Sports "hernia"

Hi all

Yesterday I was diagnosed with a sports hernia (I've been suffering with it for 5 months) - I've been told to go for a course of physio which I start this saturday.

Having done some reading around the net it seems that physio is more often than not unsuccessful and surgery is normally required......has anyone got any first hand experience of this injury/treatments/surgery?

Thanks

Adam

PS - it makes me even more proud of completing the VLM in a smidge over 6 hours!

Adam there is more than one type of hernia depending on where it is. Had one in the past and needed very slight surgery. Wasn't even given a physio option. It's done and dusted quickly, but if you go down that route remember to take time out after.

Where is it and what have they called it?

i cant remember the name of the muscle but, running horizontally across the pelvic region is a muscle that the abs and leg muscles connect to.

on the right hand side of this muscle I have a "weakening" which could become herniated.....does that help?

Hello Again Adam!

 It will be a weakness in your inguinal canal (basically just above the point that your leg joins your body).  If there is a bulge there then its an inguinal hernia - if not then its a sportsmans hernia (aka gillmore groin). 

Physio will consist of core-strengthening to see if you can overcome the weakness by improving your core muscle strength - it doesn't work very often - think its about 15% or so (I did a lot of reading of the scientific literature when I had mine done!).

If that doesn't work then the option is surgery..... there are 2 types of surgery practiced by different surgeons... One type involves going in and covering the weakened area with mesh.  Then you get muscle / scar tissue growing over the mesh which strengthens the area.   The other type involves going in and fixing the weakened area with stitches..... Sports hernia's are very common in pro-footballers and different footballers (Michael Owen, Alan Shearer, Paul Scholes, Steven Gerrard, Fernando Torres to name but a few) so you're in good company.  Pro-footballers usually have the stitching option treatment as its a much quicker recovery time - but a lot of them have to have it done again because that method of treatment isn't as robust as the mesh..... (not even sure that you can have the stitching method done in this country).

I had the mesh option in Dec 09 and it was about 12-14weeks before I could run again and about 20weeks before I could play football again (although this was more to do with the weakness in the groin tendon I also ruptured playing football and not the sports hernia).

To be honest i'm not sure whether you can have either op done on the NHS, I had mine done privately through BUPA by a Doc that had done tons on all kinds of people from Pro-athletes to pub-footballers.  Would you be NHS or do you have health insurance?

I can go into more detail about the post-op experience if you want but without wanting to go on all night i'm glad I had it done because I didn't realise how much it had been nagging away and affecting me without me realising.

What are your symptoms?

Take it easy!

thanks for the long post forty_44....the only bit of that which worries me is the 15% success rate of the physio!

 Basically, in January I was snowboarding.  I went to get up onto my heel edge and had a really really intense pain along the right side of my groin and all the way up the right side of my abs.

Between January and the end of March I played 5 a-side and squash withouth too much discomfort (as well as training for the VLM) - but there was a nagging pain there all the time which meant I could sprint, just a comfortable run. 

Then in the 2nd week of April 10 mins into my football match I pulled up sharply with exactly the same pain....the day after I could barely walk and it took 2 more days until I could walk "normally".....10 days later I ran the VLM with the help of ibuprofen and deep freeze....as long as I kept my strides short and straight I could run without much pain.

13 days after the marathon I went to play football....5 mins in I get the same pain again followed by the not being able to walk etc

Since then as long as I keep my strides short and straight I can walk fairly normally, but as soon as I try to turn (even when walking) I get a pain in my groin..........the doctor held his fingers across the muscle in my pelvis and got me to cough and said I had a weakness in the muscle......and that physio was the next step.

Everything I've read since then points to the fact that physio is normally fairly ineffective and that surgery is the only option.  I dont know how many sessions of physio I should have before I notice a difference? or how I gauge the injury before I want surgery.

I have BUPA through work so getting a quick op shouldnt be a problem....I just want it sorted asap so I can get out and run again!

I'd love more post op detail when and if you get the time......

Here's my story (and no I didn't just copy yours).........

About 12months ago I played 5-a-side and felt a stiffness in my Rt groin - took about 10mins to run off then I finished the match fine - the day later I couldn't walk because I had pain in my groin and lower right hand side of my abs. I didn't play football for 6weeks during which time I had weekly physio and my physio said he suspected a sports hernia (he was right).  When I went back to football following this I had a constant feeling of weakness and nagging pain and couldn't sprint, only short strides - then in a match I went in for a challenge and felt like i'd been shot in the groin - immediately got a lump in the tendon in my groin and a hell of a lot of ab pain couldn't walk again for 3 days. Turns out this time I ruptured a tendon as well as agravating the existing sports hernia.

Went back to physio and he referred me on to the sports hernia specialist - a Doc called Mr Scott in Fairfield hospital in Crank who has operated on a whole range of people from pro-footballers to non-sports people, he had done hundreds of these cases now.  He assessed me in a similar way, but he felt the area by inserting his fingers underneath the weak area - no good way to say this but the only way to feel the area is through the scrotum......nice! Anyhow, he confirmed the sports hernia and I had the op very soon after.

He said that everything went to plan and there were no surprises when he opened me up - apparently he uses some new kind of mesh from France that has reduced complication rates too.  Post op was not very pleasant - quite a lot of pain and discomfort for the first few weeks but I guess thats to be expected with any op, but then when you add in the fact that the op was on an area that your body uses for every single movement from sitting up to coughing its going to cause a bit of pain! Oh, and then the re-growth of hair was a bit of an itch!!!

Once the staples were out (2wks I think) it felt a hundred times more comfortable and I could start to do some rehab.and physio. I had physio once a week for about 12 weeks and gradually increased my rehab starting with some walking then pool jogging, gentle jogging, faster jogging and then sprints. All the while I was doing core stability exercises to strenghten the area and correct the muscle imbalance.

That was Dec 09 and I am doing a 10k this coming Sunday and the Great North Run this year too. I've played football for the past few weeks and feel nothing from the sports hernia op site - just a weakness in the tendong that I ruptured, but its getting stronger and stronger. Knowing what I know now would I have it done again? Definitely. I didn't realise at the time but even before the large 'events' I described above it was nagging away and I'd have aching and stiffness there for a couple of days after running or playing football.

Now it feels strong but weird - if I put pressure on the area by turning my foot inwards whilst there is resistance against it (as if your trying to move a box just with your foot) then I get a feeling in the op site - its not pain and its not uncomfortable - its just that I feel the whole area contract and pull together, maybe thats everything contracting around the mesh - i don't know, but I certainly couldn't have done that before without any pain.

I would definintely recommend the surgeon I had - I don't think there are many Drs in the Uk that do this - but you may find one closer to home.

If you want to ask anything please don't hesitate - I'd have loved to ask someone all the questions that were on my mind before I had it done - I just had to make do with trying NOT to read horror stories on the net about people who went NHS and ended up in a mess becasue they got treated for a hernia and not a sports hernia!

its fantastic to read someone having gone through the exact same thing as me.....very comforting!

So how many sessions of physio do you think I should have before I notice a difference?  I dont really fancy spending weeks and weeks on physio just for it to herniate/rupture properly....to be honest I'm more than happy to go under the knife and get it sorted!

 Thanks again for the long write up, I really appreciate it.

I guess its difficult to say how many physio appointments you would need - mine didn't show any response to physio after about 6 sessions......  I guess for me I had all the core strengthening stuff the first time around (for 6weeks) and then when it ruptured again the physio just referred me straight to the Dr.......

The physio will know how to advise you - thats presuming they have knowledge of sports hernias that is....... but you are maybe best just asking to be referred to a specialist right at the beginning and then they can assess you and then that cuts down on any wait time.  Your physio should know a surgeon who would do these op's - but I would ask them whether they have referred anyone for treatment before and if not I would try to do some research to find which surgeons are in your area that have done a few before..... if there are none I'd go to someone who has done them before - i'm sure that you'd be able to pick who you went to....

Let me know how it goes (just send me a message on here and i'll give you my email address if you want) and I will give you more detail about what to expect post-op should you end up having the op done.

Adam

Interesting....

I Pulled out of NF mara in Sep with a dull ach all down my quad (left) by the time I got home could barley walk as groin had siezed up....

Saw Doc who thought it was Gilmores Groin and put me on to a specialist... (in mean time groin eased up to just a dull ache after running that was uncomfortable but not painful.

Should also mention that when doing long runs fro the NF mara I would curl in pain when I coughed... but only when I coughed on the run....

Saw 1st specailst was a waste of space as only was seen by him so that I would not breach waiting time lists (he was a hip specialist)

Eventually saw a Groin specialist.... told him history and that was still running.... he said he had never heard of Gilmores groin (got me worried)  but he did think I had a hernia, which was proved when I had an Ultra sound....

So 6 weeks later had surgery on the hernia..... that was 3 weeks ago with mesh... told I could start jogging after 2 weeks...

So left it 18 days..... have now had a couple of jogs..... no pain from surgery site... but getting the dull ache already from the ligament at the top of leg going into groin......

not convinced that I have something else... but did speak to a mate who has been operated on By Dr Gilmore for the groin and he stated he couldn't run with his where I clearly can plus the pain levels are different......

So I am in the process of building up strength and core exercises in the groin / abs / hip flexors....

But thinking that will see a physio as may be lower back related....??????????????

had my first physio appointment this morning - the physio initially wondered if it was linked to a back problem but soon discounted that.  she is of the opinion that I have damaged the hip flexor - I'm to ice the area every night for 20 minutes, perform quad stretches (the one where you grab your foot behind you and pull) 3 times per day for 30 seconds at a time and combine this with physio from her - starting this Thursday.

She near enough killed me this morning just by jabbing her fingers into the area and massaing it for 5 mins - the only thing that kept me going was her unnatural amount of facial hair!

Sounds like a wonderful physio you've got there!! Could be worse I guess - my physio is male and I had the 'pleasure' of him jabbing his fingers into my groin once a week for months on end!  My physio also thought that my problem was back related at first and also did a lot of work to free of my hip flexors but none of that worked for me  - with any luck it'll work for you and you will be back to normal in no time!!

RFJ - I had my op in Dec and it was probably about 6weeks before I was able to go out running and still I had the same dull ache but i didn't have the associated pain that i'd been having in conjunction with it.   Over time that subsided and now when I run  80% of the time I feel nothing but then every now and again I just feel the same dullness - but maybe that's to be expected given that we have a piece of mesh inside us?! The main thing from my point of view s that I didn't have any pain like I did pre-op.  What my physio did say was that every time I stepped my rehab up a level i'd know about it for a few days after - and he was right, every time I did something more strenuous on the area it ached for a few days.

Adam - have you had any results from the icing? And did your physio say that she had seen people with sports hernia's before? I don't want to sound critical of her - but if you're the first person she's ever seen with one then how's she going to know whether its that or a hip problem? I think that knowing what I know now I'd be inclined to find sports hernia specialist (surgeon) in your area and just go an see them (it won't cost you anything anyway I doubt with BUPA) - then at least you'll have all angles covered - because the longer its left untreated and the worse the tear the longer the rehab.  Thinking back I had mine for the best part of 5 years and never knew so I had a longer than average recovery!

I'm hoping she's got the right diagnosis - I just want it sorted asap so I can start training again!

Over recent months I went through spells of icing and yeah it helped, but never actually fixed....it seemed to calm the injury and let me train still.

I'm seeing her again on Thursday so we'll see what happens, fingers crossed it can be fixed.  Time for a pilates DVD I think!

If it's a sporting hernia injury,the only thing that will solve it is surgery-sounds likeit could be a "Gilmores Groin" which is different from an inguinal hernia-it's actually a group of injuries,rather than one problem on it's own-Hopefully you have the right diagnosis-If it is a Gilmores groin then physiotherapy won't help at all-I would make enquiries at your local private hospital and specifically try and find someone who specializes in Gilmores Groin.

Failing that you could book into the London Groin and hernia clinic and see Jerry Gilmore himself,who would be able to give you a definitive answer-I should point out that I am a Chartered Physiotherapist with 25 years experience,so I do have some idea of what I'm talking about!!!-hope this helps

Hairy - Thanks

I had inguinalHernia that I didnt know I had.... but as F44 says, its onlt 4 weeks post op form me on the normal hernia.... but still believe that its Gilmores..... however..... I shall wait a bit longer before going back as there is some easing and not the intensity that I had before......

So will wait before going back about 4-6 weeks then try as you sugested.... bizarly thats what my GP thought it was was gilmores, but the Specialist didnt even know what gilmores groin was when he did the hernia....

Time will tell, so will the pain when I ramp up the milage as that will be the tester...

Hey Adam,

 How are things going and where are you up to with the recovery?

Hi

Just had gilmore's groin diagnosed yesterday. After 6 months of frustrating tests and scans my G P referred me to a private hernia consultant to have my hernia operated on. As it was constantly painful he thought it could be dangerous. Within 5 mins of proding the consultant said he didn't think it was the  hernia that could he causing the pain as it was too small on the scan and that up to 80% of people have small hernias that never cause them any pain or problem. The next 40 mins he went on to talk about Gilmore's Groin/ Sports Hermia and everything fell into place.  I then looked up other peoples symtoms and all the symtoms were identical to mine - Hurts to do sit up and getting out of bed and the car - can not stretch the leg down. Painful at the start of a run, not so much during it  but then for a day after....................and  sneezing!!!!!!!!!!!!!

He was very informative and said he would advise rest and physio and was not convinced that there was enough proof that the ops worked!! He said that if he did the hernia op as suggested I would have to rest for 6 weeks and in that time the pain would have had time to heel and it would all be put down to a successful op. As he was private and doing himself out of business I felt quite assured.

 Interestingly he said they seemed to be more common with runner that turned their  feet out slightly, which as I also have a injured knee and my running partner says that when i get tired my foot drifts out a bit and this is also the sore side. He was quite scathing of the op as he said time taken off healing is the same as if you just rested it. Hard to do when you have a race coming up though!!

The other strange thing is that you all seem to be guys and I am a girl!!!!!!!!!!!! so it looks like it's more common in men and at least you don't have to go through all the gynie stuff first because with us any pain down there can never be anything else.

Would really like to hear if there are any women sufferers out there.

I think I will go down the resting route although my consultant said if I manage to run through it, which on a good day I can, I could wait until a convienient time comes up - ie after my next race.

 You are all right about Docs not knowing about it because it seems so obvious when this last consultant looked at me. Nobody else had ever mentioned anything like it.

 Really good to read all you comments.

Hi,

I was going backwards and forwards from the docs and having scans for 6 months and nobody once suggested anything but a hernia even though the hernia was tiny and could only be seen with very fine scanners.

I would think that if you could get your doctor to look Gilmore's Groin up then he should be able to give you the advise you need. My visit to the private consultant/surgeon should not have been necessary as I was referred for a hernia op. I feel lucky that he was well informed. He was very anti the surgery route though, which he was not convinced it was necessary.

My husband just returned from a trip a board and brought back a strange  disease and because he knew what he had been bitten by, he suspected what his diagnosis might be, his doctor thanked him for bringing him something he had not come across before and was keen to look it up. So as not many GPs seem to know about Gilmores groin he might be grateful that you suggest it.

Sneezing is very painful if you don't prepare for it!!!

Good Luck