future of inguinal repair and PT

So after almost 2 weeks of physical therapy, I have noticed an improvement in the pain. That is a quick response and I consider it very promising. The pain has not yet resolved of course but the improvement is significant and I expect the recovery to require a lot of time. Nevertheless, I am more optimistic than I was a month ago and I wanted to share a few thoughts just in case someone finds it valuable for their situation.

First of all, I still believe that the lingering problems I am experiencing are the result of a bio-mechanical problem. My logic is as follows: I spent many years with a hernia including ~4 years of watchful waiting but with no symptoms which were disruptive to my active lifestyle. One thing I did notice over time though was that my movement was favoring the side with the hernia. I wouldn’t sit as flat when riding my bike or when standing I noticed myself always leaning more to one side. I did also notice minor lower back aches on the side with the hernia and my hip joint would occasionally go in and out of joint in an audible fashion.

My theory for my pain is that once the prosthetic mesh was placed inside me, and I had a large inguinal hernia according the surgical report, it was done so with the expectation that my pelvis and hip joint was moving in a normal fashion but because of years of improper movement from the hernia, I was “twisted’ out of proper posture. It has been especially noticeable when standing in place or when squatting to lift where I am not engaging my glutes correctly and therefore exhibiting a sacroiliac joint dysfunction.

The second theory I have for my pain – and this is insight which comes from noticing what does and doesn’t feel good from the PT exercises – is that when performing the exercises or for that matter any other normal daily movement, I am not breathing deeply. I also feel like that habit might have developed over time as deep abdominal breathing may have started to irritate the hernia.

The above is all pure speculation on my part based on how my body is responding to activities and the history of my hernia development/treatment. My PT routine is a very simple set of core exercises which include a series of leg lifts in each direction, clamshells, planks, and kegels (a theraband has been added to many of these for more resistance). I have also noticed the most relief from pain comes from when I do glute exercises and when I do simple planks and focus on deep, full breathing that allows my diaphragm to expand. This observation leads me to believe I had a specific area of weakness that hopefully if addressed and continued over time, I will continue to see more relief in my pain. I have carefully selected and added a couple more exercises which include push-ups and a face done prone glute exercise that seems to really activate that muscle group. When done properly, these exercise seem to benefit my situation. My day starts off better and if I find at the end of my work day I am experiencing pain then a few of the exercises such as the clamshells, take the pressure off the surgical site where the pain originates.

I certainly am nowhere near my ability to go on 30 mile expert level mountain bike rides like I could a year ago but I am hoping with with some carefully directed exercise routines I will be able to enjoy biking again.

Again this is entirely my own experience and I am far from pain free but it is meant as food for thought for anyone desperate to resolve their own pain.