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New here, professional dancer with prior surgery – have multiple questions
Hey everyone,
I’m new to this forum/resource (wish I had found it before) and I thought I would use it to ask for opinion/advice. I’m from Canada but currently reside in Los Angeles.
2 years ago I started having pain in my right groin. started as a sharp pain near my pubic bone not even doing anything intense and I felt it anytime I did anything
strenuous physical activity (mainly dancing). I also (weirdly?) started having foam in my urine (noticeably different than before).Just like any other person I eventually went to the doctor/hospital etc etc had SEVERAL blood/urine tests over the course of a year – not 1 sign of infection, or anything abnormal.
My physical therapist at the time worked closely with surgeons/doctors who work for a NHL hockey team and somehow got me to speak to them because I was on the front page of the newspaper and it got them excited. They had me do an ultrasound with a doctor
who specializes sports hernia. His findings were: Partial adductor tendon tear, partial oblique tear but nothing near the original site of pain. As my situation wasn’t getting better and I was
distressed – I finally agreed for them to do an open surgery on my right groin (because I just needed to get back to dancing asap). they found a tear over my inguinal canal – placed a mesh and voila.The problem is – the original source of pain (what feels like below the surgery – closer to where the rectus attaches to the pelvic bone) never got better. It feels like the surgery just weakened my pelvic stability and multiple new pains arose. They told me that even if there was a tear in the rectus attachment to the bone or close to it – it would eventually heal – same with the partial adductor tendon tear. But it didn’t.
Now because of my career – 4 months later I ended up moving to LA for dance and started dancing on that as much as I needed because I just had to. The pain eventually got better and less tender to the touch but it also developed on the left side.
At this point here’s a summary: Bilateral pain – that feels like “inside”. Constant burning/soreness a little above the pelvic bone – on both sides. those same spots hurt sharply when I urinate. I have moments where it somehow calms down a little bit and I manage to dance – presumably because I get warm and I’m on adrenaline – but I feel it the rest of the time especially at rest/at night, even when just walking. At first I thought it was caused by the mesh but the pain is basically the same/similar on both sides and only one side had surgery/mesh.
Throughout the last year – I had full periods where it was intolerable – and other periods where one side would get better and hurt significantly less. but never 100%. my inner thighs also hurt at rest most of the time – but not a “nerve damage” type of pain. More of a tendinitis burning type pain. and it definitely gets worse when I dance – and always hurts when I pee.I guess at this point I’m just unsure what I should be doing. I just know that it’s seriously affecting my ability to have a normal lifestyle and perform. I can’t stop thinking about it.
I don’t think a regular tendinitis – even if affecting both rectus and adductor tendons – would cause the pain/inflammation to spread and hurt when I pee so I’m guessing there are probably tears somewhere near the pelvic bone on both sides?? But if it was super severe I don’t think I would have been able to dance as much as I did (even though I’m not nearly able to dance as much as before and my groin doesn’t seem to get stronger no matter how much PT I do. My body does a lot of compensation as well in terms of movement patters/biomechanics. I still can’t walk normally since the surgery no matter how much exercise I do my right leg is restricted. The pain seems to be near the pelvic bone at the abdominal attachment and between that and my inner thighs. Up to recently – no pain felt when doing crunches/core work. just that constant burning and sharp pain when peeing.
I don’t drink, don’t smoke, I’m super lean, I eat extremely healthy (extremely) – but no matter what I do it doesn’t seem to get better.
2 MRI scans (one before surgery one after) also didn’t find anything. No osteitis pubis and no labral tear in either hip joints (to my surprise).
I don’t know if any athlete on here has had to deal with sports hernia or any similar pain but what are my options here? I’m very close to big opportunities/touring with artists but I can’t fully perform at the moment. I don’t want to consider another surgery because I’m traumatized at the lack of result/and resulting problems the first one brought me – but I also can’t just take a year off and heal holistically – especially not knowing if it actually will heal one day. And because I wasted so much money/time/etc trying to investigate and do anything the first time around – I don’t really trust that anyone really wants to help or that there is a way other than to let nature do its thing.
I’m currently in Los Angeles (from Canada). I don’t really trust the limited knowledge of the doctors who took me in the first time back home – and I only have emergency insurance here in the states that basically only covers emergency incidents. Therefore I’m a little limited in how much money I can ” waste”. I’ve gone through several athletic therapists – I’ve done so much research – I cannot physically take better care of myself both with my diet and lifestyle.
Does anyone have any thoughts? Definitely sorry for the wall of text I thought I’d be able to be more concise but it came out all at once.
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6 Replies
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PeterC
You need to be evaluated by a Sports Hernia Specialist, not a Hernia Specialist to get the best diagnosis.
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Hi everyone, thank you for taking the time to answer.
@goodintentions – I’ve had about 6-7 complete (i mean everything) blood and urine workups done over the span of a year and a half (prior and after the surgery) for the foam in the urine – nothing comes up. No stds, no protein in the urine, nothing. Same with stool tests. No kidney stones, had that ultrasounded as well. I’ve had them done both at hospitals & privately to cross-check. Same results everywhere. I don’t smoke, don’t drink, they checked my liver, kidneys, spleen via ultrasound as well. Nothing.
[USER=”935″]drtowfigh[/USER] – I am currently in LA and I’m considering coming to see you for a consultation if you think this is something you would want to have a look at. I called your office this morning – I was just weighing my options as I’m paying everything out of pocket and I’m not exactly swimming in money.(Being here on an O-1b visa I only have emergency insurance from back home).
I could potentially get an MRI this week as well to bring with me if I were to meet you since my scans are 2 years old and the situation has changed a lot overtime.[USER=”2580″]DrBrown[/USER] I understand/agree. Ideally I would be followed by a team of specialists back home as healthcare is free – unfortunately even the people I was seeing – who work for the NHL – were very limited/clueless/didn’t seem as interested to help as they were to quickly get over with it. I would’ve equally loved to see you as you seem like a passionate MD and wish you were in LA.
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Dear PeterC
You need a surgeon that will take the time to examine you and review your history.
I also have found that diagnostic injections are helpful.
Athletes often present with a long history of pain and multiple previous operations. This makes determining the exact source of the pain difficult. I often use trigger point injections to try to localize the pain. For example, assume an athlete presents with pain that is near the origin of the adductor longus tendon. If that tendon is injected with lidocaine (a local anesthetic) and the pain gets better, then that would be strong evidence that the adductor longus is the source of the pain. In a similar manner, other structures can be injected such as the ilioinguinal nerve, the genital nerve, the spermatic cord, the symphysis pubis, etc With sequential trigger point injection, the etiology of chronic pain can often be identified then the appropriate treatment can be started.
regards.
Bill Brown MD -
Dr drtowfigh Great advice ! What would be step by step process to determine it ?
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This is very complex and you need to make sure you are being seen by specialists. The question now is: is your current pain related to your procedure or to the original problem?
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quote PeterC:My physical therapist at the time worked closely with surgeons/doctors who work for a NHL hockey team and somehow got me to speak to them because I was on the front page of the newspaper and it got them excited. They had me do an ultrasound with a doctor
who specializes sports hernia. His findings were: Partial adductor tendon tear, partial oblique tear but nothing near the original site of pain. As my situation wasn’t getting better and I was
distressed – I finally agreed for them to do an open surgery on my right groin (because I just needed to get back to dancing asap). they found a tear over my inguinal canal – placed a mesh and voila[USER=”2580″]DrBrown[/USER] is an expert in athletic pubalgia (AKA sports hernia), and also in diagnosing pain sources.
It might help to know exactly what the surgeons found and exactly what they did by getting your surgery notes from the surgeon or the facility where the surgery was performed.
Letting the damage heal and getting back to dancing ASAP sounds like original damage might never have healed. The Vincera Institute in Philadelphia also specializes in athletic pubalgia and they repair the damage then have the patient do specific PT activities.
It sounds like your surgeon(s) found something that they were’t looking for, “fixed” it, but didn’t fix the source of your real problem. The foamy urine might be a red herring also, not related to the pain.
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