs alone) - no pain
Hamstring Stretch using jump rope (2 x 10) - no pain
Side Bridge- short lever - 2 Sets of 5 reps (5 sec holds) - no pain - these are hard
Supine or Side Lying Adduction- 2 Sets of 10 reps - no pain - these feel great on my abductors - do them slow and methodical - don't let foot rest at bottom
Bodyweight Squats - 2 Sets of 10 reps - no pain
Reaching 1 leg Straight leg deadlift - 2 Sets of 10 reps - no pain - surprised I can do these with no pain - feel great
25 Minute Walk - after core exercises - no pain on walk
Stretch afterwards
Day 3 - April 19th, 2009 (woke up feeling good, thought i'd have pain)
Pillow Squeeze using a Tennis Ball - 3 x 10
Shoulder Bridge - 3 x 10 (2sec holds)
Hamstring Stretch using Jump Rope - 15 sec holds per leg x 3 - felt great - hamstrings are so tight!
Knee Opener 3 x 10
Hip Rolls 2 x 15
Leg Lifts (hernia bible) 2 x 10
McGill Bird Dogs (Abs and Arms, no legs today) 2 x 10
Tummy Lifts on Stomach 1 x 30
Body Weight Squats 3 x 10 (use mirror)
Reaching 1 leg Straight leg deadlift with volleyball - 2 x10 (reaching to mirror)
35 min walk - brisk pace
Stretch afterwards
20 mins of icing on bulge area
Day 4 - April 20th, 2009
Pillow Squeeze using a Tennis Ball - 3 x 10
Shoulder Bridge - 3 x 10 (2sec holds)
Hamstring Stretch using Jump Rope - 15 sec holds per leg x 3 - felt great
Cook Hip Lift - 3 x 10 (3 sec holds)
Hip Rolls 2 x 20
Leg Lifts (hernia bible) 2 x 20
McGill Bird Dogs (Abs and Arms, 2 x 5 with legs only) 3 x 10 - abs and arms
Tummy Lifts on Stomach 1 x 30
Side Bridge Short Lever - 2 x 10 (easier today, less shaking)
Supine or Side Lying Adduction- 2 Sets of 10 reps - no pain
Body Weight Squats 3 x 10 (use mirror)
Reaching 1 leg Straight leg deadlift with volleyball - 2 x10 (reaching to mirror)
35 min walk - brisk pace
Stretch afterwards
20 mins of icing on bulge area