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| Messages 1 - 9 of total 9 in this topic |
Skeptimistic
Mountain climber
La Mancha
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Topic Author's Original Post - Apr 13, 2014 - 09:20pm PT
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Anyone here had a "sports hernia" aka athletic pubalgia? I avuslsed my adductor longus off of its insertion on the pubis about 3 wks ago. My options are physical therapy or surgery. Apparently this is a fairly uncommon affliction and not enough data on whether one course is better than the other.
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DanaB
climber
CT
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Apr 14, 2014 - 12:09am PT
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PM sent.
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crusher
climber
Santa Monica, CA
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Apr 14, 2014 - 10:50am PT
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I tore an abdominal ligament off bone (also diagnosed as a Sports Hernia) and did not have surgery. Your situation is different in terms of what you tore and the potential affect if you don't have it repaired, but as with anything why not try the PT first before resorting to surgery? I was off vigorous exercise (except walking) for 6 weeks before I was allowed, after the swelling went down and pain subsided, to gradually resume working out and easy climbing. Treated it like any torn ligament - icing and ibuprofen. Now, 3 months later I'm fine.
Good luck to you.
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S1W
climber
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Apr 14, 2014 - 11:13am PT
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Any of you guys mind sharing additional details regarding how the injury occurred, onset of pain, symptoms, etc?
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matisse
climber
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Apr 14, 2014 - 01:48pm PT
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G
I think the key piece of information you need is:
is the surgery you get now going to be different (more complicated/poorer outcome etc) than the surgery you get later? if the answer is no, then you have nothing to lose by trying PT. (I know a good one for spine pelvis stuff).
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crusher
climber
Santa Monica, CA
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Apr 14, 2014 - 02:17pm PT
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It's likely that mine occured during an especially hard non-climbing workout that included those giant ropes that you hold the ends of and flop up and down. I was doing that while "sashaying" side to side in a squat position. Sounds awful now that I say it (it was hard). I do a hard circuit-training workout twice a week.
Next morning I had pain/discomfort in my left groin area, from about belly button level down, but off to the left side. Figured I may have strained something even though I have strong abs. That's what it felt like - a burning pain that was constant. It didn't go away after 10 days so I went to the Dr., who poked and prodded and discovered the tear down low (pain was radiating up from tear area).
This is different than a traditional, or inguinal, hernia (there's no tell-tale bump and it's really a ligament tear vs. a hole in the abdominal wall) so it's can be harder to diagnose, especially in women where they're often written off as ovarian issues.
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Skeptimistic
Mountain climber
La Mancha
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Topic Author's Reply - Apr 18, 2014 - 12:11pm PT
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Thanks for all the comments; here's the update:
I opted for surgery after reading the available literature & consulting my med friends from both disciplines (pt & surgeons).
Pro-surgery camp advised that:
1) the longer we wait, the more the muscle will shorten, compromising surgical options & extending rehab time
2) losing the adductor will change the force couple on the pelvis which could lead to symphysis laxity and potential pelvic floor dysfunction
3) weakened pubis bone may be more prone to fracture with age
4) although the literature is limited, the majority of outcomes were favorable for full return to function
PT only camp advised:
1) surgery has risks including chronic pain/numbness
2) I'm not an elite athlete and likely won't notice any difference
3) surgery is expensive and most insurance won't cover it due to the limited # of cases
4) 6 weeks of rehab vs 3 months
The force couple advice is what tipped it to surgery. Insurance is covering 90% so far (I paid $1K so far). Surgery was yesterday afternoon & so far the pain is manageable wih naprosyn, but the doc gave me percocet as a back up. I'm in a hip brace for 3-6 wks to limit ad/abduction & flex/ext. also no lifting >10 lbs and toe touch weight bearing for at least 2 weeks. That's the hardest part for me. I'll be back at work on Tues (as a vestibular physical therapist, requires no lifting).
How it happened: I was performing resisted plyometric squat-to-jumps with a 30# medicine ball. When I came down & reversed direction quickly, I let my left leg abduct (move outward) under tension & then felt/heard a loud pop with associated 6/10 pain. Surprisingly the pain quickly subsided to about a 2, but when I tried to resume the exercise, it came right back. I began to worry that I'd given myself an inguinal hernia, but there was no bulge or abdominal tenderness. MRI & radiograph confirmed the avulsion. I was fortunate that there was no abdominal oblique injury.
Surgical approach was open incision placing a mesh with bony sutures to hold the bone fragment onto its origin.
Looks like no climbing for a couple months :-((
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Hampton
Social climber
Tucson, AZ
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I think I have a similar injury as the OP. Any further news on your recovery? How about you crusher, any further injury or limitations following the PT path?
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crusher
climber
Santa Monica, CA
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Nope I'm good. Occasional soreness but nothing like the original tear. I think I healed up pretty well and was lucky. Took about 3 months in total.
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