Sports Hernia Advice & Treatment

I went to see Dr. Y last September, and he then suggested some time off from running, or very easy running without pain, to see if the sports hernia (abdominal wall strain) would heal. It sort of DID heal, and then a couple of weeks ago I decided to see if I could push it, ran four miles at almost a race pace, then another at a slightly faster pace, and the pain was back again, just like that. Oyeah. Hence today's doctor visit.

From Dr. Y, two choices:

• Consult with a surgeon. This is "general surgery," not orthopedic; or
  
• Try therapy for four or five weeks first.

Surgery is not the most conservative treatment right now - therapy is. Unfortunately, the therapist that the doctor prefers is not available at the moment, because she had a baby girl yesterday. Congratulations KL! However, I got an appointment with another therapist, two weeks from now. Huh. Wish it were sooner. KL is very good - I hope this therapist is.

Other information from Dr. Y:

• The sports hernia is most likely not pulled muscles but pulled tendons. I assume that tendons take longer to heal.
  
• Sports hernia is a "rule-out" diagnosis - it's a sports hernia if no OTHER problems are found, such as a real hernia or hip problems or whatever else, and there is still pain in the right place. He found nothing except the tender abdomen.
  
• The first step in conservative treatment is to stop the injurious activity (running) for a while and see if the injured abdomen heals. I did that, because I was able to run nine marathons since September, mostly without pain. So, on to therapy.
• Be sure to get back to him if the therapy hasn't helped within four to five weeks. Actually, it'll be hard to know, because I have a marathon in four weeks, so I'll be doing a longish marathon-pace walk/run in a week and then tapering. I'd expect the injury to get better during the taper with or without therapy, so I may need more than five weeks.
  
• I asked how quickly I might expect to heal from the surgery, and he obviously couldn't give an exact answer, but I think I heard him say eight to ten weeks before running again. Less, perhaps, because I'm in good shape, but more because I'm 71. I'm surprised at that length of time - it seems like I've seen people bounce back from a real hernia repair much more quickly. If surgery is required, I want a doctor who has done a LOT of hernia repairs and can do them laparoscopically.
  
• This doctor advised ice and Tylenol for pain control, not ibuprofen, "as it may inhibit the healing process." I don't use much pain control anyway - I'd rather know what's going on in my body.

Up to now, I've been able to keep the pain at bay by simply walk/running very slowly, so slowly that a marathon takes 5 1/2 to 6 hours. Training has been at that same speed. The run part is at a good pace, about nine-minute miles, but only for 30 seconds at a time, followed by a rapid walk lasting at least that long before the next run. The result is a pace of 12 to 13 minutes per mile, and the walking somehow prevents re-injury to the abdomen even though I do end up running lots of miles at a nine-minute pace.

This morning I ran in the Stillwater Dome, walking only the corners to avoid re-injury to the adductors. The resulting pace was about 10 minutes per mile, and that amount of walking was not enough to keep the sports hernia happy. It hurts. Next time I'll try running the long sides and walking the corners plus the short sides, see how that goes.

The photo has nothing to do with anything, but I like it.