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.)

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.

Kevin Kenny: Boston and PA Strong

With all the bad blood between the Penguins and Bruins, the recovery from concussions, the potential paybacks and the pending suspension of Shawn Thornton, perhaps we can call a truce. If only for a day.

You see, Kevin Kenny, a Pennsylvania junior hockey player, suffered a spinal injury on November 16. As Boston's rally cry resounds in New England, Kevin's friends and family have remained steadfast in their support: Kenny Strong.

I believe Kevin needs us to surrender our ill will and petty resentments. As we strive to figure out the best way to minimize injuries to NHL players, let's hold Kevin in our thoughts and prayers.

If the spirit moves you, please consider sending Kevin a card or donating money to defray the costs of two surgeries and other medical costs.

Kenny Strong.

Peace, pucks, and happy holy-days.

Hockey and Hernias, Part II: Clarification and Recommendations

(Continued from Part I)

“Groin injuries are like a box of chocolates: You never know what you’re gonna get.” -Forrest Ghimp ("h" is for hockey and hernia)

Many a hockey player—whether you’re a professional like Andrew Ference or an amateur like me—has done the hockey hobble. Most of us are familiar with groin injuries, incurred or witnessed, but far fewer are unfamiliar with or confused by terms such as sports hernia, athletic pubalgia, and Gilmore’s Groin. These conditions are discussed on the Web, but the data can be overwhelming, and in some cases conflicting, so my purpose here is to condense and categorize, to sift and to simplify. Coupling what I’ve learned from my experience with this kind of injury with the comprehensive Internet research, I hope to help those who are hindered by groin injuries.

Let’s start, then, with the general terms and drill down to the more specific:

Groin: For purposes of these posts, I’ll distinguish between lower groin (below the crease formed by the leg and abdomen; the femoral region) and upper groin (region between the abdomen and the aforementioned crease; the inguinal region). I can’t speak to lower groin injuries as my injuries were upper groin problems—except to say that abdominal muscles and corresponding nerves are connected to the lower span the two regions.

Hernia: This condition is most often caused by a weakening in the wall of a muscle. Hernias are more common in men than in women, can occur at a variety of locations, and vary in origin and cause.

Inguinal hernia: The abdominal wall was weak at birth (a.k.a. congenital hernia) or weakened later on in life (a.k.a. hernia), the latter sometimes a result of repeated pressure in sports like hockey and soccer. Two types of inguinal hernias are the direct and indirect.

Indirect hernia (a.k.a. congenital hernia, true hernia): This is the most common hernia, where the protrusion or bulge of intestines has breached the abdominal wall.

Direct hernia (a.k.a. acquired hernia): This one can often go undetected by MRIs and/or x-rays and thus is more difficult to diagnose. The fascial tissue (more on that in a future post) of the inguinal floor and/or abdominal wall is weakened. The destabilized abdominal wall may not break, however, and thus not become an indirect hernia.

The definitions above are widely accepted in the medical community, but terms such as sports hernia, Gilmore’s groin, slapshot gut, and athletic pubalgia are sometimes used interchangeably even though some believe sports hernia and athletic pubalgia, for example, are different injuries.

Despite the disagreement on definitions, the doctors who diagnose and treat these injuries have come to the same conclusion: Time does not tend to heal hernias; in most, if not all, cases no amount of rest, ice, heat, elevation or Ibuprofen will fix these conditions. Surgery is often the only solution.

The remaining question, then, is which procedure to perform. Here again, as with the symptoms and diagnoses, surgeons don’t agree on a standard procedure. A common consideration is whether or not to use mesh: Is laparoscopic (a minimally invasive procedure) surgery the solution or is a deeper trip down the inguinal canal required? And when does removing mesh make sense?

As I suggested in the disclaimer, I don’t have all the answers and can only focus on my own experience. The most important thing, for me, was to find a doctor that would understand the complexities of the diagnosis and treatment. Thus, I needed someone familiar with my symptoms and who has treated other adult hockey players.

Although my doctors, Brian Busconi and Demetrius Litwin were right for me for a variety of reasons—they both have played hockey, are well-regarded in treating groin injuries (yet perform different procedures), and they collaborated before deciding which surgery was best for me—they may not be right for you. If you’re not in New England, for example, you might want to consider other doctors. With than in mind, I suggest you at least consider the following professionals, even though a thorough Internet suggest of  each may reveal unhappy clients:

California
Dr. William Brown: I’ve never contacted his office, but Dr. Brown’s client list includes the San Jose Sharks.

Georgia
Dr. Jeffrey Hoadley: I’ve never contacted his office, but Dr. Brown’s client list includes the Atlanta Thrashers.

Massachusetts
Dr. Brian Busconi and Dr. Demetrius Litwin: Busconi is a pioneer in this field, and his initial studies more than ten years ago were met with incredulity and criticism from those who are now believers. Litwin, who hails from Saskatchewan, sports an impressive resume and has a terrific bedside manner. That the two collaborate should quell any qualms about inflated egos.

Dr. Scott Martin: Direct and decisive, he recommended my arthrogram, a procedure that fixed the first injury. He’s also a consultant to the NHL.

Dr. John Stevenson: He’s not a surgeon, but his specialty is his unique commitment to spending as much time as necessary finding the right surgeon, as he did for me.

Dr. David Berger: I’ve never talked to him, but he has treated NHL players such as Penguin defenseman Brooks Orpik and Bruin defenseman Andrew Ference

Pennsylvania
Dr. William Meyers: I’ve never spoken to anyone in his office, but Dr. Meyers, who works on Hahnemann University Hospital staff, has treated professionals and amateurs in many sports. Philadelphia magazine also listed him as one of the region’s Top Doctors.

Germany
Dr. Ulrike Muschaweck: I’ve never contacted her office, but she founded the Munich Hernia Center and gets rave reviews from professional and amateur athletes.

Helpful links: A short list of sites I’ve visited

http://www.aafp.org/afp/2001/1015/p1405.html
http://www.sportsmd.com/SportsMD_Articles/id/287.aspx
http://sportsherniablog.blogspot.com/2008/03/sports-hernia-surgeons.html
http://www.sportshernia.com/sports-hernia-approach/sports-hernia-options.php
http://www.thegroinpaincenter.blogspot.com/
http://sports-hernia.net/
http://www.lloydrelease.com/

Stay tuned for my findings on stretching and nutrition as a means for injury prevention. See Part III.

Hockey and 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 backward. 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.

Courtesy of Physiqz

I believe I incurred two injuries, which is not unique for those of us 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 fracture 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 revealed 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 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.

On the Shelf, Part X: “Ice Ice Baby”

June 27, 2010

“If there’s a problem, yo, I’ll solve it.”
-Vanilla Ice

All the well-intentioned vanilla platitudes from friends and family haven’t cleared the air of despair choking the hope that I’ll play hockey again. More problematic than my doubt and lack of gratitude is my greatest fear: That I’ll lose my purpose in life.

I know that the hockey gods/The Force/The Great Pumpkin/Whatever You Want to Call Him, Her, It or Them, want me to enjoy life while I serve others as best I can, but I haven’t felt that way for much of the last eight weeks—since the surgery to repair what the surgeon called “a very large hole” in my groin.

So far, I’m two weeks behind the twelve-week recovery/physical therapy plan, and sometimes I feel like I’m losing ground. I guess I’m a slow learner and a slow healer. I’ve also allowed my unpredictable physical state to permeate my soul. And I’ve been feeling bad that I feel bad because I’m well aware that others endure catastrophes with more grace than I’ve exhibited during this temporary setback.

But the hockey gods work in mysterious and musical ways for me: I’m laying down, back on the purple couch in my Zen room, listening to a CD my wife mixed for me. The Force nudges my spirit awake as I listen to “Live Now” (Paul Brandt). My fingers then dance along to “Suerte” (Jason Mraz with Ximena Sariñana), and then, to “Good Vibrations” (Glee Cast Version). I think of all the people who are pulling for me: my wife, my hockey pals, and friends outside hockey circles. The Great Presence is transforming my knowledge into a more solid belief.

As the Glee cast sings Mr. Ice’s classic, I picture my little brother during his recent visit to Boston: He’s in the back seat of the car and rapping to the same song I’m listening to now. He surprises my wife and me with his knowledge of the lyrics, softly hip-hopping along—and then pumping up the volume, “Beachfront Avenue!”

Five hours later, I’ve listened to "Ice Ice Baby" again. I’ve decided to keep putting one front in front of the other. I’ll continue to ice ice after physical therapy and, as my brother told me not long after his 80s flashback: Forget faith and hope and expectation for a moment and just accept where I am now.

Word to my brother (and all of my supporters): Thanks. I love you.

Doozies, Don’ts, and Donuts

The 2010 Olympic Games in Vancouver—and Canada itself—have owned the international spotlight, so I’ve been spying on our northerly neighbor and posting my observations—from Eh to Zed—about this Olympiad at Canadianspy.blogspot.com.

Back here in Boston, I haven’t lost sight of our Bruins. While many citizens of Bruins Nation were clamoring for Ilya Kovalchuk, I anointed myself to special advisor status and posted my plea for patience—don’t sell the farm—at Hockeybarn.com.

From the Olympics and the NHL to the AMHL …A stick salute to Mike “the Eagle” Chase. February 9th marked the one-year anniversary of our AMHL friend’s death. Mikey has surely graduated from our dimly-lit arena to the bright lights of heaven, where you can play hockey whenever you want and nobody nabs the last Boston Kreme.

Happy 60th birthday to Dunkin’ Donuts. To celebrate the accomplishment, Dunkin’ Donuts has resurrected its Donut Contest. Last year’s winning entry, “Coffee for Your Toffee”, will be succeeded by…well, maybe this is the year for the Sour Cream Sunrise. Rather thin pin my hopes to one donut entry, I’m diversifying my donut portfolio and will soon divulge the names of the half dozen doozies I’m developing. Deadline for throwing my donuts into the ring is March 8th, so stay tuned for details.

For those of you who’ve followed the Humpty Dumpty (Sports) Hernia saga, I have an update: Sports hernias don’t appear on MRIs. This I learned from Dr. Brian Busconi, a former Harvard hockey player and a pioneer in diagnosing and treating what he referred to as injuries more commonly found in “mature athletes” like me. Surgery (not yet sure if it will be a deep dive or laparoscopy) is in my near future, but I hope to return to AMHL ice this summer.

Meanwhile, our little donut league is going strong. “Mighty Mike” Edwards has returned from knee surgery, and his Leafs are 6–2. On Wednesdays, Port Huron’s pride and joy, Mike Seeley—who was last seen pushing pedals in Portugal—has returned to the AMHL; the nimble defenseman took a turn in nets and earned a shutout (or so it was recorded at AMHL.com, but Seeley says by e-mail, “Someone thumbed a key when entering stats...I ain't never been between da pipes.”

Not ready for nets to not ready for the AMHL…These bears are probably not ready for the AMHL, but you don’t want to miss this grizzly spectacle.

And now back to the Olympics… I tossed my first few stones. That’s right, I curled for the first time. It was online, of course, (Bostonians who want the real deal: Visit Broomstones.com) but I still got to use a broom. I started off strong, but in the end (I only played one), I lost 0–3.

Finally, I know some readers are wondering who I’m rooting for in today’s gold medal hockey game. I can’t tell you because I don’t know. Not yet. More on that later.

On the Shelf, Part IX: Living the Hockey Dream

(Continued from Part VIII)

I haven’t retired (as one faithful reader has suggested), but this unyielding injury has kept me off the ice and on the shelf. So here’s another review of a hockey book (one of about five dozen on my bookshelf.)

The beguiling beauty in Brian Kennedy’s Living the Hockey Dream is the diversity of stories. Amidst the unique insights into the Gretzkys and Granatos and Hulls and Howes, Kennedy presents profiles of unheralded hockey people such as an animated arbiter, meandering minor leaguers, and a hoarder of hockey sweaters. Whether his subjects are male or female, professional or amateur, North American or European, Kennedy demonstrates a rare flair for encapsulating the abundant joys of hockey.

The Hockey Gods are (Still) Crazy: Out of Season

Thursday, July 30

“I lost out. I wasn’t playing to win…” - “Out of Season”, REO Speedwagon

I’m not playing to win. I’m not even playing. And for the first time in ten years—that’s about thirty hockey seasons for me—I won’t be drafted by an AMHL team. So out of season.

I don’t know what I did to displease the deities, but Humpty Dumpty (Sports) Hernia has flummoxed me and confounded a superior physical therapist. At times during these past eleven months I’ve felt like the cracks in HDH were sealing but then, sure as Sher-Wood, other fissures would form and leave me bitter and even more baffled.

This week has been the epitome of extremes, and HDH feels no better than it did last September. I’ve been grieving the loss of ice time and competition, so of course denial, sadness, anger, and pleading with the hockey gods have drifted in and out of my psyche. These thoughts and feelings have often lingered for too long, and acceptance of the situation has been, until tonight, fleeting.

It’s Thursday night, and I’m home alone, sort of. While my wife and a friend are at dinner, I’m enjoying quality time with my iPod and the supreme hockey beings, the ones whom, back in April, I suggested were crazy.

Well, I was right. They are crazy. Good crazy. You see, they’ve taken control of what’s shuffling through the playlist, which at the moment is REO Speedwagon’s “Out of Season”.

“I’m so out of season. You let me go and you gave me no reason…”

But instead of stewing about why the skating spirits have benched me or when HDH will be healed, I’m singing and smiling. Finally, I can find humor in lyrics that would have, until tonight, likely served as a stinging reminder about the games and seasons I’ve missed; I’m advancing through the adversity that a few days ago would have me hopping (on the one good leg) mad. How I’ve dealt with this difficulty has gone from laughable to laugh-able.

With this sharper clarity, I divine that the hockey gods are on their timetable, not mine. Perhaps they want me to prepare for the inevitable reality of being an ex-hockey player, eternally out of season.

Off the Shelf, Part II: The Hockey Gods Must Be Crazy

Continued from Part I

Wednesday April 22, 2009

The hockey gods must be crazy because they’ve interfered with my plan to play this morning.

After solid and encouraging outings last Wednesday and Friday, I felt strong and sturdy on Saturday and Sunday. But then on Monday and Tuesday, misery and tenuousness reigned supreme in Groinland. And the hockey gods allowed this.

I’ve placed several calls to Puck Paradise but have not yet received a response. Well, that’s not entirely true. In the past seven-plus months, they’ve answered my questions about why I have this pain and discomfort (so that I can learn patience and acceptance and maybe a thing or two more about coaching). But I’m still waiting for a response about the whats and whens. What exactly is the problem? What will it take to fix it? And most importantly, when will I play again?

Despite my residual doubts—maybe I pushed recovery too hard?—I have faith that the hockey halos are pleased with the AMHL Wednesday Sharks.

My oversized Mites, all eight of them on this Spring Break week, don’t need me on the ice this morning against the Canadiens.

The deities are delighted with Kate “Two Cups” Fallon’s timely saves, Greg Longtine’s two goals, and Mike Seeley’s inspired defensive display. And the hockey gods seem to have abandoned Wednesday’s points leader Tim Donahue, who misfires on three golden opportunities. The Sharks end the regular season with another win (14–1–0–1) over Donahue and Les Glorieux (7–7–0–2).

The Canadiens, or whoever next faces the Sharks, may need divine intervention or another plan (or both) to win.

Same goes for me and my groin. Plan B is acupuncture. If that doesn’t work, then the hockey gods must be crazy. Or maybe it’s just me.

Either way, I'm back on the shelf.

Off the Shelf, Part I: No Crying in Hockey

“There’s no crying in hockey,” the AMHL Photographer (also my wife), says to me as the AMHL Canadiens and Rangers play on Rink One.

She’s glad I’m coaching the Sharks—who sunk the Sabres in this morning’s first game—but is tired of me whining and pining to play again. It pains her to watch me nurse a groin injury that has kept me "On the Shelf" since early September.

Next week is Spring Break, so the Sharks will be short-handed. Instead of eleven skaters, we’ll have six or seven. So my "Over-sized Mites" are all but begging me to play the Canadiens next week.

The AMHL Photographer, who hasn’t taken an action picture of me since the second game of last season, likes me more as a player than a coach. (She jokes that she’s like Ricky Bobby’s wife, who, in Talladega Nights, deserts her husband because he’s lost his mojo as a NASCAR driver). Although she’d love it if I were playing, she doesn’t want to hear me boo-hooing if I hoick my groin again.

Adductor longus and its afflicted neighbors: this region of my left leg and abdomen is my Middle East. Just when I think peace might have a chance, hostilities flare. I have more questions than answers, too. What about acupuncture? How long is this going to take? Should I wait until I’m 100% pain-free before skating? I’ve heard everything from “don’t aggravate it” to “skate it off, wussy.”

An orthopedic surgeon has advised me to risk minor setbacks. I won’t know if the injury is healing until press the boundaries. He suggested I start skating before games again, and then go from there.

He didn’t clear me to play but didn’t forbid it either. So I’m taking it day by day.


By Friday morning, the discomfort prompted by Wednesday morning’s pre-game skate has dissipated but has not vanished. Shake and bake, baby; I’m going to give pick-up hockey a go.

Paul “Cadillac”Anastas drives me to the rink, where I reacquaint myself with playing hockey. I forgot my gloves at home, so I borrow his two-tone black and blue backup pair.

An hour later—after all the welcome-backs, a goal, a giveaway in my own zone—sweat drips from my hair and stings my eyes. I love it. I missed it.

“How’s it feel?” my hockey brethren ask about the groin.

Tender, I say as I ice the Gaza Strip. But I m more concerned about how I’ll feel in a day or two. Will this morning’s workout catch up with me this weekend?

Back at home, I call the AMHL Photographer, who made a surprise visit to the rink to watch for a few minutes and is now at work. I tell her how happy I am to be back in the game—at least for today, anyway—and am overcome with gratefulness. I thank her for her patience. “I’m moisting up, gotta go,” I conclude.

Who says there’s no crying in hockey?

Stay tuned for Part II, when—hockey gods willing—I transform my title of coach to player/coach.