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Sports Hernia/Groin anyone? Recovery? "Minimal Repair" surgery? - Page 2

post #31 of 53
Quote:
Originally Posted by ralphbalfe View Post

Hey all - prior to finding this thread, I thought I was the only one in the world that was plagued by this injury.  Ive actually had two sports hernias (diagnosed) within the last 5 years.  The first one I got when I was 25.  I have always been an avid basketball player and was never one to stretch.  I would just walk in the gym and play.  For about a year - I experienced groin pain on my right side but always brushed it off - until one day I did a spin move and collapsed.  After months and months of Xrays, MRI's, doctors, specialists, etc., I was diagnosed with a sports hernia, and being that I am located in Philly, was told to see Dr. Meyers.  There was just a small problem - I did not have $15k stashed away in my studio apartment or friend's kegerator to pay.  So ultimately I had to stop playing basketball and it magically went away after about 14 months of inactivity.  

Fast forward to this year (I am now 31), I began to play basketball again but only once a week, and the same darn thing happened, except this time it was my left side and much, much worse.  Several months of groin pain, followed by a spin move (I was running as fast as I could down the court, planted my right foot to spin left, and felt two snaps within my abdomen and groin area.  The pain this time was much more severe and I ended up going to the hospital.

Now, I am back at square one.  Insurance wont cover for the surgery.  I am in PT but it is not effective.  I can walk fine and I regularly go to the gym but experience a good amount of pain when jumping or performing any sort of lateral movements.  It would hurt even if I picked up my 3 year old and put them into their car seat.  The slightest slip in the shower or in the kitchen will aggravate the pain.  It has been about 5 months since I went to the hospital and, despite healing naturally with my first sports hernia, I do not feel too optimistic that this one is going to heal on its own.

The ridiculousness in all of this is that this injury is brushed off by insurance carriers and I am afraid that we are among such a small population that its not profitable for medical professionals to put in the necessary time and research to get this right.  There are only a handful of sports hernia surgeons out there and they all have different approaches and they all hate each other - something is just not right.  

I will keep everyone posted on my condition and would definitely appreciate reading more about others' paths to recovery.  

As a recap, I am 5 months into my second "all-natural, fingers-crossed, give me a miracle" rehab.  If I am fully healed within 6 months or so, then hopefully this could be encouraging to those that are either reluctant to go the surgical route or that cannot afford to pay out of pocket.  Best of luck to all my fellow sports-herniators!

-Ryan
Get an ultrasound of the inguinal canal while performing a valsalva maneuver. If you see a bubble you got an hernia. Surgery is easy put a mesh in the hole to stop tissue from going into the hole itself.
If you have one rehab won't help you, sorry.
post #32 of 53

Hi guys,

 

I have been recently diagnosed with sports hernia. It took almost a year to come to this, I have been trying conservation approach for almost last 8 months. Thought I have seen improvements can't seem to get back to normal activities. I am from New Zealand, and laproscopic surgery seems to the only option with mesh. I am doing investigation on both mesh and non mesh would prefer a non mesh solution but can't seem to find anyone in NZ who would perform that. Anyone who has had sports hernia surgery with mesh were you be able to get to normal activities?

post #33 of 53
Quote:
Originally Posted by Jive1983 View Post
 

Hi guys,

 

I have been recently diagnosed with sports hernia. It took almost a year to come to this, I have been trying conservation approach for almost last 8 months. Thought I have seen improvements can't seem to get back to normal activities. I am from New Zealand, and laproscopic surgery seems to the only option with mesh. I am doing investigation on both mesh and non mesh would prefer a non mesh solution but can't seem to find anyone in NZ who would perform that. Anyone who has had sports hernia surgery with mesh were you be able to get to normal activities?


I had a mesh repair about three years ago.  Seems it was about a month before I got the okay to go at it again.  Don't let the no mesh hype get to you.  All that kinda freaked me out to, but I am fine now.  The mesh screens have gotten better as time has gone by.  The guy who fixed me up was a very skilled at the procedure.  Look for someone who does lots of them.  It won't get better, just worse.  You need a surgery to fix it.

post #34 of 53
Thread Starter 
Quote:
Originally Posted by Jive1983 View Post
 

Hi guys,

 

I have been recently diagnosed with sports hernia. It took almost a year to come to this, I have been trying conservation approach for almost last 8 months. Thought I have seen improvements can't seem to get back to normal activities. I am from New Zealand, and laproscopic surgery seems to the only option with mesh. I am doing investigation on both mesh and non mesh would prefer a non mesh solution but can't seem to find anyone in NZ who would perform that. Anyone who has had sports hernia surgery with mesh were you be able to get to normal activities?

 

Sports hernia isn't an inguinal hernia. 

 

Inguinal hernia = complete tear in fascia, with something (usually fat or a bit of intestine) that can/does pop through the tear and be pushed back in.

 

Sports hernia = soft spot in the fascia that can bulge (not visible to the naked eye; difficult for a non-sports hernia specialist to see even using dynamic ultrasound or feel with a finger) and if you are unlucky rub against a nerve causing pain.

 

Both can be fixed with or without mesh. Repair of both conditions is essentially the same as long as we're talking about a small inguinal hernia compared to a sports hernia (patch/strengthen the fascia). Non-mesh has a much higher failure rate when done by a non-specialist, and mesh has a much lower failure rate when done by a non-specialist-- hence why general surgeons (non-specialist) use (as they should) mesh. 

 

Ultimately, the peer reviewed literature indicates that the most important thing is the experience of the surgeon with the repair he or she is doing. Getting a mesh specialist to do a non-mesh repair seems to me (a layman; read: not a DR!) like a really bad idea. 

 

People repaired both by mesh and non-mesh can have complete recoveries-- and can participate in their sports at a level equal to before the injury. Some people repaired by both types of surgeries never recover, or have enduring, debilitating pain. Non-mesh repair, I take it, has advantages in terms of flexibility and lowering of the pretty low risk of some problem with the mesh contracting, balling up, entangling with nerves down the line. Mesh has advantages in ultimate strength and ease of performing the repair. A great surgeon, experienced in either method-- if that method is suitable for the injury you have-- can do a repair that will allow plenty of flexibility, and full return to sport. 

post #35 of 53
I read all your comments and posts and have a pretty good understanding of the condition. That being said....I have concluded (don't have insurance to get dr approved conclusions) that I have sports hernia. It however doesn't hurt at all doing day to day activities. I read some reports of continual pain after surgery but is this a continuation of pain they already had or new pain? I guess I'm trying to consider if surgery is a good option if I'm risking having pain that I don't currently have. Any opinions or information would be appreciated
post #36 of 53
I wish I saw this thread sooner. I am 24 years old and believe I have a sports hernia. I used to play soccer and do races. I have been having serious pain in my lower right abdomen and groin area. I have had serious trouble with diagnosing what it could posibbly be. I have bad pain standing for more than 30 minutes and can't wear tight pants/shorts. It aches down there constantly and i have sharp pain when i move. I've been dealing with this for over a year and it has ruined my life. I've been to a urologist, gastro, primary care, hospital and more. Ive had blood work done multiple times, a colonoscopy, two mri's, a ct scan and an xray. They thought it could possibly be my appendix and they took it out but it never stopped the pain. I went to a surgeon and he said it could be this. He said he has done about 12 mesh repairs for sports hernias. I am worried of the consequences of having a mesh the size of an index card put in. I read alot about complications, tightness of scare tissue, balling up of mesh, and it not stopping the pain and causing more. I live in Connecticut and cannot find a Dr that does non mesh surgury. I am tired of being in constant pain and don't know what to do. Should i just go for the mesh? I read that it worked for some but there isn't much discussion on the internet of either surgury.
post #37 of 53
Thread Starter 
Checking in to respond to the two above posts. Just a note: I'm traveling in Africa for two months for work... so don't count on me necessarily being able to weigh in during that time. Also, remember I'm not a doctor and I can't give medical advice...

Scottfish: This is one of those vexing, unsolvable issues. Yes, there is a chance of giving yourself lasting post-operative pain whenever you have surgery-- particularly in this area of the body. Don't quote me on it (you can do a Google or literature search and get ACTUAL stats), but I think post-hernia surgery pain (and sports hernia surgery is essentially hernia surgery with variations) exists in something like 30% of patients. Yeah, that's high. My biggest fear was being the unlucky percent who end up going down a rough route. You can search the literature for what the risk factors for pain are. Yes, some portion of those folks are having new or worse pain than before. I was told by my surgeon that he does his repair on the basis of finding a sports hernia AND the patient reporting pain; he is not doing work for structural purposes because it's not proven that sports hernia necessarily leads to inguinal hernia or any other physical non-pain based issue. That makes it harder: Is it worth risking pain to eliminate pain? Nobody can answer that but you, with some guidance from your doctor (and whatever you think the risk is). I'd put a major caveat on your self-diagonoses though: Pain in the lower abdomen/groin can be caused by 1001 things. There's referred pain from the hips, spinal stuff, tears, hernias, etc. I would surely not count on self-diagnoses-- and I'd be worried about any doctor willing to do surgery on the basis of self-diagnoses (I'm sure such a thing is illegal).

Chris: Nobody on the Internet, least of all strangers with a n=1 level of experience, can tell you what you should do. There is very little certainty when it comes to surgery. Everything is based on statistical chance. Some folks get repaired by mesh and are fine; others have issues. Some get repaired without mesh and are fine; others have issues. There is no right answer on this thing. Which is what makes it frustrating/difficult. And there's little in the way of strong, double-blind, randomized research that's easy to normalize and make it super clear which repair types are best. My reading of the literature is that the most important predictors (on the doctor's side) of positive outcome is: the doctor's degree of specialty with the type of surgery being done, the doctor's total number of repairs done with that type of repair, and the doctors age (old age is not a good predictor, but you can bet the super young ones don't have the experience). I'd rather have a doc do mesh who has done mesh 500 times, including 10 a month in the last few years than a doc who has done maybe 50 repairs and only 3 without mesh in the last few years.

My understanding (and this comes specifically with hernia repairs; there's not enough literature on sports hernia, even if repairs are nearly identical) is that mesh is so popular because it has a much lower failure rate than non-mesh-- when performed by a general surgeon. It doesn't have to be a work of art sort of repair to hold. Non-mesh is far more dependent on the surgeon's degree of experience and speciality. But a great surgeon can probably work wonders with either. I'd guess mesh is ultimately a stronger repair, but probably results in marginally less flexibility and higher rates of certain types of post-surgical complications (mesh contraction, balling up, rejection, etc). Non-mesh, as a rule, isn't as strong and is harder to perform. The worst thing, I think, would be having a non-mesh repair that falls apart!

And of course the bottom line is that there isn't really two repairs: mesh vs. non-mesh. Among both approaches there are many different approaches, styles, variations (open/lap, mesh types, mesh anchoring methods, layers cut and repairs, mesh placement, minimal repair, desarda, the canadian surgery, etc, etc, on and one). There are even disagreements over what sports hernia even is!

Sorry to not have a definitive answer for either of you. I know how frustrating and scary it is... I've been there. It's definitely a diagnoses worth considering if the pain is bad enough and nothing else has yet explained it. The next step is finding someone who is qualified and skilled enough to actually diagnoses it from physical exam/imaging...
post #38 of 53
Thanks for responding. I've been looking for non mesh surgeons because I keep hearing bad things about mesh. There seems to be only a handleful of drs that are capable of performing non mesh operations in the country. Unfortunately the closest one Dr Meyers doesn't take insurance because he's that good. If only I could have saw the future and not picked soccer as my main sport lol.
post #39 of 53

The incidence of significant chronic pain after hernia repair is probably around 10%. Studies that report incidence as high as 30 % are including pain of any degree and pain in the fairly short term. There is probably no significant difference in pain between mesh and non mesh repairs. The recurrence rate seems to be higher with non mesh. The reason one hears about problems with mesh repairs is because the vast majority of repairs are being done with mesh. If most repairs were being done without mesh then you would be hearing about those problems. Ironically, the mesh repair was first devised not to reduce recurrence but to reduce pain, by reducing the tension in the repair.

 

My practice was in a health plan where patients with pain or recurrence would come back to see me or a colleague who would let me know. I saw no difference in pain between the nonmesh repairs I did in the first part of my career and the mesh repairs I did the second. I did see several recurrences in the roughly 500 nonmesh repairs I did and none in the similar number of mesh repairs. I saw one patient with significant chronic pain after a mesh repair. Over the years I continued to modify my technique to reduce the risk of chronic pain--use of light meshes and interrupted, absorbable sutures.Some of these changes were too late in my career to know if they resulted in a higher recurrence rate but it is easier to treat recurrence than chronic pain.

 

My experience as a patient is that I had a hernia on both sides, both repaired by the Shouldice technique--a non mesh technique that is somewhat more difficult to perform. I picked the surgeon, not the technique, and the surgeon later changed his technique to mesh. On one side I had some pain for a couple of years, but the pain was minimal, didn't interfere with activities, and eventually went away completely. Had I been in a study I would have been considered a patient with chronic pain. 

 

I have no experience doing surgery for sports hernia.

post #40 of 53
I ended up finding an experienced Dr who does the mesh. He actually found a very small real hernia. I get the surgury mid may so we'll see what happens. I will post how it went afterwards and whether i still have pain.
post #41 of 53

Hello,

 

Justruss, hearing your recovery process was extremely helpful and relieving. I am 20 years old and a collegiate pole vaulter. Right around the middle of January I woke up with a hitch in my right groin. I brushed it off as a minor body ding, but as the season progressed it got worse and worse. After 2 weeks I did some research and immediately suspected a "sports hernia". However, none of the athletic trainers were convinced (as well they shouldn't have been, given that it was so early in the injury). I took 6 weeks off, rehabbed to strengthen the muscles around the core, and continued participating in weightlifting and various activities like volleyball, with no pain. I started conditioning again (i.e, lots of sprint work) with little to no pain. I did 8 weeks without vaulting/explosive jumping. My first practice back, within 3 takeoffs, my groin was on fire and it hurt to walk. I got sent to a team doctor and was diagnosed with a sports hernia. I was sent to another doc for a second opinion and he too said it was most definitely a sports hernia. Surgery was delayed until May 27, with the initial injury occurring in January. Obviously, I was out for the season, but was told I couldn't make it any worse, so I would play basketball once in awhile for about 60 minutes until the pain was too much. I continued jogging and doing short run pole vault drills to keep my core strong. Running was fine, but jumping explosively off my left leg absolutely killed me.

 

Anyways, I got the mesh surgery May 27 with general anesthesia. My doctor was fairly experienced, and said everything went well. One incision 1.5 inches in length, He said he could actually see the tear which surprised him, as most are microscopic. After the surgery he told me in a perfect world I should walk "12 hours naked tomorrow morning!" 

 

Recovery day 1 I walked about 3 miles with a 3/10 pain and a hitch in my step. Not quite 12 hours, but I tried ;). I was prescribed Norco which I definitely needed. Coughing and sneezing raised the pain to a 7/10, and laughing was extremely uncomfortable. I did find that the longer I walked, the better my leg felt throughout the day. I stopped the narcotics after 4 days, and am continuing to walk between 2-5 miles every day. It is now day 9 and pain is very minimal. I am hoping to start jogging after 2 weeks. I want to take the recovery slowly because the summer is our off season and I do not want this injury returning!

 

If anyone is still interested in this topic I will update as well, because like Justruss said, there are not many positive recovery topics about this fairly unknown topic of sports hernias. I should add that both doctors I went to said there was no way of recovering without surgery, while my surgeon said the surgery only speeds up the process, but eventually it WILL heal on its own. He actually prefers not to do the surgery unless the patient is young in athletics (like myself) or a professional athlete where a quicker recovery is absolutely necessary. i.e, he won't do the surgery on a 60 year old who plays pickup basketball all the time, he will tell them to "pick a different sport". As someone who will be involved in athletics my entire life, this was very irritating to hear, but since he agreed  to do the surgery if I desired, I wasn't going to bring it up.

 

P.S. My doctor said they call it a sports hernia so the insurance companies will pay for it. While it is not the technical term of course, the insurance companies don't cover athletic pubalgia because it's "exploratory."

 

Sorry for the long post, good luck to anyone considering/rehabbing from the surgery!

 

Jon

post #42 of 53

I have been recently diagnosed with "sports hernia", the MRI showed I have on both sides.  I have been to a orthopedic surgeon which has did some research as to where to send me for a specialist in this field.  He said there isn't any in Montreal, Ottawa or Toronto, so I'm now wondering what direction to go in now.   If anyone with this kind of injury knows of a surgeon in this field, please send me a message, I have been suffering almost 2 yrs. now and need some relief. Thank-You   Tammy

post #43 of 53
Thread Starter 

I've been away (and I am again: in Vietnam), so my check-ins aren't all that frequent. But winter is coming... and I'll be back for Oktoberfest. :)

 

Thanks for the great additions here, folks. It'll be great to get a few more experiences over time. 

 

A few notes:

 

Oldgoat nailed it: Choose the surgeon, not the surgery. That's what I did. I'd have been comfortable with either repair, though I leaned towards non-mesh, in part because the surgeon/center I went to recommended it for someone of my profile (athletic, thin, lean muscle mass, flexible, the sports they asked about my desire to continue doing-- this was a question on the intake form). We agreed that when they did the surgery I would defer to the surgeon to do the surgery he thought best once confronted with the open area... if he thought mesh was needed (he didn't think it would be) he said he'd use mesh. Like Shouldice, the repair I had claims to be tension-free, though it's really more like tension reduced. They use a continuous stitch (non dissolvable!), and do a little trickery to reduce tension on the repair by shifting it to an oblique insertion/origination point. Honestly, it's not all that different, just refined and personalized a bit.

 

Sports hernia (athletic pubalgia... painful groin in athletic movements) is a contentious topic, and some insurance considers its treatment experimental/exploratory. I think the official diagnosis in German for mine was weiche Leiste, or "soft/weak groin"-- which sounds like a bit of an insult. :) 

 

Classic symptoms are those after or during sport, particularly with explosive and cutting movements that put shear forces across the groin. Mine fit that profile, and was far worse when it was cold (I was tight). 

 

In any case, I'm still feeling damn near perfect, and boulder hard about 3 times a week (often hitting very tense positions approaching splits, and doing pretty hard core moves)-- touring, skiing off-piste (powder is softer anyway). 

 

Keep the stories/experiences coming. And if you register just to pop into this thread, please don't just make it a drive by asking for advice since this is a bit of a tight community, and only a real doctor can diagnose and treat you. I think we'll take sports hernia + sports experiences just to get more datapoints... bonus if you ski or do snow sports! 

post #44 of 53
Hello all. This has been a very informative thread that I stumbled upon after hours of research on sports hernias (athletic pubalgia). Thank you all for your inputs here! It's also quite encouraging to find that I'm not alone in discovering that there are very few surgeons/doctors that are aware of how to diagnose (much less repair) this nagging injury.

What happened to me:
I'm 38 and a daily surfer that likes to push it. Not that it really matters, but I'm relatively advanced in the sport, which can lead to putting myself in awkward positions under load at times. Ironically, during a relatively benign top turn while surfing in June 2015, my injury was of an acute nature that suddenly caused piercing pain in the lower abdominal seam along the "V". The pain was very localized and it seemed I clearly strained/tore the muscle in the area.

Treatment:
Went to my primary care doc. He agreed that it looks like we have a strain situation. Ordered rest, ice, and some pain meds and expected pain to subside over time. Follow up appt was made for 3wks later. After 3 weeks of laying low, I tried once again to surf (not aggressively) only to find the return of the localized piercing pain after a simple bottom turn. Same spot, same level of pain.

Doctor then ordered 2 months of zero activities that flare up the pain (plus physical therapy). Ok so fast fwd 2 months...the pain had subsided to mere tightness in the area and stretching/strengthening exercises ordered via PT seemed to be helping. I did, however, notice that the area where the abductor attaches to the pelvis that I would call my groin (the surgeon hates when I use this term and I'm not 100% sure of the anatomical description accuracy here anyway) started to hurt in addition to the original local site at the ab "V". The groin hurt worst with lunges.

I had done zero activities that flared up the ab injury for months, and while the new groin pain was disconcerting, I figured I'd take a positive outlook and assume I was on the road to success. Mind you, by this point I was concerned that this was the notorious "sports hernia" based on lots of research that I'd been doing over the 3 months since the injury. This was especially the case with the newly acquired groin pain that I remember reading could happen.

I then had an incident while cooking. Yes, cooking. I was chopping up garlic when a clove squirted out of the bunch. I made a quick lunge to catch it to prevent the clove from dropping to the ground. The original piercing pain returned at nearly the same level in the localized area of that lower ab "V" seam. The doc got a call with "hey doc, I can't even cook without this thing flaring up, wtf?".

Now an MRI was ordered .... took a month to get in for an MRI so we're now into October 2015 at 4mo from the original injury. MRI showed zero anomalies. At this point I was nearly certain that this was a sports hernia. Yup, I read that negative MRIs are common amongst those with sports hernias.

Doc then sent me to an ortho surgeon/specialist that reiterated zero findings in the MRI, but he agreed that this is likely a sports hernia that simply didn't show up in the MRI. He then said he doesn't recommend surgery since it's only successful about 50% of the time. He added that the successful 50% population likely only improved due to the lack of activity during recovery from surgery. My research did not produce nearly as pessimistic of success rate for the surgical repair of a sports hernia, so I shook my head and moved on to find my own specialist.

I went to Dr Craig Smith in LA since he was the only sports hernia repair surgeon in the Southern California area that I could find. I brought my MRI. He didn't even bother to look at it because he has his own diagnostic procedure. He did several simple stress tests to isolate the pain area and how to exploit the injury. He also got my complete history and then explained I'm a textbook candidate for surgery to repair this clear case of a sports hernia. I asked about the added lower groin pain, which he said would go away once the stress on the ab tear site was relieved. He thought I was a perfect candidate for surgery because of the injury location along the "V", the time since the original injury, the attempt at R&R and PT, and the very localized size of the piercing pain site. Given all of this and my level of fitness, he estimated 85-90% chance of success with surgical repair. He said he often turns down surgical repair unless the case is textbook. This is consistent with what I've read across the Internet about him.

Awesome. Just the answer I was looking for. Surgery time.

I had my surgery a week ago (mid Feb 2016). He did what he called a bilateral laparoscopic hernia repair with mesh. He explained that he applies the mesh very similarly to a standard inguinal hernia repair, but simply extends the mesh much higher to extend beyond the site of pain. I'm sure it's a bit more complicated than this, but that was it in a nutshell. The mesh is intended to take the tensile loading placed on the injury site during strenuous activities, thereby eliminating the nerve flare up due to aggravation of the torn site. During surgery he did not locate a tear, but figured it was one or several micro-tears (acc to him this is not uncommon and the reason MRIs are typically negative).

Day of surgery...I was pretty knocked out after general anesthesia and easily could handle the 2hr drive back home (San Diego). Days 2-3 sucked....was painful to sit and I had difficulty sleeping because I couldn't even lay on my side without pain. I could shower immediately since the laparoscopic entry sites were all sutured with super glue which have held up perfectly...sweet. To my surprise, I could immediately walk without much pain and did so from Day 2. I have increased walking distance each day, and am already walking several miles a day. I am nearly ready to attempt lightly jogging. We'll see....Dr Smith said to push it as far as my body allows without reaching more than 3 out of 10 of pain. I'm very tentative to push this too hard because I want success, but I also think that pushing things a bit can help accelerate healing and increase flexibility to the repaired area.

After only a week, the originally injured site and lower groin are still sore, but I expected that so soon after surgery. I'm hopeful the pain will slowly subside and eventually disappear altogether.

Will keep you posted with my progress!
post #45 of 53
Thread Starter 
Quote:
Originally Posted by CaliforniaChris View Post

Hello all. This has been a very informative thread that I stumbled upon after hours of research on sports hernias (athletic pubalgia). Thank you all for your inputs here! It's also quite encouraging to find that I'm not alone in discovering that there are very few surgeons/doctors that are aware of how to diagnose (much less repair) this nagging injury.

What happened to me:
I'm 38 and a daily surfer that likes to push it. Not that it really matters, but I'm relatively advanced in the sport, which can lead to putting myself in awkward positions under load at times. Ironically, during a relatively benign top turn while surfing in June 2015, my injury was of an acute nature that suddenly caused piercing pain in the lower abdominal seam along the "V". The pain was very localized and it seemed I clearly strained/tore the muscle in the area.

Treatment:
Went to my primary care doc. He agreed that it looks like we have a strain situation. Ordered rest, ice, and some pain meds and expected pain to subside over time. Follow up appt was made for 3wks later. After 3 weeks of laying low, I tried once again to surf (not aggressively) only to find the return of the localized piercing pain after a simple bottom turn. Same spot, same level of pain.

Doctor then ordered 2 months of zero activities that flare up the pain (plus physical therapy). Ok so fast fwd 2 months...the pain had subsided to mere tightness in the area and stretching/strengthening exercises ordered via PT seemed to be helping. I did, however, notice that the area where the abductor attaches to the pelvis that I would call my groin (the surgeon hates when I use this term and I'm not 100% sure of the anatomical description accuracy here anyway) started to hurt in addition to the original local site at the ab "V". The groin hurt worst with lunges.

I had done zero activities that flared up the ab injury for months, and while the new groin pain was disconcerting, I figured I'd take a positive outlook and assume I was on the road to success. Mind you, by this point I was concerned that this was the notorious "sports hernia" based on lots of research that I'd been doing over the 3 months since the injury. This was especially the case with the newly acquired groin pain that I remember reading could happen.

I then had an incident while cooking. Yes, cooking. I was chopping up garlic when a clove squirted out of the bunch. I made a quick lunge to catch it to prevent the clove from dropping to the ground. The original piercing pain returned at nearly the same level in the localized area of that lower ab "V" seam. The doc got a call with "hey doc, I can't even cook without this thing flaring up, wtf?".

Now an MRI was ordered .... took a month to get in for an MRI so we're now into October 2015 at 4mo from the original injury. MRI showed zero anomalies. At this point I was nearly certain that this was a sports hernia. Yup, I read that negative MRIs are common amongst those with sports hernias.

Doc then sent me to an ortho surgeon/specialist that reiterated zero findings in the MRI, but he agreed that this is likely a sports hernia that simply didn't show up in the MRI. He then said he doesn't recommend surgery since it's only successful about 50% of the time. He added that the successful 50% population likely only improved due to the lack of activity during recovery from surgery. My research did not produce nearly as pessimistic of success rate for the surgical repair of a sports hernia, so I shook my head and moved on to find my own specialist.

I went to Dr Craig Smith in LA since he was the only sports hernia repair surgeon in the Southern California area that I could find. I brought my MRI. He didn't even bother to look at it because he has his own diagnostic procedure. He did several simple stress tests to isolate the pain area and how to exploit the injury. He also got my complete history and then explained I'm a textbook candidate for surgery to repair this clear case of a sports hernia. I asked about the added lower groin pain, which he said would go away once the stress on the ab tear site was relieved. He thought I was a perfect candidate for surgery because of the injury location along the "V", the time since the original injury, the attempt at R&R and PT, and the very localized size of the piercing pain site. Given all of this and my level of fitness, he estimated 85-90% chance of success with surgical repair. He said he often turns down surgical repair unless the case is textbook. This is consistent with what I've read across the Internet about him.

Awesome. Just the answer I was looking for. Surgery time.

I had my surgery a week ago (mid Feb 2016). He did what he called a bilateral laparoscopic hernia repair with mesh. He explained that he applies the mesh very similarly to a standard inguinal hernia repair, but simply extends the mesh much higher to extend beyond the site of pain. I'm sure it's a bit more complicated than this, but that was it in a nutshell. The mesh is intended to take the tensile loading placed on the injury site during strenuous activities, thereby eliminating the nerve flare up due to aggravation of the torn site. During surgery he did not locate a tear, but figured it was one or several micro-tears (acc to him this is not uncommon and the reason MRIs are typically negative).

Day of surgery...I was pretty knocked out after general anesthesia and easily could handle the 2hr drive back home (San Diego). Days 2-3 sucked....was painful to sit and I had difficulty sleeping because I couldn't even lay on my side without pain. I could shower immediately since the laparoscopic entry sites were all sutured with super glue which have held up perfectly...sweet. To my surprise, I could immediately walk without much pain and did so from Day 2. I have increased walking distance each day, and am already walking several miles a day. I am nearly ready to attempt lightly jogging. We'll see....Dr Smith said to push it as far as my body allows without reaching more than 3 out of 10 of pain. I'm very tentative to push this too hard because I want success, but I also think that pushing things a bit can help accelerate healing and increase flexibility to the repaired area.

After only a week, the originally injured site and lower groin are still sore, but I expected that so soon after surgery. I'm hopeful the pain will slowly subside and eventually disappear altogether.

Will keep you posted with my progress!

 

Good luck. Sounds like you're off to a great recovery. 

 

In my own experience, constant, progressive use with incredibly gradual progressive loading seemed like it was key to full recovery. It's such a complex part of the body, and the nerves, muscles, connective tissues need to experience load/tension to end up with fibers lined up the right direction during remodeling (like tendons) and nerves-brain tuned to experience movement and tension as normal and not dangerous (or painful). At the same time, you don't want to life a fridge after a month even if it feels like you could...

 

The hard part was psychological: Pretty sure when I was afraid of pushing too hard I was likely more at risk of not pushing hard enough; pretty sure that when I felt like superman, the danger was overdoing it. I ramped up the frequency and intensity of various sports very, very smoothly, so I was always confident adding 5% more wasn't going to cause damage. I was playing the long game, and, so far at least, it has worked. 

post #46 of 53

I am a 37 yr old male very active and I believe i also may have sports hernia, this may be the second time, though the injuries seem different.  Both occurred while playing soccer, one i was about to shot and i heard a pop in my groin area, it took me months to recover. This recent one happened 5 weeks ago, while sprinting, i was about to pass and then a sudden sharp pain in my groin area. I was unable to sleep for a day, and it was painful walking. Reason i havent seen a Dr yet is that this one i didnt hear a pop, its improved somewhat, and i just want to give it time. I think its a sports hernia because i have a sharp piercing pain in the right side of my pubic region. No pain when i walk, however initially when i run there was pain, but now its just dull. Moving laterally the pain appears, doing situps there is pain, sneezing pain, and when i wake up or my muscle is at rest there is a tightness in my groin area and almost disappears when i walk. When i squat my groin area is tight. The tightness has improved slightly. I will be seeing my Dr in 3 weeks, since that will be the two month mark if additional gains are not made. If i am referred to a specialist i intend to utilize a non-surgical option unless that doesnt resolve it. What do you guys think Sports hernia or something else?

post #47 of 53
Thread Starter 
Quote:
Originally Posted by Kojo Boateng View Post

I am a 37 yr old male very active and I believe i also may have sports hernia, this may be the second time, though the injuries seem different.  Both occurred while playing soccer, one i was about to shot and i heard a pop in my groin area, it took me months to recover. This recent one happened 5 weeks ago, while sprinting, i was about to pass and then a sudden sharp pain in my groin area. I was unable to sleep for a day, and it was painful walking. Reason i havent seen a Dr yet is that this one i didnt hear a pop, its improved somewhat, and i just want to give it time. I think its a sports hernia because i have a sharp piercing pain in the right side of my pubic region. No pain when i walk, however initially when i run there was pain, but now its just dull. Moving laterally the pain appears, doing situps there is pain, sneezing pain, and when i wake up or my muscle is at rest there is a tightness in my groin area and almost disappears when i walk. When i squat my groin area is tight. The tightness has improved slightly. I will be seeing my Dr in 3 weeks, since that will be the two month mark if additional gains are not made. If i am referred to a specialist i intend to utilize a non-surgical option unless that doesnt resolve it. What do you guys think Sports hernia or something else?

I don't think it is anything-- because I'm not a doctor, and nobody can diagnose you over the Internet. Sorry.

I really want to prevent this thread from turning into a "I think I have XYZ ailment, haven't been to a doc-- what do you think?"

The point of this thread is to talk about sports hernia, follow recovery/treatment-- and in particular how it relates to, well, skiing. I don't want to be harsh about it, but we're getting too many speculative, drive-by register + posts that have nothing to do with skiing, and potentially nothing to do with this injury. At a certain point the thread becomes a disservice...
post #48 of 53
Hello justruss
I diagnosed with sport hernia after mri told i had nothing by mr simon march in gilmore clinic
And he told me that i had to do the both sides is weak but i feel more pain in the right side

So i did in both side but i had problem 2 weeks after surgery my little brother came near and put his hand on my left made my groin strech and then i made a sudden painful move which i didnt sleep for two days then i am afraid that something had torn in the surgery area
Very severe pain for 5 days then i went to the doctor he told that surgery is fine and nothing is there may be some scar tissue had broken rest and stop doing exersices for five days and i will see you in 22-4-2016 next friday

I feel pain still in the left groin very painful till now .. Coughing snezzeing all stuff is painfull till now
MY RIGHT SIDE IS SO GOOD THANK GOD I FEEL LITTLE DISCOMFORT ONLY
Is something happened in my left side
My left hip and lower back is painful now
What could had happened .. I am so upset
post #49 of 53
Anyone help me i have been 5 weeks post surgery till today i had sevre pain in my left side
post #50 of 53
Quote:
Originally Posted by Jive1983 View Post
 

Hi guys,

 

I have been recently diagnosed with sports hernia. It took almost a year to come to this, I have been trying conservation approach for almost last 8 months. Thought I have seen improvements can't seem to get back to normal activities. I am from New Zealand, and laproscopic surgery seems to the only option with mesh. I am doing investigation on both mesh and non mesh would prefer a non mesh solution but can't seem to find anyone in NZ who would perform that. Anyone who has had sports hernia surgery with mesh were you be able to get to normal activities?

My mom was diagonised by our family Doc with hernia. IUt was by last year our Doc diagonised this. We didnt have any hope in the begining. Just like you said , mom lost all hapiness and she had for life. We reside in Toronto and we consulted a doc as per our cousins suggestion. It was in Shouldice hospital that my cousin suggested to. We hesitated to go in the begining. Happened to see an article on the same. There was two hernia repair that they suggested. One was, Mesh repair (There are many different types of mesh repairs. The common characteristic is the dependence on mesh, an artificial foreign material, to address the hernia. Instead of an actual anatomical repair, a mesh implant is placed over or in the hernia defect to ”patch“ or ”plug“ the opening in the muscle and connective tissue. The repair depends on scar tissue to grow into the mesh, forming a large layer of scar tissue. As the scar tissue shrinks, so does the mesh, creating a fibrous mass, which is often associated with chronic or long-term complications in mesh surgery) and another was  Laparoscopic hernia surgery (This type of surgery is performed under general anaesthetic. Three small openings are made in the abdomen. Then, the abdomen is filled with gas (carbon dioxide), so that the surgeon can see the abdominal organs through Instruments which display the images on a TV screen. Other instruments are inserted through the openings and used to insert the mesh and staples or screws used to anchor the mesh in the repair of the hernia. Mesh must be used to reinforce the abdominal wall). the information in bracket are from the following article:http://shouldice.com/the-shouldice-repair.aspx​ . Jive1983,hope this would help you out as it helped our family. My mom underwent the second treatment. She is completely alright now.

post #51 of 53

Just read your article about your Sports Hernia, and would like to tell you my hernia history: 1989 , first double hernia repair surgery; then the same surgery all over again in 1996. Then Umbilical hernia surgery in 2010. Now I have a Sports Hernia on the right side; equal to the area that my right testicle resides. I am due for a preoperative exam of some sort on August 22, 2016. I totally hate to have surgery again, but hernias only get worse. I previously worked for a mortuary many years ago, and was required to lift extremely, cumbersome amounts of weight, without the proper amount of human help, to balance the lifting. I do a lot of mountain trail hiking, and have been known to get into a few canoes ! Hope that you are well and recovered with no remaining concerns. I absolutely dislike having to go "under" for any operation whatsoever.Thank you for your expertly detailed article of your Sports Hernia issue. Colt2014

post #52 of 53

Hello All,

I just stumbled on this forum post after doing some (seemingly perpetual) research on groin pain/sport hernias. I figured I'd share my experiences with diagnosing and treating a sports hernia:

 

Background:

     I am a 27 year old male, active duty U.S. Marine, lean, fit, 6'0, about 175lbs, and was very active leading up to the injury. No prior hernias and no major lower body injuries/traumas other than a motorcycle crash a few years back to the opposite side of my sports hernia. Not an athlete of any specific sport, really just a runner, weightlifter, and functional combat fitness athlete.  Although, admittedly my lower body is not very strong in comparison to my core and upper body. 

 

Timeline:

(For those who care, months are pretty much accurate; As for days....probably factor in a +/- week or two.)

 

Dec 5, 2015: Initial (suspected) Injury

     -I was dared to sky dive from the hull of an SR-71 while chugging a fifth of bourbon, smoking a Cuban, and wrestling a rhinoceros during the free fall.....or perhaps I went for a leisurely skate around the local ice rink with my wife......cant remember which.....Any ways I had also not been weight lifting for about a year before the injury due to training limitations and had resumed a few weeks prior as well.  So my injury was either an acute injury sustained during a fall at the ice rink..er, skydiving....or from jumping back into weightlifting too quickly.  My money is on one particular fall I took during skating that more or less forced adduction of my left leg to its limit with my entire body weight. 

 

Dec 17, 2015:  First Doctor Visit

     -I knew something was askew as my body typically heals or begins to show signs of healing of minor strains and sprains within a week or two.  Both of my groins had been sore after skating because I don't normally skate but my right groin returned to normal after one day and my left groin continued to ache and was becoming more sore with certain lower body and back weight lifting exercises.  Despite the relatively minor pain, I went for a 2.5 mile/25 min interval run on like Dec 15ish;  It included sprints for brief periods but was an easy to easy/medium workout.  The pain that I experienced DURING the sprints was probably approaching a 5/10 or 6/10 but I pushed through because I was convinced I wasn't injured. The pain I experienced the following day was probably about 7/10 when I would try to sit up out of bed or engage my left abdominals at all and radiated all the way up about half of my abdomen.  Typically the pain resided in the deepest, non-palpable portion of my left groin, right where the top of the thigh meets the abdomen.  Now I knew I was injured. Doctor said it was a severe strain, ordered RICE for about 4 weeks.

 

Jan 15, 2016:  Not a strain- Ultrasound ordered

     -The pain from the sprint workout subsided to pre-run levels about 4-5 days later but there was still a nagging pain that persisted with squats, running, and adduction in general.  The doctor suspected an inguinal hernia and ordered an ultrasound.  He also told me to take it easy for another 4 weeks.  The ultrasound was negative for an inguinal hernia or other conditions.

 

Feb 18, 2016: Diagnosis of Exclusion- MRI ordered

     - The doctor ordered an MRI of the affected area.  The MRI was negative for an inguinal hernia or other conditions. The doc now ordered 4 weeks of physical therapy before he would put in a referral to an orthopedic surgeon. 

 

Mar 1-31, 2016: PT for nought

     - I began my physical therapy (2x per week for 4 weeks) and by this point quite pessimistic about the PT process as I had already done the bulk of my research, desperate to find an explanation for the pain I was experiencing.  I was firmly convinced I had a sports hernia based on the dozens of medical journal articles I had read on the diagnostic and treatment procedures for them.  The physical therapy regimen was ineffective and pain levels remained unaffected. 

 

Apr 25, 2016: Referral to Ortho

     -I finally got my referral to the orthopedic surgeon and felt I was getting somewhere.  The ortho ordered an MRI with contrast (arthrogram, I think?) of my left hip to look for whatever he was looking for...torn ligaments, cartilage, tendons I'm assuming.  He noted there was a "slight disturbance" in my labrum but certainly not enough to cause the pain or warrant surgery.  I was referred to a general surgeon for a suspected sports hernia...SCORE.

 

May 15, 2016: PT AGAIN!? And a definitive diagnosis!!

     -The general surgeon I was referred to was incredibly knowledgeable and he echoed all of the research I had found in the medical journals, so not only was I validated but I was relieved.  He said that I definitely had a sports hernia, that I was a candidate for surgery, and that the procedure that he performed (laproscopic mesh) had an 85-90% success rate.  He told me that he wanted me to complete one more 4 week PT regimen just in case it could save me from the knife but I knew it would likely be in vain. I played along.  The second physical therapy regimen was ineffective and pain levels remained unaffected. 

 

Aug 10, 2016: Surgery...Finally.

     -I had my surgery last week on Aug 10 and will now detail my progress in terms of days post-op. (Surgery day = S)

   S-Day: Upon waking my whole abdomen and groin were very numb from the local anesthetic but I was extremely alert for just having been under anesthesia.  The recovery nurse told me that I had been "too sleepy" for the anesthesiologist and was given Narcan. I got 30x 5/325 Norcos for pain and was given a freebie before I left the hospital with my wife as my driver.  Pain was virtually all over my abdomen for the remainder of the day, about 2-3/10, and I got more groggy as the day wore on.  Not too bad of a day overall. Took it very easy.

   S+1 to S+3: These days were pretty damn miserable.  Pain was about 4-5/10 resting and would increase with sudden or core-engaging movements, 2x Norcos every 4-5 hours, sleeping on my back only, entire stomach area is swollen and tender to the touch, walking was super slow and painful but I tried, I avoided coughing and laughing like the plague, napped at least once each day I think...thats about it.

   S+4 to S+6: Pain gradually became much more manageable and I stopped taking pain pills on S+6.  I walked about 15min a day. I sneezed accidentally on one of these days and regretted it immediately. It's very easy to feel that my abs are growing back around the mesh; it feels as if there are stitches holding my entire gut together and that if I inhale too deeply, stretch too far, or lay on my back too flatly they may rip out. It's a strange sensation. 

   S+7 to S+8: Abdomen is pretty much back to normal in terms of swelling, I'm able to sleep on my side a little easier but it's still painful, pain isn't constant and only gets worse, about 3/10, towards the end of the day or if I go for a longer walk.  Doc told me to take 800mg of ibuprofen 3x per time regardless of pain level and it helps.  

   S+9: Best day so far.  Pain is continuing to ease up and walking is getting better.  Still slow but it's improving.  Painful getting into and out of my car and I find myself sitting reclined a little more than I usually would to avoid pain.  I've got a follow up with the surgeon next week.  Oh yeah and I've got  nagging pain, 2/10, in my left testicle that seems to be routine with this procedure.  Ill ask the doc.

 

Before the surgery, if I was standing still and I flexed my left glute, as if to adduct my affected leg without my leg actually moving anywhere, I could consistently produce the pain in my groin.  I tried that a couple days ago after the surgery and it still seemed to be there so hopefully that will be resolved with the increased strength from the mesh; I can only assume that's how it will work.  I apologize for the intensely long post but this has been one of the most frustrating events of my life and thought I should share it.  Peace.

post #53 of 53

Thanks for sharing

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