Monday, July 14, 2014

Hockey and Hernias, Part III: Plan B, Plan Let's See

A lot of AMHlers and other hockey friends have asked me when I’ll be back playing hockey.  I’m grateful for their compassion and support.

Not sure, is what I tell them, or I shrug my shoulders.

Have I retired?

No. Well, probably. At least from real competitive hockey. Maybe not, though, from pick-up activity. My return to any form of significant exercise other than walking will depend upon what magic the hockey gods might contribute to my healing. I want to alleviate the pain incurred from surgery to fix what medical professionals refer to as athletic pubalgia and/or a sports hernia.

Essentially, it’s an injury affecting the pelvic floor or inguinal canal. As I’ve mentioned in previous posts, diagnosis is difficult because MRI’s usually don’t reveal the damage that we know is there and that will not heal on its own. (Any doctor who tells you to “give it time because you’re old” and who is not familiar with this conditions probably isn’t the right doctor for you.). Surgery tends to be the only recourse to find the torn tissue.

For those of you who’ve benefited from surgical repair, more power to you. I wish you continued hockey happiness.

For those whom surgery has not healed, or who too often feel even worse, you may find company at this Mayo Clinic online forum or perhaps here, where I’ll continue to share my experience.

I don’t fault my surgeons for their baffled reactions to why my pain is just as intense and more widespread than what it was before surgery in 2010; they were clear from the outset that about five percent of surgeries are unsuccessful. The reasons, from what one of my surgeons has told me, are all over the map.

The surgeon can inject steroids to the painful area and call for additional MRIs. In my case, these steroids haven’t helped, and additional MRIs (from different providers) have not shown any evidence of damage. Exploratory surgery is not something the surgeon wants to do, and I don’t blame him.

Rather than waiting for MRI technology to improve, I’ve researched options for those of us who want to get back to focusing on sports, fun, family…whatever arena that gives us purpose and contentedness.

Pelvic floor therapy. My new Plan A. This is not about “strengthening the core,” what traditional physical therapists help their clients with; this is about releasing what might be an entrapped nerve.

Trigger point massage. Probably Plan B. Larry Warnock here in the Boston area has been a terrific resource. He’s proactive in the TPM community and responsive to email. If you’re outside New England, ask a local TPM therapist about what Larry “Thejocdoc” Warnock calls a “pelvic unwind.” My insurance doesn’t cover massage, but the cost is reasonable and not prohibitive.

Cold-laser light therapy. Plan C? Proactive and responsive to email also describes acupuncturist Craig Armine. He’s based in Phoenix, AZ and tells me that it’s important for cold laser administrators, typically chiropractors and acupuncturists, to use 500 milliwatt lasers in a cluster formation at a wavelength of 810 nm.

Magnetic Resonance Neurography. Partly because MRN is a relatively new procedure, it’s much more expensive than an MRI. I’m not sure if insurance would cover it. And I hear that the MRN may not define the problem.

I’ll let you know more in August, after I visit with a pelvic floor specialist.

Please email with any questions. I’m happy to help. 

Continued here.
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