T Nation

Sports Hernia

Has anyone ever rehab-ed a sports hernia without having surgery?

From what I understand, you cant rehab it. Maybe if its in the first stage. I had three hernias repaired at the same time. I was out of comission for a little while but now I can lift like I never had them. Expensive though. Still paying that shit off.

I’ve referenced this twice.

Google Mike Boyle Understanding Sports Hernia.

curious as to what you got it from, if u dont’ mind

[quote]HolyMacaroni wrote:
curious as to what you got it from, if u dont’ mind[/quote]

This

The cause is not determined. The Dr. said that this is typical. Every few weeks I meet with a new specialist & they end up shrugging their shoulders. Apparently its not bad enough for surgery but it wont heal.

We have conservatively managed a TON of these in conjunction with a physical therapist with whom I work closely. I think that the sports hernia surgical options are among the most overused and idiotic procedures out there, in the overwhelming majority of cases.

Let me guess; it’s on the right side…

www.EricCressey.com

I do agree that the surgical options are the most overused, and an unnecessary procedure. As an athletic trainer at a high performance rehab facility, I do see this quite often, and it has good rehab potential when you combine manual therapy particularly with ART/Graston Techniques.

Look for Boyle’s: “Understanding Sports Hernia May Mean Understanding Adduction”

I hate to contradict a contributer but let us imagine you intend to be active and play sport your whole life. Now imagine that in 20 years time you’re still managing it conservatively and paying for physio. You’ll either have given up and got fat or be cursing not getting the op. Get the surgery. Otherwise you’ll always be ‘managing it’ and never be able to push yourself.

On the other hand lots of people get wrongly diagnosed with one of these things.

PM if you want to hear from someone who’s actually had one.

BTW the physio afterwards will cost as much as the actual surgery.

Actually its on the left side. I had read the article by Mike Boyle when I was first diagnosed. It was very informative but over my head. Here is the abridged version of the story. I had groin pain one day at work. I saw a general doctor who said it was a bad groin pull

[quote]MGerometta wrote:
I do agree that the surgical options are the most overused, and an unnecessary procedure. As an athletic trainer at a high performance rehab facility, I do see this quite often, and it has good rehab potential when you combine manual therapy particularly with ART/Graston Techniques.

Look for Boyle’s: “Understanding Sports Hernia May Mean Understanding Adduction”

[/quote]

How does ART help with a torn ligament/tendon?

16 weeks of therapy,2 mri’s, ionotopheresis, CT, and steroid injection and its still no better. If you can offer any help I am listening.

I had 2 inguinals and an abdominal surgically repaired at the same time. It was rough being laid up for awhile but I can lift weights like I never had them.

Surgery aint cheap and hopefully your insurance is better than mine.

Jslim. I’m not saying this again. See a good surgeon with plenty of sports injury experience.

Mike Boyle may be a good coach and I’m sure but his article is misleading/wrong.

[quote]Eric Cressey wrote:
We have conservatively managed a TON of these in conjunction with a physical therapist with whom I work closely. I think that the sports hernia surgical options are among the most overused and idiotic procedures out there, in the overwhelming majority of cases.

Let me guess; it’s on the right side…

www.EricCressey.com[/quote]

Just getting terminology correct. An inguinal hernia cannot be managed and can become a surgical emergency if incarcerated. Now is a “sports Hernia” the same as an inguinal hernia. In the normal medical field “sports hernia” is not an actual diagnosis that can be billed to insurance/medicaid/medicare. The human body can herniate many things, just trying to get clarification.

[quote]DJHT wrote:

[quote]Eric Cressey wrote:
We have conservatively managed a TON of these in conjunction with a physical therapist with whom I work closely. I think that the sports hernia surgical options are among the most overused and idiotic procedures out there, in the overwhelming majority of cases.

Let me guess; it’s on the right side…

www.EricCressey.com[/quote]

Just getting terminology correct. An inguinal hernia cannot be managed and can become a surgical emergency if incarcerated. Now is a “sports Hernia” the same as an inguinal hernia. In the normal medical field “sports hernia” is not an actual diagnosis that can be billed to insurance/medicaid/medicare. The human body can herniate many things, just trying to get clarification.[/quote]

On the British side of the pond a sports hernia (or more correctly Gilmore’s Groin) is a tear between the ingrinal ligament and the conjoined tendon. Nothing protrudes through the gap as yet but the tear is definite and can’t be repaired by the body naturally.

Over here the diagnosis sports hernia isn’t used as a junk term for lower abdominal/groin pain.

A Gilmore’s Groin repair can certainly be billed to a private health coverer in the UK. The NHS can take about 2-3 years to get around to performing the surgery.

Anyway we’re pissing in the wind the guy needs to see medical profesionals not a bunch of people on the internet- even good coaches and trainers. They could have stopped him developing this problem by training him correctly but it’s too late now.

OP have they done the finger test on you?

finger test? I saw a surgeon during the initial PT after the MRI showed an adema(sp) around my left adductor attachment to the pelvis. He is the leader in the field for my area and he wont do surgery. Currently I am scheduled to meet with another surgeon on the other side of the state.

The finger test is pushing a finger up through the gap where the tube goes up from the testicles. Inverting the scrotum. The doctor can thereby feel the inside of the bottom of the abdominal wall where the tear would be.

They didn’t think scans showed much where I had mine. Maybe an MRI does.

Lot’s of things have similar pain symptoms in this part of the body. All I can really say is to see good doctors and you have to trust them.

I’d repeat I spent as much on post op physio as on the surgery. It was well worth it.

Firstly i suppose it goes without saying that sports hernia is simply an umbrella term given to a number of different specific conditions that are similar in that they manifest as upper groin/ lower abdominal pain. However this over simplification has lead to most of the problems as different individuals have individualized and patterned muscle tears, imbalances etc. I think that Erics comment about surgery being over utilised is very valid statement.

However the lack of consensus on both physical therapy protocols and recovery mirrors the lack of diagnostic clarity most people deal with when addressing this problem. Surgery will not fix the underlying problem that lead to the hernia in the first place nor will a physical therapy program ill suited for sports hernia. An individual needs to be carefully assessed to determine the specific set of circumstances involved in both the progression of the hernia and the best mode of therapy. I myself have been suffering with this condition for over 6 months.

I have recently read Mike Boyle and some of Erics work in this area and its been the most informative and useful on the topic i have found to date. A protocol of ART followed by static stretching and increasing hip mobility, followed by unilateral leg work and core strengthening is a basic summary of what is entailed but even after two weeks i am noticing slight improvements. However PT is only part of the puzzle. You must allow your body to heal itself. This may seem simple but being an athlete allowing yourself to rest can be a massive psychological battle. Also aiding the whole process with sound nutrition etc is as important as nutrition during heavy training. Any foods with antinflammatory properties are extremely useful.

  1. Tumeric and black pepper : Suppress proinflammatory genes and increase antioxidant bioavailability. Very very useful for pain, similar effect to Nsaids without the negative implications. Clinical studies in animals have shown to increase rate of muscular repair after trauma etc

  2. Fish oils EPA and DHA: dont need a science lesson here theres enough out there for ppl to have seen the benefits already.

[quote]jslim wrote:
Has anyone ever rehab-ed a sports hernia without having surgery?[/quote]

Maybe.

I pulled an adductor (the left one, fwiw, doing floor fighting) that hurt all the way up to where it inserts on the pubic bone. Is that what you mean by sports hernia? (This is one definition.) Some other people mean this to be a synonym for inguinal hernia gotten through sports. If you had what I did, I’ll tell you what I did. Your call. My experience is that the damn just doesn’t heal without strengthening it. Once I started that, I improved a lot and am mostly back to where I was.

Assuming it is an adductor issue, the best thing I found was blue balls. No, not those… I mean one of those 65 cm stability balls. Lie on your back, stick it between your knees and squeeze it 10 times, then squeeze & hold for 20 seconds, then while still squeezing it, do 10 crunches, pulling the ball to your nose. Do yourself a favor and throw in a couple of rotator cuff exercises between these. Makes a good warm up.

Repeat 3 or 4 times. You are practicing moving it and then stabilizing with it. If the squeezes get easy, do them strong and fast (= sort of lame plyo work). Looks funny, works well.

Stand up, get into squat position but use your elbows to push your knees out at the bottom and hold again (as a stretch) for 20 - 30 seconds. Repeat at some point before you actually try and lift anything. Make sure you keep your back straight and really try to get your butt to your heels. Once this gets easy, try and squeeze your knees together while at the bottom.

I added the above to my workout and it takes only a few minutes, but greatly helped me strengthen the adductors. My squats suffered quite a bit until I started this since rising up out of the hole made everything really hurt.

– jj