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4 years of hip/groin pain. Help!
Getting a dynamic ultrasound study with valsava is pretty easy and it may be helpful, sometimes clinics also do them standing up with valsava, but I think the key thing is not just coughing but actually bearing down. That may be something worth pursuing.
Dr Chen and Dr Towfigh are both hernia experts in Los Angeles that see a lot of the challenging cases like ones you’ll find on this forum, it could be worth making an office visit with either (or both) of them.
If you have a core muscle or pelvic muscle injury that is being overlooked you could always venture across the country to Vincera Institute in Philadelphia, it’s quite a trek but they handle many pro athletes in the US.
Anyway, good luck and keep us posted.