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Slightly "odd" hernia presentations; trying to understand meaning
So I’ve posted here before that I’m pretty sure I have a fairly small left side inguinal hernia; nothing new there. However there are a few aspects of mine that I’m trying to get a better understanding of, because they seem to differ slightly from what is “typical.” I’m also assuming mine is direct, since there is a visible bulge, but above the top of the scrotum, but who knows… Ok, so these are the things I’ve noticed:
1. When I increase intra abdominal pressure, it feels as though it’s inflating, almost like a small balloon, and has a similar feeling to the touch when I press on it, as opposed to the feeling of a solid mass pushing outwards from inside my abdomen (there is something in there, which I can feel at times, but it’s much smaller than the inflated bulge).
2. The bulge is always reducible, but when I do, it’s almost as though I’m pushing on a spring, as it comes right back out due to a significant amount of elasticity. It’s as if I’m pushing on a little spring.
3. When I push it in all the way, and then suck in in such a way that significantly reduces the intra abdominal pressure on my lower abdomen, it stays “in.” I can’t “suck it back in” but I can hold it in with my abdominal muscles alone.
4. Even though I feel “something” back there, it feels like it’s a layer or so deeper than seems typical, and doesn’t feel like it goes in or out of a “hole.”
5. There can be minor discomfort in the area, which feels muscular, and the area I most often feel an ache is up by where the muscles attach to the iliac crest.
So, this has me wondering, is there an actual rupture, through which something is protruding, or have some of my abdominal muscles perhaps stretched/thinned/lost elasticity, allowing things to “fall out of place” without there being an actual herniation? If that were the case, would that fall into the almost-all-encompassing “sports hernia” classification? My preferred athletic activity is heavy barbell lifting, and even with this hernia I’ve kept squatting and deadlifting the past couple of years (but I stopped using a belt, to reduce intra abdominal pressure).
If that’s the case, is there anything I can do to prevent progression and possible tearing, or even reverse some of the damage?
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4 Replies
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quote drtowfigh:Sounds like a pretty classic inguinal hernia.Barbell lifting, etc., has not been shown to increase abdominal pressure, and so is considered safe for those with hernias.
Thanks! Prior to having some US imaging done, any way to know whether it’s direct or indirect (if that even matters) based on where it is/how it goes in/out?
The actual defect (where I can feel something there) feels to be just above the pubic bone, while the visible part (the outward protrusion with nothing underneath) seems to be just below.
Interesting about the findings re: barbell lifting. I certainly have modified my technique a bit since this happened (I used to wear a belt, for the explicit purpose of doing the hardest valsalva maneuver possible, but have since ditched that). Still take my breaths into my stomach (vs chest) but am not doing so with nearly the same force.
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Sounds like a pretty classic inguinal hernia.
Barbell lifting, etc., has not been shown to increase abdominal pressure, and so is considered safe for those with hernias.
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This actually all sounds pretty typical to me, certainly in my experience. Whether direct or indirect, my understanding is that it doesn’t make much of a difference, certainly in terms of how it’s repaired, but also likely in how it feels. I think only an experienced surgeon would be able to tell for sure. I was actually told I had an indirect hernia by one surgeon, and direct by another. Having surgery tomorrow and won’t even know for sure likely until it’s over. I would just go ahead and get a consultation with an experienced surgeon. If it is a traditional inguinal hernia, I think the only way to avoid more damage is to avoid abdominal pressure – coughing, lifting anything heavy, straining when going to the bathroom, squats, etc. I was told that I could continue running with a hernia and that it might even help to slow its progression by strengthening my core. But ultimately the vast majority of hernias are going to get worse eventually, and they don’t tend to really get appreciably better. I’ve heard that some small ones might potentially never need repair, depending on a variety of factors. But that seems to be the rare exception. Once I noticed mine for the first time a few months ago, it seems to have only gotten slightly worse despite avoiding the aforementioned things. I chose to get the surgery because I was having symptoms and it has limited me somewhat. Much of the time I’m fine, but I have to be careful. And I figured I’d get it repaired while still on the smaller side so as to try and avoid potential complications. Everyone is different, though. Best of luck.
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Hope nobody minds my bumping this; would love any thoughts, particularly from our resident experts! Thanks.
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