|
|
Hey Mike,
I was wondering if you’ve ever worked with any athletes that have/had athletic pubalgia. I actually have that on my right side and it can get extremely painful. I had to sit out three years of football because of it. I recently saw that Mario Williams the Texans defensive end suffers from it , and he is still playing the season with this injury. I asked him how he deals with the pain and he simply said “its so hard to even say.” So my question is what types of things would you do with someone who has this injury. To help them deal with it? What are some exercises, anything actually that will save me from the pain I suffer from. I really want to get back into playing ball or some sport.
Thanks Mike
Steve,
Great question. While I haven’t seen a ton of cases of athletic pubalgia/sports hernia myself, I’ve seen a ton of hip impingements on the right side. The answer is a really loaded one, but if I can make one assumption it’s that your right hip external rotators/abductors ARE NOT as strong as they should be.Imagine standing on both feet, and then picking up your left foot – you SHOULD be able to maintain a fairly neutral center of gravity.
What happens if your right hip is weak is that your pelvis shifts to the right, and closes off your joint space. In other words, your right hip isn’t strong enough to “push” your pelvis/hip back over towards the mid-line.
This is very common in people with a hip impingement, and I’d assume it’s similar in those with a sports hernia/AP as well. In this case, instead of the hip joint getting irritated, it’s the muscles that are getting overworked (i.e. your adductors) that cause the problem.
Mike Boyle has written about this pretty extensively – when he sees people with AP/sports hernia, their adductors were strained at one point in time and they were never properly treated. You have to do several things to resolve the issue:
- Treat the local dysfunction, i.e. the scarred/adhered/fibrotic adductors with soft-tissue work (SMR, ART, massage, etc.)
- Strengthen the opposing muscles, namely the glutes, in the frontal and transverse planes. Start with isolation work, and then progress to single-leg work and exercises that strengthen/stabilize the glutes in all three planes.
That’s a really long-winded answer, but I hope it gives you some insight. A lot of this is conjecture without seeing you, but I’d imagine you’re like a lot of the clients we see at IFAST.
If you or Mario ever want an in-person assessment, give me a call.
Read more from Mike.
PDF 
Mike Robertson is the President of Robertson Training Systems and the co-owner of Indianapolis Fitness and Sports Training (I-FAST) in Indianapolis, Indiana. Mike has made a name for himself as one of the premier performance coaches in the world, helping clients and athletes from all walks of life achieve their physique and sports performance goals. 
I just got surgery on my sports hernia 6 months ago.
Honestly, there’s no chance I could have done anything athletic
ever again had I not gotten the surgery. I was unable to lift/train
in any way at all for over a year. The doctor that operated on me
said that most who have a sports hernia have seen half a dozen
doctors and had the injury for over a year before they finally go
to get surgery from him. My advice, get the surgery ASAP because
the injury won’t go away if you don’t. It took me 3 weeks
post-surgery to start jogging again. 6 weeks post-surgery I was
able to get back to lifting heavy. Now, I feel great and I can’t
imagine ever having to go back to when I had the sports hernia.
Here’s the guy who operated on me’s site. Even if you don’t go to
him, if you suffer from the injury I suggest calling him. He has
little tests he can tell you to do that will indicate what type of
sports hernia you have and he’ll give you advice on what action to
take. If anyone has any other questions for me, feel free to e-mail
me at cdguitarist87@aol.com Physical therapy PROBABLY won’t work
unless you started on it within 6 weeks of getting the sports
hernia, honestly surgery is the answer most of the time. It sucks
but it’s true. Your doctor won’t want to tell you that because
chances are he doesn’t know anything about sports hernia, none of
mine did until I went to this doc.
http://sportshernia.com/
I had the beginning stages of a sports hernia this past
summer. I started as strain of my pectineus and I eventually felt
pain in my lower abdomen after doing a lot of eccentric core work.
I stopped doing exercises that bothered it, stretched twice a day
and got some tissue work done a few times. It has felt great
since.
I was misdiagnosed with a sports hernia by 3 different
doctors. After two months of intense pain and 2 days before my
scheduled surgery, I found out the pain originated in my lumbar
spine.
Mike you should post this Q&A on your blog too,
great answer. Nice to see you posting articles regularly on
here!
http://haskestrength.blogspot.com/2010/10/athletic-pubalgia.html
On the note of impingement (and not necessarily athletic
pubalgia), the right hip abduction and external rotation works very
well, but works even better when combined with pelvic stability
from the top. If you cue the obliques to come on, getting the
pelvis more stable, the impingement is often relieved
immediately.
I suffered from this “athletic pubalgia,” “sports hernia” a
few years ago. I had three operations, an MRI, ultrasound scans,
corticosteroid injections into my pubic symphysis, ART therapy,
physical therapy, etc. I flew to Munich, Germany for the hernia
repair surgery, which helped my abdominal pain, but didn’t relieve
the pain in both of my adductors. Then I flew to Philadelphia to
have another repair surgery where they did the “pelvic floor
repair” with Dr. William Myers, who did Donavan McNabb’s surgery
when he was with the Eagles. This didn’t allow me to get back to
playing soccer at a high level, and in a lucky connection of a
friend of a friend, I found the solution in Lincoln, Nebraska of
all places. After being evaluated and lectured for 2 hours by Dr.
Ron Hruska, finally something made sense as he explained my injury
as a result of bio-mechanical imbalances in my glutes, hips,
adductors, and obliques. He lead me through exercises to rebalance
my posture and helped me achieve proper bio-mechanical, and
postural balance. I saw him twice and have completely recovered
from my troubles. My vertical jump and 40 time were the best I’ve
ever accomplished after 2 months of seeing Hruska for the first
time. If anyone has questions, please feel free to email me, as I
know how frustrating this injury can be. I have shared this contact
with many pro soccer players I know, and they all swear by this
guy…adding years to their careers. Cody.L.Anderson@gmail.com.
http://hruskaclinic.com/ Best of Luck!!!
Mike, does your suggested treatment work for short/tightened hip abductors?
My instructor noticed when I attempt rear kicks with my left leg,my foot turns outward (which according to my instructor) as body is compensating for the restriction of hip joint rotation. Ive started yoga to see if it will help but only early days.