another doctor is excited to learn about the sports hernia

so i had an appt with an osteopath who works in a neurology group. she used to practice prolotherapy in her own practice, but unfortunately insurance won't cover prolotherapy (of course not, right?) and she couldn't afford to keep her own practice. she no longer practices prolotherapy in the group she now works with.

i told her my story and she told me that she has a patient who is a physical therapist who has all the symptoms i described. she believes now that he has ap. he also was misdiagnosed with epididymitis then non-bacterial prostatitis. then eventually groin strain. then the next. years later he is still in pain. she actually listened to my story, unlike previous doctors, and was open to learning more about this injury since she was an authentic and good doctor. i didn't feel like a patient that was viewed as either a pain in the ass with a phantom, probably psychosomatic, injury- quite the contrary.

well, another doctor learns about the dreaded injury. 9 months ago, i had a young and athletic hernia specialist say he doesn't even believe ap exists and it's a crap story. perhaps we can all share the info with our doctors and hope they will listen and learn about the injury on their own time. if you want, email me and i can send you a copy of an article written by an expert ap surgeon. you can print it out to mail to doctors that told you that you have anything but ap since they have never heard of it.

going to receive neural and prolo therapies

as stated in the earlier post (one below), these two therapies can hopefully help with lingering nerve pains due to the damage that ap can cause.

i have an appointment with a doctor in nyc next week who does both these treatments plus others, and has treated ap before. at last a doctor near me who apparently knows the injury!

i will report on what he says after my first appt. if any of you sufferers are from nyc area, and think you want to see this doctor, contact me and i will get you his info.

neural therapy and prolotherapy

i recently learned that neural therapy is used in germany to tend to the nerve pains brought about by ap. i know they use a special approach with the neural therapy, but i am not sure how that differs from the neural therapy i have read about online.

from what i have learned, the dreaded sh injury can cause your body to go into all kinds of musculoskeltal imbalnces (which also can be a predisposition to ap). the si joint can go out of whack, which in itself is very painful (take it from me).

prolotherapy is commonly used for strengthening up the connective tissues at problem areas/joints such as a hypermobile si joint. it is also used for relieving pain from such injuries.
neural therapy is used for pain via a neuropathy of sorts as well as nerve pain from scar tissue. injections are both placed into scar tissue and also into the nerve root. apparently it is great for chronic pain such as with a long-standing ap injury.

not too many doctors do these therapies. in fact it is very hard to find good ones with experience. but if you suffer from lingering nerve pain then it might be worth it to find one or two docs to choose from.

recovery from nerve pain due to ap

dr muschaweck in munich recommends taking a lot of vitamin b (in particular 6 and 12) as well as painkillers like advil. high doses should be ingested.

over in munich, when there is a patient with lingering post-op pain, she often sends them to see a homeopath who administers treatments. of course, homeopathy does originate in germany, so maybe that has something to do with it. but, the main doctor for bayern munich, the respected team from munich, is a homeopath that is respected all over europe.

this homeopath agrees with dr muschaweck in that no physical activity can be resumed until the nerves have calmed down, which can take a good long while if the patient has suffered from the injury long enough. in my personal case, i had the pains very bad for 18 months pre-op. but, i beleive i began the injury in 1999, and then had a second bout of bad pain, perhaps a worsening of the condition, again in 2002. so who knows how long i really had the condition. that said, i am not sure if the dr would consider me as having the injury for 18 months or 5 years before surgery.

some signs and symptoms of a sports hernia

many people have groin pain that is chronic. sufferers of athletic pubalgia have symptoms that also exist in numerous other pathologies.
obviously, the worse the injury, combined with chronicity of the condition, can have a exacerbating effects of the symptoms. it can also be noted that a chronic sports hernia causes muscle imbalances in the pelvis, back, and legs which in themselves can be painful but repairable conditions. here are some syptoms reported by some sufferers...

• dull ache, often accompanied by sharp pains, especially after activity involving hip flexion and/or twisting. such an activity can be as simple as raking leaves or someting more demanding such as playing soccer or moving furniture.
• pain is often felt off of the corner of the pubic bone, and can radiate to the testicle(s) in males.
• there is almost always accompanied adductor muslce tightness and often pain in the adductors. it can be difficult to adduct (squeeze them together) the leg(s) because of this.
• pain can also be felt while twisting, from the pubic bone up to the inguinal ligament. this pain can also wrap around to the hip and lower back.
• there can be irritation of the nerves that travel to the perineum and genitals.
• it can be painful to externally rotate your bent leg, but it can also hurt to internally rotate your femur. this can be interpereted as a pathology involving the hip. attempting to kick a soccer ball with the inside of your foot is such a movement that can induce sharp pain, as can sitting cross-legged, or "Indian style."
• there can be intense pain while trying to get up out of bed, causing the sufferer to need to roll off of the bed as opposed to sitting up first.
• in general, bearing down, as in coughing, can be painful, just as in an inguinal hernia.

a couple of misdiagnoses

some conditions are "diagnosed" when a sports hernia might actually be the culprit:

1) pulled groin/groin strain: so while one may in fact pull/strain the groin or adductor muscles during sports or the overload that a sports hernia is caused by, a patient who see such a chronic groin strain that will not go away should seek out more advice from a more experienced doctor of physical/sports medicine. sure the injury can be chronic, but if you are in doubt of the diagnosis, and the mri doesn't show any tears....

2) inguinal hernia: as we know, ap/sports hernia is NOT an inguinal hernia. if a doctor tells you it is, and he has never heard of AP, then he or she is in left field. if an inguinal hernia was also called AP, you would think that any doctor would have heard of it by now, considering thousands of inguinal hernias are diagnosed every day. i had to tell this to several orthopedic surgeons, even after the surgeries i had for AP. one of them would not budge, so i printed out info on sports hernias and mailed it to him (needless to say, i have no interest in going back to see him)! when i left his office, he told me i have something totally unrelated, which was proven wrong by the next 2 practitioners i saw afterwards.

3) non-bacterial prostatitis (chronic): obviously applies to only males. since the phantom pains are in the groin, your doctor might send you to see a urologist. the ur will natrually assume that the problem is under his speciality range and will do his/her best to diagnose you. when the nerves around the groin are irritated (such as when you get kicked in the groin), the body reacts by tightening up the muscles in that area. with severe, chronic nerve irritation, the tissues will also be chronically tightened. such a scenario can cause the prostate gland to be swollen as well, seeing how the gland is attached to the pelvic floor via connective tissues. the ur won't think of this, and if you suggest a muscular issue (like i did), he might tell you that you are wrong and you have this mysterious swelling in your prostate that might be caused by a bacteria, which they cannot find. hmmm, makes you wonder. this is what happened to me, and i was put on levaquin for 35 days! after 7 months, i had given up on my ur and went my own route. chronic prostatitis has no cure as far as the ur's are concerned, basically because all eitologies are theoretcial. that is another reason why all doctors should have basic knowledge of sports hernias and their prevelence; chronic prostatitis is a much worse diagnosis than a sports hernia.

there are more to come...

to stretch or not to stretch?

i did a bunch of stretching before my surgeries (as instructed by a pt) as well as afterwards.

for the last 2 months i have not been stretching, and it has made a difference. an irritated nerve can be more irritated by stretching it. it would make sense to me, that a deep lunge/psoas stretch would more than likely irritate those nerves that are located in the fascia of the psoas. note the nerves that are often irritated in the sports hernia: ilionguinal, iliohypogastric, and genitofemoral nerves.

i wish a doctor would post here and provide insight on the irritation of these nerves. from what i understand, in many cases of ap there is a tearing of the obliques. the ilioinguinal and iliohypogastric nerves pass bewteen the layers of obliques. i can only assume that is why reaching overhead and twisting is painful to so many that suffer from this injury.

so, i think that stretching was bad for me. that is, until the nerves really began to calm down through a period of NOT STRETCHING. by the time i had my surgeries, i was no longer in shape, in fact, i had lost about 27 pounds due to lack of mobility and desire to eat due to pain, and sickness from the antibiotics i was carelessly put on.
as my nerves are slowly becoming less irritated, my mobility has begun to really come back. i can bend over without pain most of the time.