Hockey and Hernias, Part V: Pelvic Floors and Physiqz

(continued from Part IV)

In 2010, I shared my experience with the so-called sports hernia. I had no idea then that so many people would find that story or the subsequent posts on the same topic.

Long after I thought I was done writing about this subject and figured my posts were buried on the Internet, Jon Chambers found my story. Jon is the content editor at Physiquz.com, a site dedicated to physical therapy and powerlifting. He has written many pieces about sports hernias, including the guest post that follows.

 Image provided by Physiqz

by Jon Chambers

The complex sports hernia injury is largely misunderstood. In fact, the name ‘sports hernia’ is a misnomer as there is no true herniation present. On the contrary, it is actually a structural weakness that develops in the deep abdominal wall and exterior obliques. This damaged soft tissue lays the groundwork for the injury’s worst symptom: chronic groin pain that doesn’t seem to respond to traditional physical therapy methods.

Effective treatment methods are largely unknown to general practitioners, leading to difficulties in receiving an accurate, positive diagnosis. For this reason, the professional advice of an expert should become a top priority for those injured. With that said, medical understanding of the problem has expanded dramatically since first mentions made their way into research journals in the 1980s. Using these studies as a roadmap, an effective roadmap to recovery has been born.

Increasingly, evidence points to muscular imbalances as the primary culprit in developing the injury. As the adductor muscles of the inner thigh become stronger, the core is unable to compensate—resulting in tears as the abdomen is forced far beyond its limits. “One-sided” athletic activities that are repetitive in nature, such as the kick of a soccer ball or the hitting of a hockey puck, are a main contributor to this uneven development.

The solution to resolving pain lies in working to restore balance. By utilizing a full-core rehabilitation approach, those afflicted are able to restore symmetry to the muscles of the hip and groin. As the athlete regains proper movement patterns, pressure is then lifted from the area allowing for relief.

Conservative treatment should be prescribed for 6 weeks. If substantial progress is not made in that time towards lowering pain levels, however, moving forward with surgery should not be feared. At surgical success rates of 95% and higher, taking the time to find a doctor specifically trained in the treatment of sports hernias is well worth the effort.

(Jim Dwyer here again, with an update on my situation and comments on Jon's post. I'd say that I'm in the 5% category. Hard to say what may have gone wrong with the surgery or subsequent physical therapy because there are so many suspects—bones, ligaments, nerves, fascia and tendons—that reside in the pelvic floor.

Before even finding a surgeon, I recommend finding a pelvic floor therapist, someone who has performed a manual exam on hockey or soccer players.

If you're like me and learning about pelvic floor therapy after surgery, you too can benefit. After four or five visits with the pros at The Pelvic Health and Rehabilitation Center (Lexington, MA), the pain has decreased in frequency and duration. There is no magic fix for it, but there is relief. Even with the mysterious and maddening flare-ups, I'm hopeful that I can enjoy life more.

I don't expect to ever play organized hockey again and powerlifting is not my thing. Maybe a pick-up game or power walking. If I can do those activities with less pain, I'll consider that a victory. 

Thanks to all of you have visited the site and to the people like Jon who are doing their best to help those who seek help with pelvic floor pain.)