Saturday, July 17, 2010

Hockey Hernias, Part I: Disquietude and the Disclaimer

The purpose for this post is to help hockey players (and other athletes, as well as those who live with them) who are enduring or susceptible to incurring a common, yet confusing condition: the hernia.

The first in a series, which will include topics such as treatments, nutrition, and prevention, this piece is related strictly to the symptoms and diagnosis.

Disclaimer: I am not a doctor and in no way suggest that you should take any of the information below as the truth for your situation. I can only relay what I’ve learned from my own experience:

In September 2008, during an AMHL game, I was skating backwards. I didn’t step on a puck or stick, and I don’t recall over-extending my left leg—when piercing pain in my left groin felled me. I couldn’t rise or skate toward the locker room on my own power, but half an hour later I could walk out of the arena, hefting my hockey bag on my shoulder. Within three or four days, blood had drained down the length of my inner thigh, all the way to my knee. The picture reminded me of a map of Argentina. I was able to ride the stationary bike (not a wise move) without much discomfort, but I quit doing that when my primary care physician told me that I had torn a groin muscle and then recommended rest followed by physical therapy.
Six weeks later, I was back on the ice, only for a few laps of light skating. No pain—at least when I was on the ice. But three days later, the pain returned for no apparent reason.

So, two rounds of PT, an MRI, a pick-up game, seven doctors, one arthrogram, one doozy of a sneeze, and one surgery later, here I am.

I believe I incurred two injuries, which is not unique for those of whose who repeatedly and forcefully stride, to the groin: The first was what one orthopedic specialist termed, after analyzing the MRI, a grade one tear that also likely entailed a minor stress facture as muscle pulled muscle away from the pubic bone. This type of injury, he said, only needed time to heal. But I still had inexplicable onset (delayed) pain, so another orthopedic specialist recommended an x-ray arthrogram, which revelead no major damage, and cortisone, which alleviated the first injury but not the second. The more formidable irritant, what Doctor Number Six (with an assist from Doctor Number Seven) would diagnose as something akin to a direct hernia, required surgery to repair what the he would say was “a very large hole” in the inguinal floor (more on that later).

I’m immersed in physical therapy and hopefully on my way to returning to playing hockey. I’m behind schedule yet realize not every patient is on the same recovery timeline. So that gets me back to the crux of the disclaimer: The information below is culled from what I’ve learned in conversations with doctors, comprehensive Internet research, and the day-to-day disquietude of recovery.

If you’re a hockey player or enthusiast, you’re likely familiar with general terms such as groin and hernia. Perhaps, however, you (like me, when I first sought diagnosis and subsequent treatment) are confused by words like athletic pubalgia, inguinal canal, and sports hernia. The information on the Internet can be overwhelming, and in some cases conflicting. Feel free to research these terms on your own, or wait until the next segment, where I’ll post my research results.
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