[pubalgia2019]

quote DrBrown:

Dear Pubalgia2019
Adductor injuries often improve after a steroid injection.
Ask your local doctor to inject the origin of the adductor longus tendon and the surrounding periosteum with marcaine and decadron.
If your local doctor has any questions I would be pleased to talk with them.
If you do not improve in a few months, then surgery is an option.
Regards.
Bill Brown MD

Thanks, Dr. Brown! Will ask the local doctor and go from there.

Still hoping I can avoid surgery, yet I’m dying to go back to playing soccer. It’s one of those 50-50 things. I heard of many patients with my diagnostic and went back to playing, while others did surgery. So it’s tough to gauge that…

[pubalgia2019]

quote ctguy:

FWIW, on my “small” SH… I just went through PRP last Friday and as the doctor put it when he inserted the needle into the base of my RA (where there was asymmetrical thinning), he said “wow, thats crunchy”. Turns out there was calcification in the wound where he did the PRP injection and where the pain was. The pain for me happened only during certain movements.

The doctor explained (as he was breaking up the calcium with the needle), muscles as they rub up against the calcified area can feel it and cause pain.

Its only been a week, so we’ll see where this goes.

Also, I had a small partial tear in my AL at its pubic insertion that has gotten much better. This area also injected with PRP, but no crunch there.

Thanks. This helps! I think my ultrasound showed calcification. They took a while to look at it and said it was calcification likely from a previous injury in that area.

I wonder if I should look into PRP. It seems like you had a similar injury with the small tear.

[pubalgia2019]

quote drtowfigh:

Time and rest are the best healers for sports hernia, adductor Or rectus tears or strain. We don’t operate usually for strains or grade 1 tears.

Thank you for your answer. I was just concerned that it has been months (January 2019) and now at least 10 weeks of full rest since last MRI and injury, with no running and that I still feel a stab with certain lunges or certain movements.

It’s a 1 pain on a scale to 10, but enough to be afraid to start running or playing.

Also thanks for clarifying that’s a Grade 1, I wasn’t sure if it’s a 2 based on the results.

[pubalgia2019]

I forgot to tag doctor [USER=”935″]drtowfigh[/USER] and [USER=”2580″]DrBrown[/USER]

[pubalgia2019]

I have a similar issue, rehabbed first for 6 weeks, felt okay, went back to playing soccer, got injured again. 2 weeks of decent pain when coughing or sneezing, then it slowly started to go away. Did an MRI with AP protocol and MSK Ultrasound, and been rehabbing again for the past 6-7 weeks, mostly core, hip, strength, dry needling.

Pain is gone for normal activities, like running in straight line or lateral runs, but at certain movement of my leg (angles) or if I do lateral and forward lounges, I can still feel some pain in my groin. So I’m afraid to go back to playing.

Any thoughts on whether I need more time to heal? I know surgery can fix it, but since I don’t have every day pain, was wondering if it’s better to avoid it.

Here are the results:

PROCEDURE: MRI PELVIS MSK WO CONTRAST
TECHNIQUE: Multiplanar MRI of the pelvis was performed utilizing noncontrast T1-weighted and fluid sensitive sequences.
COMPARISON: Prior sports hernia ultrasound dated 5/1/2019. Pelvic radiograph dated 1/28/2019.

FINDINGS:

The femoral heads are well-formed and seated within well-formed acetabula. There is no femoral avascular necrosis, fracture or significant osteoarthritis.

Minimal L5-S1 disc desiccation is seen. The sacroiliac joints and symphysis pubis are intact.

There is no hip effusion, iliopsoas or trochanteric bursitis.

There is mild left adductor origin tendinosis with a low-grade partial-thickness tear. The right adductor tendon origin is intact. The rectus abdominis-adductor longus aponeurotic plate is intact.

The tendinous insertions of the gluteal, iliopsoas, and hamstring origins are intact.

There is no muscle atrophy. Grade 1 strains of the left adductor musculature are seen.

IMPRESSION:

Low-grade partial-thickness left adductor origin tendon tear superimposed on mild tendinosis and grade 1 left adductor muscle strains.

—————————————————–

PROCEDURE: US SPORTS HERNIA

HISTORY: Left groin pain.

TECHNIQUE: Targeted ultrasound was performed using a high frequency linear array transducer.

COMPARISON: 10/26/2016

FINDINGS/
IMPRESSION:

Visualized rectus abdominis musculature and insertion are intact.

There is mild tendinosis of the right adductor origin without tearing.

There is thickening, hypoechogenicity, and irregularity of the left adductor origin with scattered areas of calcification, likely related to degeneration/prior trauma. No high-grade tear is identified. There is mild associated hypervascularity at the left adductor origin, consistent with a low-grade strain.

No inguinal hernia is identified on the left with dynamic imaging.