Frustrating injury - no diagnosis

[dave t]

Hi there

Hope someone may be able to help and seen my sypmtoms before.

I am a distance runner competing at a high level in the uk but ahve been struggling with an injury since late Feb. Unfortunatly i tend not to take notice of injuries and usually can run through it and recover with some light training so the order things happened to me is a bit unclear.

Therefore I might as well just tell you the symptoms.

Groin pain in the RH side - in particular when pulling the legs together.
Abdominal pain in the rh side - can feel this when i stretch this area in conjunction with groin and also coughing/sneezing.
Mid-lower back pain in the RH side - not always there.
Nerve/Sciatica pain - in RH leg hamstring, glutes and genitals.

My GP thought i might have a hernia and referred me to a specialist who told me i didnt and went as far to rule out a sports hernia.
I have seen two phyisos who both believe that the symptoms point towards a sports hernia. Seeing a specialist sports doctor next week who appraently will be able to diagnose this.

I am not running at the moment and am fed up and confused about what is wrong. Pulled ou of the london marathon the week before after struggling through 15 weeks of training and just need to get a diagnosis to get to the bottom of it.

Any advice/help would be gratefully appreciated.

Thanks

Dave

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[Sports_Rx]

From your symptoms I would have said hernia too.

Any pain doing sit ups? Esp if someone resists you during the movement - stops you curling up at under 30 degrees?

Multiple diagnoses co-exist with groin pain which can make diagnosis tricky. Could be other things like osteitis pubis, adductor tendinopthy etc.

Any pain around your pubic bone (postive squeeze test, one leg hopping etc)?

I'd also check your pelvic stability and core strength.

[dave t]

Cheers for the reply. Yes i do get pain doing sit ups or twisitng as soon as i start curling.

Dave

[Lachlan]

There are often multiple causes of groin pain as it represents lumbopelvic dysfunction, which can place excessive strain on many structures.

Yes the pain with the sit ups is indicative of a "hernia" although that term is fading out. Often Hernia's are actually minor tears in the external oblique, transversus abdominis or rectus abdominus insertions. Due to there being no palpable hernia present it is unlikley surgery will be of benifit for this.

You are also complaining of pain squeezing the knees together, indicative of adductor related groin pain, which would most likely be due to tendinopathy.

Its possible for nerve entrapments to occur around that area too as you mentioned you experience nerve pain.

Commonly adductor and "hernia" pain will refer to the genital region.

My question to you is- Where is the worst pain located? (the one that stops you from continuing activity)

[ausphys]

Has anyone assessed your lumbar spine and SIJ? If you have an instability that could be causing referred pain into the groin region, additionally muscles like the adductors, and rectus could be over compensating causing your hernia like symptoms

[physiobob]

Could also be a Conjoint tendon injury. Perhaps the best thing is to look at all areas first using a diagnostic ultrasound.

[KiwiDPT]

I agree with AusPhys. While it could be a sports hernia, I would have the lumbar spine checked out again. Many of your sx's sound related. What position are you in when you pull your knees together? On stomach, back, knees towards chest, hook lying?

[lasdaone]

Hello everyone. I am new to this; and the reason why I registered was to see if anyone out there can help me with my frustrating injury-no diagnosis! Here's my situation: For the past 2years now I've had this nagging pain on my left hamstring that shoots to the inner thigh, up the groin, and up to the abdominal area. Every time I try running the pain happens. If I walk fast it hurts! I've had an ultrasound to rule out a sports hernia, I've had around five MRI's and countless x-rays. No one can find a diagnosis. I've tried accupuncture, physical therapy and seeing a chiropracter. Nothing has helped!!! Can anyone provide me with some feedback??? Thanks.