September 30, 2013

Recovery and Rehabilitation from Athletic Pubalgia (Sports Hernia) Surgery - Part 1: Weeks 1-6

I am now 4 months out from athletic pubalgia surgery and feeling much, much better. I decided to summarize the progression for those that may have questions about the post-op of this surgery. Keep in mind that the healing time varies significantly depending on how long you have had the injury and how significant the injury was. I had problems for 8 months leading up to the surgery (and could not even walk without significant pain) and therefore my recovery has been pretty slow. In contrast, my friend Bret only had the injury for about a month and was running 4 miles without pain a mere 15 days after surgery (August 27, 2013). Jerk! :) I would bet that most people are somewhere in between Bret's recovery and mine. My surgeon said that my injury was the worst of this type he's ever seen in a female, and he's been doing these procedures for three decades.

Although there have been a few setbacks, I am making overall progress week to week. I'm not going to lie, the past few months have been very hard. BUT I do (finally) have confidence that there is an end to this injury!

I have been posting every day about my recovery on my Fast Running Blog if you want to see the daily ups and downs. On this site, I am breaking up the recovery into 3 blogs - First 6 weeks, 6 weeks - 12 weeks, and 3 months - 4 months.

Week 1: HARD. I had a difficult time just sitting up by myself because of the pain from the surgery. (Note: do not schedule a flight home the day after surgery). I began "walking" the day after surgery, starting with only 20 ft and progressing to about a half mile by the end of the week. There was a lot of hunching over and A LOT of laying around. I had discomfort with every movement and occasionally shooting pains from my groin to my back. I was only able to sleep for a couple hours at a time and with tons of pillows under my knees and ice packs.
Rock bottom - riding the scooter at the grocery store.

Week 2: Still in a lot of pain. I went off narcotics after a week, although I never felt like the drugs helped much. After moving around for a couple hours at a time, I had to lay down for several hours to recover. Overall pelvic pain dominated the week and ice was my savior. I walked every day and got up to a distance of 1 mile. I was only waking up 1-2 times a night needing a new ice pack.

Week 3: Definitely doing better. I was able to keep the pain in check after activity by laying for 30 minutes and letting the injury site relax. We traveled to Oregon for our friends' wedding and I was able to do some short walks to waterfalls along the Columbia River Gorge. The pool seemed to help with range of motion and loosening up muscles. Sleeping through the night now.

Week 4: Back to feeling pretty normal with daily living with just a general achy-ness. We got a cute, old foster dog for healing powers and a friend to walk with. I started walking for several miles every day and felt about the same as pre-surgery - groin discomfort, TFL and glute pain. Although I felt a little better, overall I couldn't tell if the surgery did anything yet. I started physical therapy with these exercises: 

- 5 min, 10s holds of light pelvic tilt 
- 3 x 15 glute activation - make sure glute fires first (
- 3 x 15 oblique cable exercisee 
- 1 x 10 core stability hip rotation (
- 1 x 10 straight leg raise 
- Pelvic adjustment

Week 5: Lots more walking. I was still struggling with compensation patterns but am able to walk several miles a day. I tried running for a couple minutes and it caused my adductor and groin to be sore the following day. Continued the routine of physical therapy and made some progress. Increased the number of sets on other PT exercises and added these exercises as well:

- 90 second hold of strain-counterstrain position of iliopsoas
- 1 x 10s psoas inhibition exercise (patient lies supine in hook lying and is instructed to dorsiflex at the ankle and push through their quadriceps as if to gently slide up the mat. The challenge is to contract the quadriceps without activating the hamstrings. If done correctly, the tibialis anterior and quadriceps are activated, while the hamstrings and psoas are inhibited)

Week 6: I incorporated a tiny bit of running into my walks. I could only run for a minute or two before my right leg ran out of power or my groin started to hurt. I am still very diligent about the PT exercises every day.


  1. Massage Therapist Michael’s Natural Therapies has been successfully treating it’s clients since 2005, assisting in everything from injury recovery for athletes to providing relaxing massages to those that simply wish to indulge themselves.

  2. Although there have been a few setbacks, I am making overall progress week to week. Hockey Awards

  3. You did much better than I am doing. How are you now? I went 7 mos. until surgery. The rectus is still sore up and down. Actually, much more sore UP than down where the injury was. It's a rough road!

  4. My son is a high school wrestler. He herniated his groin in practice the other day. The training staff is estimating that he needs to have surgery to repair it. I'd love to get a second opinion from a surgical specialist.