-
Inguinal Hernia, Sports Hernia, Lingering SI joint issues, or other?
Hi, thank you for adding me. Probably the easiest way to ask my question is to give my story in chronological order, so here goes:
in March 2016 I had my first and so far only child. I am a small person at 5 feet tall, 115 pounds, and had a significant diastasis recti after birth (though no back pain during pregnancy). I worked to heal the diastasis for 6 months through the MuTu system, which involved a lot of squatting, before returning to running. While tapering down my running after a 10 mile race, summer of 2017 I started to have right-sided hip-area pain while I was squatting. I didn’t think much of it, but soon it seemed like muscles were guarding in the area and I was having a lot of right-sided back tightness. In the fall, my pelvis and back felt twisted, so I sought out chiropractic care and PT, though all my pain was in my right hip. 10 weeks of PT and a prednisone pack did not clear things up, so in February 2018 I sought out an X-Ray and MRI to look for a hip labral tear. The no-contrast MRI and X-ray found no hip pathology at all (FAI or tear), but some degeneration at the pubic symphysis and possible slight degeneration at the right SI joint. The cortisone shot to the hip I got in tandem for diagnostic purposes did actually provide me a lot of relief, however.
I continued to pursue answers to help what now seemed to be severe muscle imbalances and now ligaments that did not want to hold my SI joint in place. In June 2018, I began what became quite a few rounds of regenerative injections with a leader in the field (both prolotherapy and PRP) to my SI ligaments and gained almost all my stability back over the next year and a half. However, I continued to have hip/inguinal area pain, so pursued more imaging in the spring of 2019. I got a lumbar MRI, which came back completely clean except some mild degeneration of lower facet joints, and another hip MRI, this time with contrast, which came back completely clean (including muscle and tendons).
Because a lot of my pain and inflammation was around my psoas attachments at my hip, down the front of my leg, and in my back, my doctors and PTs turned their attention to that. I had injections (PRP, cortisone, and prolotherapy) to both back and hip area attachments of my psoas, with limited relief.
After doing more research, I decided to keep digging and sought out a hernia specialist in October 2019. He did an exam and, although he did not think I had a hernia, decided to order an ultrasound since I had already done so much imaging. The ultrasound came back with “mild tendinosis of the adductor origin, which appears otherwise intact,” and “tiny, reducible inguinal hernia.” Armed with this report, early in December 2019 I saw Dr. Grishkan, based on recommendations and the news that he is so skilled doing hernia repairs without mesh.
Dr. Grishkan, in short, did not think my inguinal hernia was causing my symptoms. He would not agree to do surgery for the hernia, but said he thought I might have a sports hernia and would schedule surgery to fix that (though nothing was noted on any of my MRIs, and only the mild tendinosis of my adductors was noted on ultrasound). The surgery would be somewhat exploratory and he would fix whatever he found was torn. I am not keen on going into a surgery that I don’t even know what will be done during.
I am scheduled to meet with a second hernia surgeon to get his opinion, but he only repairs with mesh, which I would like to avoid since I already have so much nerve and inflammation stuff going on and I am a small person (5 feet, 115 pounds).
My third option would be to travel to see another surgeon who could give another opinion and does not use mesh, but that is a frustrating prospect for me as Dr. Grishkan is so skilled, takes my insurance, and is literally 7 minutes from my house.
So, I am at somewhat of a loss as to where to turn or what to do next. My current symptoms are: inflammation and mild burning around the groin area that travels down the front of my leg and up into my torso. I also have general groin “weakness.” I sometimes get burning in my low back as well. Sometimes I have very little pain, but I always feel pulling and guarding, almost like my whole body is twisted to protect whatever is going on there. I also get a “fullness” feeling in my torso, like being bloated, but not from the bowels. Occasionally I get a very sharp (but very small) pinching feeling in my groin. I haven’t noticed too many patterns with my flares except that with an activity like cleaning I seem to get increased pain/inflammation, and I am always worse at the beginning of my cycle. Prolonged sitting or standing can also cause a flare usually the next day as well.
Any advice would be appreciated. Is the noted hernia worth risking a mesh surgery to fix or the cost of seeking an out-of-town non-mesh surgery? Are my symptoms likely due to a true hernia? Or is the risk of going into a *possible* sports hernia surgery with a respected surgeon a reasonable option? Thank you for reading. I know this was very long.
Log in to reply.