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Sports Hernia?

Woodchuck ATC · · Unknown Hometown · Joined Nov 2007 · Points: 3,280

Good short article in newest Climbing mag about the do's/don'ts of climbing injury recovery to typical injuries. An interesting read as 3 of the covered injuries are ones I've had or still suffer from.

Aaron Olson · · Seattle, WA · Joined Apr 2011 · Points: 5

I was recently diagnosed with a very small abdominal hernia. I went climbing, did some strenuous routes and then two days after, I felt like I had been kicked in the groin repeatedly. I went to a hernia specialist recommended by a friend of mine who is a doc (this guy had done 3000+ hernia surgeries), which was where I got my diagnosis. His recommendation was to give it a rest for a few weeks and then slowly get back into climbing. I followed the recommendation and started climbing, which at first felt a little strenuous, but now (about 2 months later), I am feeling good. My big concern was that I have a Yosemite trip planned for June and wanted to get the surgery done now so I could train in a month or so. I will see how it goes, but no surgery is looking like the best option at the moment.

Bryan Feinstein · · Jackson, WY · Joined Dec 2008 · Points: 20

I just had Dr. Meyers core muscle surgical repair in Philadelphia today. I again was ruled out from having a traditional abdominal/inguinal type hernia by MRI and clinical assessment. Unless he happened to fix one during surgery which is very possible that I dont remember now as propofol and versed are wonderful drugs. Follow up appointment and PT starts tomorrow.

His MRI protocol confirmed I had pathology of the adductor longus tendons and rectus abdominis. I still potentially have a labral tear and CAM lesion in my left hip, but he was pretty confident that the source of my muscle dysfunction and pain was from the core injury.

That was my initial gut feeling as well and decided to go for it.

I have to wait about 2 months to see Phillipon in Vail, CO for a hip consult anyways, so things seem to have lined up good with timing.

He said I had significant tears in many or the origins as well as a partial detachment of the left adductor longus insertion. And post surgery still believed that it would not have healed back to pre-injury status with rest/PT/etc.

Granted I know the man is a surgeon and am always a bit hesitant, but my impression is that he is a very genuine man that has a good bedside manner and took the time to answer questions, and I didn't feel forced into surgery (other than my own desire to find an answer as to how to get better).

So far the experience at Vincera has been excellent and I hope the recovery and rehab continues down that path.

He is saying 6-8 weeks and I will hopefully be back up to activity that I haven't been able to do now for 4 months. We shall see.

I'll be sure to post updates as I'm sure people are interested and this has been a long, tiring, mentally exhausting process for myself that I would love to be of assistance to others having questions.

marty funkhouser · · Unknown Hometown · Joined Dec 2007 · Points: 20

Way to go Bryan. Glad its been a satisfactory experience so far. Thanks for the updates.

Bryan Feinstein · · Jackson, WY · Joined Dec 2008 · Points: 20

My only regret was not getting the MRA arthrogram besides or in addition to the original 3T MRI, as it can be a diagnostic indicator of intraarticular versus extraarticular hip/groin pain since they usually inject lidocaine and cortisone. Just for an added piece of information on decided on whether to proceed with surgery.

However, it sounds from the Meyers MRI and what he actually saw and repaired in surgery that it would have likely be irrelevant in my case.

I would technically be cleared to fly back home tomorrow if everything tonight goes well, but I am staying in Philadelphia for at least a week, maybe 2, to begin their rehab program with their own people.

Bryan Feinstein · · Jackson, WY · Joined Dec 2008 · Points: 20

Meyers confirmed to me on Friday after the surgery that I would not have healed back to normal without the surgery. He thought that the correct physical therapy could potentially get me back into activity but that it would never be the same without the repair.

Pain 24 hours out isn't too bad, but make the wrong move or cough a little too much, and that changes quickly and instantly. Sometimes I wish I had just broken my leg...

The good doc responds quickly on a personal cell phone to any and all questions or concerns that his patients have, which is so refreshing after some recent experiences that were on the other end of the spectrum.

Rehab facility so far is impressive with highly knowledgable staff. I think I was one of the few people in there not making millions of dollars a year to kick, throw, shoot some type of ball.

Peter D. · · Fairfield, OH · Joined Jul 2010 · Points: 25

Thanks for the update Bryan. What kind of advice did they give you on sitting, standing etc. I've seen people get stuck in flexed posture after hernia surgeries with mesh. Your repair sounds very extensive, just wondering what are your precautions?

Good luck with every thing, glad you found a good doc.

Bryan Feinstein · · Jackson, WY · Joined Dec 2008 · Points: 20

This is not a traditional hernia. This doc prefers to not use any mesh and does an open incision. He thinks there are many more complications with mesh versus sutures. In fact, there were a few patients there getting previous surgeries redone at had been done by others with mesh.

1 day post we walked about a mile and started easy isometric contractions of core muscles to prevent atrophy and derecruitment

He said he repair was very strong and it would be hard to ruin it. I was instructed to make sure to move throughout the day in order to keep things from tightening up more and resulting in a longer rehab. I'm day 3 post-op and although I have had enough scares due to stabbing pain from twisting or moving in the wrong way, I'm feeling pretty good about things and off any pain medication.

Pretty much the same exercises every day for week one and then we progress to muscle massage and some more advanced exercises.

DavidBurrusDDS · · Unknown Hometown · Joined Feb 2014 · Points: 0

I too have been having abdominal/groin pain for the last year and a half. I had a core muscle repair with Dr. Meyers in February of 2013. At the time of surgery he said he thought I also had a hip component, but that this core repair is a good place to start. A year later I am still having discomfort. After another visit out to Philly, I am now scheduled for a arthroscopic hip scope and a adductor revision. From what I was told,t the hip a lot of the time is the under lying issue (impingement or labral tear). With hip disfunction your body compensates abdominal muscles/hip flexors to the point of tearing sometimes. My rectus abdominus repair has healed, but now as a continued result of my hip disfunction I have a new tear in my adductor. Here are some links to a couple articles that I have found explaining hip/sport hernia connection:

hss.edu/newsroom_common-hip…

medscape.com/viewarticle/76…

orthopedicsmagazine.com/fou…

health.usnews.com/health-ne…

Bryan Feinstein · · Jackson, WY · Joined Dec 2008 · Points: 20

Sorry to hear that David. This indeed is one of the most frustrating types of injuries and the co-morbidity of hip pathology versus adductor/abs makes it even more frustrating.

If you have to be treated for these things, Vincera is the place to go.

I am aware that my potential labral tear may need to be addressed at a later time.

However my mechanism felt like it was strain of the adductor tendon, I had done it the year before in the same place. Meyers confirmed in the open procedure that my adductor longus tendon showed almost a complete chronic rupture.

I'm hoping it heals, and the hip is a non issue. I still think it's the right thing to do the core repair first unless someone can tell you that your hip is 100% the problem, since it is a much more invasive procedure and has a much more significant recovery period.

I'm currently 4 weeks out and doing rehab out here. I hope this is the only procedure but I realize it might not be...

Did you get back to activity following the repair? What were your symptoms and limitations before?

Stephen Burns · · Telluride, CO · Joined Jul 2010 · Points: 25

Hey Bryan, I hope your recovery continues to go well. Know you are not alone! I have my own appointment with the Steadman-Hawkings clinic out of denver for a consult on a CAM lesion with most likely FAI and Labram tear. Fun stuff indeed. I keep posted as to my own diagnosis and recovery.

Bryan Feinstein · · Jackson, WY · Joined Dec 2008 · Points: 20

Thanks and Good luck, it's a long road sometimes. I've had some friends see Dr. Phillipon and have heard he is amazing. I had another MRI on my right side as well which showed showed another Labral tear on the other side. However, I'm still not convinced the Labral tears are involved with my symptoms.

marty funkhouser · · Unknown Hometown · Joined Dec 2007 · Points: 20

I think you're wise to be wary of the torn labrum diagnosis and especially the FAI diagnosis. There was a quality paper a couple years ago that found radiographic evidence of FAI in 99% of the healthy participants in the study. I'm not aware of a similar study concerning torn labrums but it wouldn't surprise me if the findings would be similar.

ncbi.nlm.nih.gov/pubmed/216…

StevenMcKraken · · Unknown Hometown · Joined Jul 2015 · Points: 0
DavidBurrusDDS wrote:I too have been having abdominal/groin pain for the last year and a half. I had a core muscle repair with Dr. Meyers in February of 2013. At the time of surgery he said he thought I also had a hip component, but that this core repair is a good place to start. A year later I am still having discomfort. After another visit out to Philly, I am now scheduled for a arthroscopic hip scope and a adductor revision. From what I was told,t the hip a lot of the time is the under lying issue (impingement or labral tear). With hip disfunction your body compensates abdominal muscles/hip flexors to the point of tearing sometimes. My rectus abdominus repair has healed, but now as a continued result of my hip disfunction I have a new tear in my adductor. Here are some links to a couple articles that I have found explaining hip/sport hernia connection: hss.edu/newsroom_common-hip… medscape.com/viewarticle/76… orthopedicsmagazine.com/fou… health.usnews.com/health-ne…
Have you tried anything like an abdominal binder? I struggled with the pain so I did a little research and people suggested one of these. My parents couldn't find one in stores, so we ended up ordering one from braceability.com. I made me feel very compressed and just solid so I surprisingly enjoyed wearing it. If you're all healed up and everything that's great! But, if you're still struggling i would recommend this. I had my surgery a couple years ago and that really helped me, especially with how old I am. Hope everything is going well for you!
Guideline #1: Don't be a jerk.

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