Tuesday, January 8, 2008

muscle imbalances and the si joint

the sports hernia, if left alone, untreated, for a long time, can very easily lead to muscle imbalances in and around the pelvis.
as one of the keys to our cores, the transversalis muscle is injured and can go into spasm as a result. this in itself can cause a domino effect of muslce imblances which can lead to great pain and dysfuntions. without the t.a. muscle to help support your lumbar spine, other muscles must become hypertonic to take over. linked to the t.a. via fascial connections are the pelvic floor muscles, the quadratus lumborum, and the gluteals, not to mention the obliques and rectus in the abdomen.
sometimes this imbalance or imbalances can lead to issues with the sacroiliac joint. si joint dysfunction is common yet, like sports hernias, is often missed when coming to a diagnosis for pain near the joint itself as well as the hip, groin, lower back, buttock, and tailbone.
if the muscle imbalance that occurs locks up compartments such as psoas, the pelvis can rotate which can in turn affect the si joint. si joint dysfunction can be severely painful in itself, and probably cannot be permanently corrected without the treatment of existing sports hernia(s).
it should also be noted that trigger points left untreated can also lead to a viscious cycle where the shortened, tightened muscles can not be stretched or lengthened due to these painful trigger points. once these are addressed, the position of the si joint can be addressed.

68 comments:

jeffer25 said...

test

jeffer25 said...

I am pretty sure i have a sports hernia thats giving me pain for well over 3 months now...Do you think physical therapy or possibly anabolic steroids might work?Also how much does the lady in Munich charge for just one side?thx alot
Jeffrey

sports herniac said...

hey jeff
sorry for late reply.
dr um charges just over 5k per side. well worth it, it includes surgery, stay in hotel, post op followup, preop testing, etc.
she is the best, if you need the sugeries, that is the way i'd go as many would also agree.
hope you feel better.
www.hernien.de

Christopher said...

Hi,

Thank you so much for this site. I'm a 30 year old ex-college athlete and have had left SH pain for almost 3 years. I was relieved to find this note on SI joint dysfunction associated with SH since I also suffer from left side SI joint pain and illiopsoas tightness (which began approx 6 months after my SH pain). Though I've met a # of physician's who believe in SH, none have made any connection between my SH and back pain. I'm going to have laproscopic mesh repair in a month (since UHC insurance won't cover Meyers technique) and was wondering if you or anyone else thinks that once my groin is hopefully stabilized and strengthened from the surgery if the illiopsoas and subsequent SI joint dysfunction will theoretically loosen up and restabilize respectively? Would seeing a chiropractor for SI adjustments prior to surgery be beneficial? Or should I wait until after the surgery? Is it a good idea to stretch and massage my illiopsoas before surgery? Lastly, I've also developed lower leg pain (anterior/lateral compartments) when walking and think it's due to the instability and shifting of my pelvis. Has anyone else out there had this problem? Thanks again for this site!! Chris

Christopher said...

Hi again,

After reading through your various postings I am curious about the nerve pain you've sustained. Over the last two months I've noticed that after stretching or walking long distances I get pins-and-needles in my testicles, groin, and inner thigh. I am worried that I may have sustained permanent scar tissue around my ilio-inguinal nerves. Also, b/c I'm getting surgery in a month I'm concerned that this could all be due to something other than SH, like referred SI joint pain or prostatitis. Errr...This is really frustrating...Any helpful differential diagnosis advice would be much appreciated. Thanks again, Chris

sports herniac said...

chris
sorry to hear about your pains.
i would not stretch the iliopsoas deeply if at all. will make pain worse esp if there are trigger pts in there.
if you can get to nyc in march i can find you a diagnosis for sure.
there might be scar tissue causing lots of those pains.
your case sounds like mine in the progression.
you need to first get a positive diagnosis.
doubt you have prostatitis, they would have told you by now.
i would not get chiro adjustments, they didn't help me at all.
the sij pain might be from a shift in the pelvis from the injry and your body protecting itself from it. that in turn can cause lots of pain via muscle imbalances.
feel better

Ben said...

Chris - I am a 36 yr old ex college and pro athlete self-diagnosing a recent sports hernia... my profile is extremely similar to yours, all stemming from SI trauma (diving for a loose ball into bleachers) a few years back. Recently suffered real psoas tightness and general lower back pain... been playing thru it and 2 days ago started to develop ALL the symptoms of SH. Thus the research/surfing. When is your surgry and where?

Sports Herniac - are you in NYC as well? any recommended docs for this in the city??

Thanks, Ben

Christopher said...
This comment has been removed by a blog administrator.
Christopher said...

Hey Sports Herniac,

Who is the person, clinic, etc in NYC that can give me a definitive diagnosis? Thanks, Chris

sports herniac said...

christopher and ben
the doctor is only going to be visiting nyc in march. i don't know if it is ok for me to post more info on the internet due to the doctor's schedule and i dont have the doctor's approval to do so.
but if you post on teh letsrun.com site's sports hernia forum thread, and make it so you can see your email address, i will email you.
i am near nyc.
ben, i can also recommend a manual therapist that might be able to help overall.

runningnet said...

Midstride sneeze at end of 6 hour run triggered groing injury.Evaluation for sports hernia led to Jan 15th laparoscopic repair

Doing much better at 9 day re-check.The doc stressed to me that the mesh provides the scaffolding only.The strength of the repair comes from the scar cells that fill in the mesh.So till that happens,any major contraction of abd. muscles (sneezing,lifting,twisting exercises)could displace the mesh & undo the work.
No driving for first week.No lifting over 15 pounds for two weeks.

Some thoughts.
Cold packs 20 minutes on/20 off for first 2 days.
The Hydrocodone prescription pain pills does the equivalent of cementing your colon closed.I only took them the first 3 days,then switched to ibuprofen for 2 days,then just tylenol.I haven't needed any pain meds the past few days.If you have to take those pills,get a bag of dried prunes & drink a ton of water.The straining is bad for the incision.

First day post op- one 4 block walk.It took me 30 minutes.
2nd post-op day- Two 4 block walks
3rd post -op day- Three 4 block walks.pace is picking up.
4th Four
5th Four
6th Six
7th 4 1/2 miles of walking
8th 6 miles of walking.I find that if I don't exceed 1 1/2 miles per walk & keep the pace reasonable it's not painful.
9th 7 1/2 miles
planned Rehap program after 1st two weeks:

Week 3 post op-Light ellipitical crosstrainer use to supplement walks
very light weights,but higher reps

Week 4 post op- easy runs, NO SPRINTING!

Week 5 post op- can add pushups,pullups,situps

after 6 weeks,can consider retrying kickboxing classes,etc.

Christopher said...

Hey Runningnet,

Good to hear that your surgery went well. As you can tell by my posts, I'll be undergoing the same procedure.

What were your symptoms?

Could you descibe what your diagnostic work indicated before your surgery? Specifically, what did your imaging tests show (all mine are negative)?

Also, did the Dr. tell you what pathology was observed via the scope once he/she got in there?

The info you provided about postop recovery is helpful.

Thanks a bunch. Chris

steveo said...

Sportshernic

I just ran across this blog and I can't tell you how great it is to finally find a source of concrete information on the dreaded sports hernia.

You seem to have quite a bit of expertise on the subject and I'm trying to figure some of this stuff out.

I had an inguinal hernia operation about 6 weeks ago. I went to two surgeons, both do sports hernia surgeries and regular inguinal surgeries. Both of them said they thought my problem was a "small" inguinal hernia (I didn't have any bulge at all).

But, I had all the symptoms of a sports hernia (dull ache when attempting a sit up or squeezing my legs together)

Now 6 weeks out of surgery I feel THE EXACT same!! I was just wondering is it possible to have BOTH and inguinal hernia AND a sports hernia???? Have you come across this talking with any doctors??

Thanks so much (sorry this is so long)

sports herniac said...

sorry
i wish i knew steveo, but alas i am no doctor.
maybe it just takes time to go away, i am 19 mos out post op and slowly improving. i still have some pain issues but then again i went 18 mos preop in extreme pain and surrounded by clueless, useless doctors who would not even admit that i had soft tissue injuries. so i think that is making my recovery slower.
did you have the pain for long pre-surgery, or did it build up over a long time? that might be a sign that it will take you a while to recoup.
regardless of pre-op symptoms and timeframe, it will most likely take you a lot longer than 6 weeks to get over the initial pain. soft tissue injuries are more painful than bone breaks and more complicated to treat.
scar tissue is often the cause of post-op pain, as is the case with me, along with developed compensatory muscle patterns/muscle imbalances.
imagine hurting your foot for a long time. you eventually limp. then you eventually get off the crutches but you still kind of limp. the "kind of" is your body working around the injury. muscles move into different movement patterns to achive this, and over time it can result in the whole skeleton getting thrown off. the compensatory patterns themselves can cause pains.
so... that being said, an nice overall rehab program taken very slowly and cautiously would be the best approach in my meager opinion.
i wish i could help more.

2baloo said...
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2baloo said...

Christopher
There is an excellent review article by Authur Nam & Fred Brody of the George Washington University Medical Centre might answer some of your questions around differential diagnoses: Management and treatment of sports hernia 206(1)p. 154 - 164, Journal of the American College of Surgeons, January 2008. Most universities with a medical school would subscribe to this journal so you or a student friend could download it off a university library citation linker.

sports herniac said...

hey 2baloo
personally, i would go see either dr meyers in philly or, even better,
to munich to have dr muschaweck do your surgery.
i *think* they are roughly the same $, muschaweck might be cheaper, but regardless of price, muschaweck's approach is less invasive and she has performed more surgeries than meyers.
hospital stay is included in muschaweck's cost of just over 5k per side done. and there is beer in the minifridge of the hotel/hospital room!

feel better, keep posting

2baloo said...

Thanks for the info.

I did not see anything specific to athletica pubalgia/sports hernia on Dr.Muschawuck's web page. I have emailed some questions to her clinic(including the one I asked you about the laparoscopy)and will wait.

sports herniac said...

they call the injury "sportsman's groin" in dr muschaweck's clinic.
good luck!

Christopher said...

Hi Sports herniac,

I'm getting laparoscopic surgery on 2/21/08 and had a few remaining questions regarding nerve pain, si joint, illiopsoas...

1. Any advice on the differential diagnosis between strictly referred groin pain from the si joint and AP? My si joint pain occured 6 mos after my groin pain so I've always considered the si joint issue secondary to the groin pain...Now I'm wondering...

2. For a month now (3 years w AP) I've had pins-and-needles in my groin, testes, and perenium after stretching or walking...Is this likely due to nerves? Is it typical?

3. Have you found any benefit from prolotherapy for si joint instability?

4. Lastly, for 9 mos now I've developed below the knee lower leg pain/ankle pain, lower leg swelling, and lateral peroneal nerve knee pain...Do you know of any AP cases where this has occurred? I'm thinking this is due to postural pelvice changes and hamstring tightening...Just a guess...

Thanks again for your time...Chris

sports herniac said...

chris
you and i have what sounds like exact symptoms. my pain in sij/perineum/sit bone began 6 mos after my sports hernia became painful and symptomatic.
what you ask regarding the pelvic imbalance and postural change, in my theory, is dead on and is perhaps causing those pains.
recently, i was told that my sij is doing fine- not hyper nor hypo mobile. the tissues have definitely gotten changed as my pelvis did.
i think, from what i gather from all the practitioners i have seen over the past few years, as well as endless reading, is that the changes in the muscles and fascial system is effecting the nerves in teh pelvis. in particular, the lumbar and sacral plexuses (plexi?).
i know the genitofemoral nerve does get effected by the sh, esp the genital branch. the genitofemoral nerve runs along ths psoas fascia. hence perhaps the lunge stretching can stretch the nerves and will irritate it much more.
the obturator and ilioinguinal nerves both run down into the inner thigh. i get wierd numbness yet zinging pains along the inner groin when i scrape it with my fingernail or if i stretch the adductors for too long or too deep, i cannot figure out which makes it worse.
note the posterior femoral cutaneous nerve and its pathway as well.
basicall, i still have some pain where the sh surgery was as well as pain around the inner sit bone and perineum. but it is much less since sugery.
i *think* the scar tissue and postural change is at fault here.
i have also been told that realisticly, for someone who has been very weakened by this injury, especially if he/she has had it for an extended time, it can take 2-3 years to recover.
i have had some pain down leg but i think that w/ me it was/is the sciatic nerve.
i have had bad issues with trigger pts in the gluteal muscles on the affected side. on that side, my butt is much smaller than the other. my left leg is also smaller and in general the whole left trunk down to the leg is weaker.
i hope this helps.

sports herniac said...

oh and yes my left hamstrings (bad side) were/still are tight.
fascailly speaking, the hamstring attachment runs up to the sit bone to a ligament along sacrum.
a big line of tension that needs to be realeased.
find a therapist or osteopath who can tell if your pelvis has rotated. my guess is that your painful side has rotated anteriorly and perhaps medially. like mine.

Christopher said...

Hey Sports herniac,

A massage/PT therapist and a chiro both noted months back that my pelvis was indeed rotated both anteriorly and medially. After receiving a deep massage around the SI joint and psoas, I was actually pain free in those areas for day and a half. I never went back though since I had a hunch that permanent relief wouldn't occur until the SH was fixed. So that has always been my anecdotal evidence for secondary psoas/si joint dysfunction. Your experience (unfortunately) and website confirms that as well.

Have you ever had periods of time (weeks, months) preop when the groin pain was less or even non-existent after exercise? For the first two years my groin pain was predictable and constant after certain activities. However, for the past 6 months the groin pain has fluctuated and been more bearable. The damn si joint and psoas pain is always present though...Confusing.

Thanks a bunch...Chris

sports herniac said...

hey chris
i had intermittent groin pain on the worse side off and off for 2 years before i had a blowout of the tissues. then i was in pain that was very bad and spread to sij/perineum at around 6 mos. then i got treated by a pt/manual pt + did exercises for a year and got somewhat betterto the point to where i could have decent moments and bad moments. then i had surgery.
still some good days mixed with not as good days but always getting better. i became very deconditioned with so long of having the injury, so it has been hard getting back to balance nd on track.
manual therapy has been essential to my rebuilding but my insurance company wont cover it. they wouldnt even cover pt post op let along recognize my injury and sugery.
i'd work on getting that pelvis realigned by seeing a very good osteopath or perhaps find a good structural integration practitioner (rolfing is a type of si work, is more or less the basis of si).

2baloo said...

Has anyone who has been diagnosed with a sports hernia found that their groin/pelvic pain is worse after, not during, activity? How about pain when standing up after sitting? How would you describe the pain? Does it change with positioning? How about when sleeping - is one position better than others?
Thanks!

runningnet said...

The pain was worse after exercise.I ran 50 miles with the injury.It really bothered me more afterward.

I think it bothered me more sitting than standing
When laying down,the pain was worse when turning from one side to the next.
I definetly was more comfortable laying with a thin pillow between my legs just above knee level.

2baloo said...

Thanks Christopher!
The thing that was throwing me about my AP diagnosis was the pain AFTER activity when much of what I had read before finding this blog implied pain during. Ofcourse my activity is down to walking a couple of blocks - not running 50K!

Sports Herniac - I have read in your list of signs & symtoms that pain after activity is common - must have missed that the first time through. You seem to have done all the work for us! How did you find out about Dr. Muschaweck?

sports herniac said...

i had the same deal as running net and also, walking downhill was near impossible, some days i couldn't do it at all.
definitely, though, pain after any kind of activity.
i found dr muschaweck through research. i feel very lucky that i did!
i am glad to hear that this blog is helping people sort through some of this stuff. if i knew what i was doing with computers i'd maybe start more of a site and update it and whatnot. but i barely get by doing this blog; as you can tell, i hardly update it.

YosemitePaul said...

Hi, I've only just come across youre informative blog, and thought I'd add my own experiences.
I'm a 47 year old male from the U.K. I'm a gentle runner; perhaps 25 miles a week, a bit of road and mountain biking. Nothing too extreme just keeping healthy! Back in October '07 I started getting aches in my right groin and testicle, this ache progressed down into my right thigh. Made worse by more activity, coughing, sneezing etc.. I went to see my doctor who diagnosed adductor strain, and rest. The ache didn't go away, more rest, still no relief, back again, then a diagnosis of trapped nerve in my spine. Thus followed 6 weeks of physio. No better, to be followed by my doctor coming up with 'I haven't a clue, what do you think it is?' By this point I'd done some googling and come up with a self diagnosis of possible sports hernia, which got the response 'I've never heard of one of those'! I managed to get my doctoer to send me to a specialist who I found on the net,(and through the U.K. health system cost me money). Within 30 minutes of questioning and examination he diagnosed the sports hernia.
I paid more money (£2500/$5000) and had surgery 7 days ago. I'm now recovering.
Even after coming out from the anaesthetic and under the influence of morphine I could feel the pains in my groin, testicle and leg had gone!!
I've read reports on this blog of getting back to life quickly, I'm afraid for me that isn't the case, perhaps because I'm older, but 7 days on am still struggling with even short walks and stair climbing. Getting to into bed is a pain in the arse! I'm suffering little pain and think this poor mobility is more down to the scar and residual suture which is digging into either end of the 5 inch scar in my abdomen.
I'm due to have the suture out in 8 days during which time I've been informed to rest. After that (which will be 2 weeks post op.) physio, then perhaps back to light running 3/4 weeks post op. No heavy lifting for 3 months and no sit ups for 6 months.
My surgeon was fantastic, he appeared to diagnose the problem easily and quickly. He's explained the injury and repair in detail. I'd thoroughly recommend anyone find the right guy, to get the job done correctly, and not rely on information given to you by your family doctor who perhaps doesn't have the experience of seeing such a problem.
Perhaps if you don't mind I'll keep letting you know how the rehabilitation goes over the next few weeks and months.
Paul.

Manithurts said...

Sports Herniac, I just stumbled across this blog, and it is truly a site for sore abdominal walls.

I've had poorly diagnosed testicular/ groin/ abdominal pain for the past five years. It started five years ago, caused by fairly light trauma to my left testicle, and it got much worse about two and a half years ago after some awful physical therapy in Brooklyn (to be fair, around that time I also may have "strained" myself a bit in the bedroom, and I was mugged-- thrown to the ground and kicked-- that's unrelated to the bedroom stuff).

At various points, the pain was diagnosed as epididymitis, then as a torsion of the appendix testis, then as epididymitis, then as pelvic floor dysfunction. Physical therapy helped a bit, but the pain seemed to spread-- into the groin,

Finally, after seeing at least six urologists, three sports medicine doctors/orthopedists, several internists, a physiatrist, a neurologist, and a GI doctor, an orthopedic surgeon found that I had a large labral tear.

However, another orthopedic surgeon doesn't think a labral tear should be causing any testicular pain-- which is my chief complaint. And before this diagnosis, my internist was suggesting a CT-scan to rule out a sports hernia. The possible diagnosis of sports hernia was brought up, more recently, by another urologist, and even by a physical therapist who specializes in treating hip disorders and labral tears.

After doing some research, it does seem that a sports hernia might fit my symptoms quite a bit better. About four years ago, there was a slight bulge in the abdomen on my left side, but I had an urologist say that was normal-- since I was skinny, it was just an organ poking through. I'm not making that up-- that's what this guy said.

I have at some points had a fair amount of sensitivity at the tip of my penis-- a sort of nerve-like burning feeling, especially when it would rub against fabric. Could that be a sign of nerve entrapment? Most of my pain is more around the testicular/scrotal area, and in the groin, abdomen, and buttock. All on the left side.

You've mentioned that you know a doctor in New York who can make a good diagnosis. I'd love to get that person's name and number.

Thanks for your help. This has been the most frustrating, difficult, draining experience of my life. I'm only 28, so I know things will get worse, but man, this is awful. I'm sorry that anybody has to go through this.

Christopher said...

Hi Sportsherniac,

I just had my SH laparoscopic repair on 2/21. The surgeon found tearing on the transverse fascia on the left and right side and therefore applied mesh to both. Only time will tell if this was the right approach, however, he did seem confident with my outcome.

One question...What are your recommendations for post-op recovery? Anything to avoid?

I'm supposed to begin walking progressive distances for the next two weeks before I meet with him again.

Thanks, Chris

2baloo said...

Christopher
Who was your surgeon? Did he actually see the tears in the transversalis & did he need to explore your inguinal canals to do so? Just wondering because I had a "normal" laparoscopy by a surgeon who was not a sports hernia expert & am left wondering what to do next.

2baloo said...
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sports herniac said...

hi christopher
i hope you are feeling better!
i can't offer any advice for rehab.
all i know is that i had/have entrapped nerves from scar tissue, and deep stretching made things worse.
wish i could help

Christopher said...

Hi 2baloo,

What do you mean by "normal laparoscopy"? -Do you mean "the findings were normal"? Did your Dr. explore the inguinal region?

My Dr. found bilateral tearing of the transversalis fascia in the inguinal canal. He showed me pictures of the tearing post-op. Are you asking if he explored throughout the canal? If so, I don't think he did.

Before surgery I asked him about my pain that extends down to where my hamstring originates. He said the pain was typically referred from the tearing up higher in the inguinal canal.

Also, before surgery he requested a pelvic MRI (which was my 4th, 1st with him) which he and a fellow radiologist noticed "smudging" in the inguinal canal indicating some type of pathology. This was the first time someone actually noticed pathology via MRI. He told me after the surgery that he's experimenting with MRI by using a different field of view angle when scanning for sports hernias. From my experience, it takes a doctor who knows what he/she is looking for.

I'm now 4 days post-op with minimal pain and stiffness (no pain meds). Time will tell if this was the answer.

I'd like to hear more about your case. Take care.

Chris

2baloo said...
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2baloo said...
This comment has been removed by the author.
Christopher said...

Hey 2baloo,

I would recommend Dr. Novick based on his knowledge, experience, and his office and nursing staff (they promptly returned my calls and helped facilitate my visit from out-of-state). It's too early to tell if the laparoscopic/mesh approach on me was beneficial so I can't recommend him regarding his approach. However, most of the academic literature shows around a 90% success rate regardless of the approach. There's a good review article out there that explains how each approach works.

One thing to keep in mind is that for every 1 person whose surgery failed, there are many more people who had success.

Finding a surgeon who knows what to look for will be your best bet. Why haven't you considered any other US Dr.'s?

Chris

sports herniac said...

2baloo
i would imagine, though i don't knwo for sure, that the soft/lax tissue would be from a sports hernias. articles state a loose feeling posterior inguinal wall as indicitive of a sports hernia along with stretching of the transverse fascia and dialated inguinal ring.
if i were you i would email dr um at info@hernien.de right away and inquire about her visiting the usa anytime soon, like in march.
i had/still sort of have but not as bad, pain at pubic ramus. the obturator nerve passes through that fascia along the obturator foramen. i definitely had bilater ap. now, post-op, might be dealing with entrapped obturator nerve, meaning it was/is entrapped in scar tissue.

2baloo said...

Sports Herniac
Is she actually seeing patients - it might be an imposition...

sports herniac said...

2baloo
email her today

2baloo said...
This comment has been removed by the author.
2baloo said...

Christopher - How are you doing????

jeffer25 said...

my initial injury was an extreme stretch of my lower abdomen that caused a tearing pain where abdominal meets the hip.Its easily aggravated by excessive walking and pain radiates down into the testes and whole genital area even penis.Sneezing also aggravates the radiating pain as well.I went and saw my local surgeon and he doesnt even know what a sports hernia is and recommended pain jkillers etc. and said i dont have a hernia.I am almost positive i tore a muscle thats causing the nerve entrapment here and now im scared to get it done with just a regular hernia surgeon.I feel i need a specialist whos done many sports hernia operations.Can someone tell me how to get in touch with Dr. Novick ive heard about? im also interested in lady in Germany.I called Dr. Meyers and he says an mri needs to be done first.Is this critical? doesnt the doctor find the tear upon operation or should mri always be done first?I did alot of research on best prices through hernia clinics in the US and founf one in PA for $3800 total cost and NY $2600 total cost but being they just fix regular hernias im wandering if it would be worth the risk or should i get it done by the lady in Germany for 7k just to be sure it gets done right?
much thx alll

Christopher said...

Hi 2Baloo,

I'm now 9 days out from my surgery and the pain in the groin is almost completely gone. I notice the pain only at the end of day given that my groin is weakened. Overall, I can carry on with my normal daily activities (obviously no exercising etc.). My secondary back pain and tight iliopsoas is still present, but I hope once my groin heals enough those issues can be worked out through PT, massage, and prolotx. Thus far, I'm happy with how I'm recovering, again, time will tell. I'll provide more updates once I return to the Dr. in two weeks and then begin PT, etc.

How is your search going?

Thanks for inquiry and take care.

Chris

Christopher said...
This comment has been removed by a blog administrator.
jeffer25 said...

I wanted to hopefully get an opinion on explaining my symptoms a bit more.As i said i had a tearing intense pain where abdomen meets hip when all this first started 5 months ago and over a couple weeks i started having off and on radiating pain to the right side of my testes that has remained consistnet but over the last 2 months i seem to have a pretty constant aching burning right behind my testes and now the radiating pain changes sides from right to left.Now im freaked out that my left side might be bad too or can my right side affect both sides of testes?Penis as well has varying levels of nerve pain.I strongly believe it to all be related to the right side because if i aggravate my abdomen muscles too much like walking over a block or 2 etc it will really aggravate the radiating nerve pain on the right side of my testes all the way down im just hoping the aching burning nerve pain thats always there is related to the initial tear?Anyone has these symptoms or are these definitely sports hernia symptoms?I caused the inury by a really crazy strech of my lower abdome that i know tore something i can feel the tear always or if i do a minor stretch i can feel the tearing sensation come on still.I m just about to line up surgery and dont want to go with a regular hernia surgeon if hes just going to reinforce the area and not treat the tear.This has been a pretty scarring experience overall for me and ive been out of work,feel like a cripple and cant stop thinking about it cause im always in pain so i just want to get it done right the first time but dont have insurance and having to borrow money from the parents and they are price conscious so im in a bad place here..Much thx for any advice youall can give me

2baloo said...

jeffer25,
I have not had surgery but I think everyone on this blog will agree that you should go to the right surgeon in the first place. I have been told that few surgeons know what to look for and treat. Maybe see a sports medicine specialist first if someone can recommend one 'cause there are lots of things to rule out. Also some medications help nerve pain until things are figured out for you.
Hope you are feeling better soon.

2baloo said...
This comment has been removed by the author.
sports herniac said...

jeff
what state do you live in?
that might help with the lack of insurance.
i had to borrow money, too.
i went to germany cuz by the time i went there, i had enough of the pain and wanted to see the best.
i had same symptoms you describe.

sports herniac said...

i hear mixed reviews on dr brown

maybe try dr david muldar at mcgill univ in montreal?

2baloo said...

Sports Herniac
How does AP affect the obturator nerve - is this why some surgeons do the adductor release?

Christopher - waiting for another update!

sports herniac said...

hi 2baloo
that is the question that i am also seeking the answer for!!
i've no idea. all i know is the anatomy of the obturator nerve. from what i have learned via my manual therapists, it is very possible that my obturator nerve is entrapped or affected. but that doesn't seem to be the issue with the sports hernia sufferers i have come across.
the entrapment of that nerve does happen to soccer/football and hockey players as well as other athletes who flex at the hip a lot.
who knows, i wish i did!

Christopher said...

Hey Sports herniac,

I've been investigating self-administered techniques to help with my si joint and iliopsoas issue and came across Julstro. I think I may have seen a post from you on her site. I have her triathelete book and was wondering if there were any techniques that have been particularly helpful for you?

What do you think is the best way to treat and stabilize the si-joint post-op for sports hernia? PT? Chiropractic adjustment? Prolotx? Some combo of all three? Thanks, Chris

2baloo said...

Sports Herniac!
How can I get in touch with someone who has had surgery in Munich to get an idea about what to expect.

sports herniac said...

2baloo
i had surgery in munich. my story gives good details as do many posts on letsrun.com sports hernia forum
good luck

2baloo said...
This comment has been removed by the author.
sports herniac said...

that is hard to say for sure. i think there are equal amount of people still suffering from the nerve pains who have gone to meyers or muschaweck.
she claims that everyone that she operates on is pain free within a few months and if not, then it is something other than a sh causing the pain.
i don't know how to answer your question with confidence, sorry.
i think there are many factors that decide whether or not the pain is chronic or not post-op.

Francesca said...

I have been searching on your blog for posts by women. I have had a mysterious groin problem for over four years. Too long to go into the saga of treatment attempts and changing symptoms, but it started with sharp pain after sitting for extended periods and now I have all sorts of hypertonic muscle issues. My psoas, adductors, quadratus lumborum all causing a lot of pain and trouble. I did see a dr. through SF Kaiser who has done some sports hernia operations and he basically told me that even if I did have one he wouldn't operate because I wasn't a professional athlete.
Have you seen posts by women who were diagnosed with sports hernias? It is apparently much less common.

Thank you for this post.

2baloo said...

Francesca,
Go to www.dellon.com and the pamphlet on groin pain. Let me know what you think.

chicago said...

Fortunate to have located this site....
I had symptoms for over 3 years - lower stomach pain usually triggered by sprinting, changing directions,kicking a ball. This past spring I started experiencing pain in my groin - sleeping in bed was almost as bad as everything else (isolating the stomach and triggering groin pain). Had bi-lateral SH surgery in Milwaukee 7 weeks ago. Sneezing is not causing nearly as much pain as it use to, but I am far from 100%. I was recently told recovery could be 6-9 months due to the length of problem prior to surgery. I'm shocked the Dr. is not encouraging a more specific post-surgery rehab plan. Have been encouraged to exercise as long as pain is not involved. I hope others are more impressed with the Dr's guidance - I've been disappointed. I'm 36, in great health, and very eager to continue my athletic interests, but am concerned if I will ever be truly pain free. If one could specify a plan to follow to help balance my body in hopes of improving recovery, i would appreciate it. Chiro? PT? Massage? I am committed to getting better, but need guidance to help get there. ANY help is GREATLY appreciated! To those just starting out, PLEASE identify a Dr who specializes in SH diagnosis - Mine took 3 years, 3 MRI's and I ended up having the 1st Dr. I saw 3 years ago do the surgery (even the pros miss them occasionally!)

ATP said...

Hi Chris, I'm wondering if anyone has had success with rehab post surgery to correct a sports hernia?

Thanks

Will said...

If you have a sports hernia (or groin pain in general) and can get to the UK please see David Lloyd...

http://www.lloydrelease.com/david-lloyd/

He is very good.

DO NOT visit Jerry Gilmore.... he is about 20 years behind regarding technology and knowledge.

Take this from someone who's been there and done that and an expert on the subject.

(I'm posting this under every subject heading as it's very important and potentially life changing)

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