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In-Depth Sports Hernia Guide [Infographic]

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  • In-Depth Sports Hernia Guide [Infographic]

    Hi everyone!

    After having the privilege to speak with Dr. Towfigh and being invited to the forum we wanted to share a guide and infographic we created that draws from various scientific journals and provides a lot of very helpful information for anyone suffering with the vexing sports hernia injury.

    First acknowledged in literature in the 1980s, medical understanding of the issue has since grown tremendously. With this enhanced understanding and knowledge much progress has been made towards the development of effective rehabilitation and surgical techniques.



    You can read more from the actual guide here: https://physiqz.com/physical-therapy...etic-pubalgia/

    For questions regarding the article please feel free to leave them below and we will try to answer as quickly as we can!
    Physiqz.com

  • #2
    Thanks for the added details about sports hernias / inguinal disruption.

    On a related note, here are a list of surgeons in the USA who are reported to be capable of diagnosing and performing surgery sports hernia / inguinal disruption / athletic pubalgia injuries. The sports hernia repair is typically a non-mesh tissue repair, or similar.


    EAST COAST SPORTS HERNIA SPECIALISTS:

    - Dr William Meyers - Philadelphia PA

    - Dr Alexander Poor - Philadelphia PA

    - Dr Litwin - UMass MA

    - Dr Brian Busconi - UMass

    - Dr Andrew Boyarsky - NJ


    WEST COAST SPORTS HERNIA SPECIALISTS

    - Dr William Brown - Fremont CA


    I believe Dr Shirin Towfigh may perform sports hernia surgery as well, but I am not certain of that.

    If anyone knows of any other sports hernia surgeons, feel free to add them to the list.

    Comment


    • #3
      In addition to the US based surgeons I listed, for Europe a well-known sports hernia specialist is:

      - Dr Ulrike Muschaweck in Germany / UK

      Comment


      • #4
        Question: Does the sports hernia ever present with a bulge? Much of what I am experiencing sounds very similar other than the fact that my muscle aches radiate upward and outward (from around "4b" to the outer, upper edge of "2" on the diagram) and there is a bit of a bulge that seems originate just above "4b."

        Part of what has me coming back to the sports hernia is what causes them makes a lot of sense for me: my primary form of physical activity is power lifting (squatting, deadlifting, overhead pressing; particularly squatting). What the larger article says about creating a significant imbalance fits my working out to a T.

        All that being said, the fact that there's visible bulging sounds like it may limit the diagnosis to a true inguinal hernia.

        Comment


        • #5
          Originally posted by Chaunce1234 View Post
          Thanks for the added details about sports hernias / inguinal disruption.

          On a related note, here are a list of surgeons in the USA who are reported to be capable of diagnosing and performing surgery sports hernia / inguinal disruption / athletic pubalgia injuries. The sports hernia repair is typically a non-mesh tissue repair, or similar.


          EAST COAST SPORTS HERNIA SPECIALISTS:

          - Dr William Meyers - Philadelphia PA

          - Dr Alexander Poor - Philadelphia PA

          - Dr Litwin - UMass MA

          - Dr Brian Busconi - UMass

          - Dr Andrew Boyarsky - NJ


          WEST COAST SPORTS HERNIA SPECIALISTS

          - Dr William Brown - Fremont CA


          I believe Dr Shirin Towfigh may perform sports hernia surgery as well, but I am not certain of that.

          If anyone knows of any other sports hernia surgeons, feel free to add them to the list.
          Thank-you for your excellent contribution to the thread!
          Physiqz.com

          Comment


          • #6
            Originally posted by UhOh! View Post
            Question: Does the sports hernia ever present with a bulge? Much of what I am experiencing sounds very similar other than the fact that my muscle aches radiate upward and outward (from around "4b" to the outer, upper edge of "2" on the diagram) and there is a bit of a bulge that seems originate just above "4b."

            Part of what has me coming back to the sports hernia is what causes them makes a lot of sense for me: my primary form of physical activity is power lifting (squatting, deadlifting, overhead pressing; particularly squatting). What the larger article says about creating a significant imbalance fits my working out to a T.

            All that being said, the fact that there's visible bulging sounds like it may limit the diagnosis to a true inguinal hernia.
            I actually just recently spoke with Dr. Goldstein of "The Hernia Institute" in New York and he told me that several of his patients that presented sports hernia symptoms in-fact has an indirect inguinal hernia--which is a "real" herniation. In this case, a small bugle will present itself--though not always palpable from the outside of the body like your case.

            It is great that you mentioned your powerlifting background. I am actually a competitive powerlifter and experienced the same imbalance issues that ultimately, I believe, led to my sports hernia. Muscular imbalances seem to play a very large, if not the largest, role in developing the injury.
            Physiqz.com

            Comment


            • #7
              Other surgeons for sports hernia:

              Michael Brunt: St Louis, MO

              Aali Sheen: Manchester, UK

              Giampiero Campanelli: Milan, Italy

              I also repair them.

              Note that most groin pain that is labeled as “sports hernia” is not a true muscle tear rather a run of the mill inguinal Hernia. Their treatment is different.
              #ItsNotJustAHernia
              www.BeverlyHillsHerniaCenter.com

              Comment


              • #8
                drtowfigh

                How would you know the difference between a Inguinal Hernia (recurrence) and a sports hernia? I don’t have a bulge but I have achy pain in th same area as my repair.

                Comment


                • #9
                  Completely different examination findings and symptoms. A surgeon specialist can help differentiate.

                  Most St people don’t have sports hernias. You have to a true athlete with huge muscles to get them, typically.
                  #ItsNotJustAHernia
                  www.BeverlyHillsHerniaCenter.com

                  Comment


                  • #10
                    drtowfigh

                    Ok thank you! Would constant bloating go with one more than another?

                    Comment


                    • #11
                      In my experience bloating is more often seen with the typical Hernia. Sports hernias are tears that are painful but often don’t have content in them so bloating does not occur
                      #ItsNotJustAHernia
                      www.BeverlyHillsHerniaCenter.com

                      Comment


                      • #12
                        drtowfigh

                        would a MRI show either of those diagnoses? I don't have a bulge for a recurrent hernia but if it was "hidden," would it still show? I'm trying to figure out what's causing my issues. thank you!

                        Comment


                        • #13
                          Is it accurate to say that some "sports hernia / inguinal disruption" is basically the painful start of a direct inguinal hernia, but that has not broken through to full herniation completely yet? I recall reading that somewhere, but I do not understand the complex groin anatomy well enough to make sense of it.

                          On a related note, this video presentation from Dr Ulrike Muschaweck on inguinal disruption / groin injuries may be of interest to some readers here, she describes the classic inguinal disruption injury, as well as her particular approach to repairing these injuries:

                          https://www.youtube.com/watch?v=w-Rz4V-eGZI


                          Note the video is intended for a medical audience and has some graphic imagery, so the squeamish may want to avoid.
                          Last edited by Chaunce1234; 04-23-2018, 11:33 AM. Reason: Apologies, not sure why the font is bold all of a sudden

                          Comment


                          • #14
                            Originally posted by Physiqz View Post

                            I actually just recently spoke with Dr. Goldstein of "The Hernia Institute" in New York and he told me that several of his patients that presented sports hernia symptoms in-fact has an indirect inguinal hernia--which is a "real" herniation. In this case, a small bugle will present itself--though not always palpable from the outside of the body like your case.

                            It is great that you mentioned your powerlifting background. I am actually a competitive powerlifter and experienced the same imbalance issues that ultimately, I believe, led to my sports hernia. Muscular imbalances seem to play a very large, if not the largest, role in developing the injury.
                            At this point, if I had to guess (and it's truly a guess), I would guess that what started as a sports hernia eventually progressed to a direct hernia, because I didn't recognize the signs and kept lifting through it. However it sounds as though anything with a very visible bulge is a true hernia of some type.

                            I am guessing direct because the bulge always, immediately, and automatically completely reduces upon laying down, with no manual reduction necessary. However I'm sure one of the docs can correct me if I am mistaken; I'm going by what a number of "difference between direct and indirect" charts show.

                            I would also guess direct since the only discomfort I ever feel is muscular (vs. nerve/testicle) and if I manually reduce it while standing, then push all the air out of my abdomen/hold lower abdominals taut it stays in. However unlike an indirect (I think) it doesn't stay in on its own for a time, then pop back out; it's consistently visible unless I lay down or reduce with finger.

                            Who knows... Will have proper surgical diagnosis at some point.

                            Comment


                            • #15
                              Originally posted by Physiqz View Post



                              It is great that you mentioned your powerlifting background. I am actually a competitive powerlifter and experienced the same imbalance issues that ultimately, I believe, led to my sports hernia. Muscular imbalances seem to play a very large, if not the largest, role in developing the injury.
                              I also have another hypothesis, which you may be in a great position to comment on: I think that, for any lifters with a weak area of the lower abdominal wall, the use of a lifting belt has the potential to actually increase the likelihood of developing a hernia. Using the belt properly, one creates more intraabdominal pressure than would naturally occur (even with a valsalva). However, the groin area doesn't have the belt to brace against, so the tissue alone has to withstand that pressure increase.

                              I used a belt up until about two years ago, when I first realized I probably had a hernia. Since then, that's been a no-go.

                              Also curious what exercises you'd recommend for someone wanting to even out that imbalance. I've taken a look through the guide on your site, but am a little lost, since I'm not injured to the point I can no longer lift without pain and need to essentially come back from zero. I still lift 3x/week and am squatting 1.5-1.75x bodyweight (which has always been on the heavier side for me, with or without belt or hernia), so my activities aren't limited. I just want to avoid it getting any worse and keep everything as strong as possible.

                              Comment

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