Sports Hernia Questions: Diagnosis, Treatment and Recovery Time

You're listening to the Restoring Human Movement podcast. Thanks for joining the movement movement. I'm Sebastian Gonzales, show curator and head clinician at Performance Play Sports Care in Southern California. This show is for active people, those who refuse to let pain and injury get in the way of their life and how they want to live it. Trails and trips, fields and courts, whatever moves you. Each episode features rotating host, expert guest, and real clinical conversations that help you move better and trust your body again. Here we go. Struggling with a sports hernia and looking for the right recovery plan? Download our Sports Hernia Athletic Pupalgia Recovery Guide absolutely free.

In just one hour, you'll have a complete recovery plan, helping you get back to your normal activities with less discomfort and more confidence, whether you're playing soccer, baseball, or sprinting in any sport. No more endless searching and piecing together conflicting information. This guide gives you the clear, structured steps that you'll need to dramatically improve your recovery. I've been covering a lot on sports hernias, which if you don't know what that is or if you have questions about the details of what it is, I suggest you listen to the other podcasts that I've done over the recent few months.

I've intended them to be kind of almost in order of telling what the condition is, as well as some of the integral parts, the anatomy, and so on. But for you guys to make sure that you're on the right podcast, a sports hernia is generally groin pain, typically with athletic populations. It can include adductor pain, right at the pubic symphysis, it can go down a little bit into the inner part of the thigh, the crease of the hip, lower abdominal area, and it tends to increase with twisting, turning, especially sitting up and using resisted adduction, which is squeezing your knees together. So if you guys are wondering more about those parts, please go to the old podcast.

In this episode today, I want to cover just some of the common questions and concerns we get from people. I think this would help you guys get better information about potentially what your recovery may look like and to make sure you're headed in the right direction. The first question that we almost always get from people who have first experienced this verbiage of a sports hernia is, Are you sure I don't have an inguinal or ephemeral hernia? How can you tell the difference? Now, to be clear, we are not experts. I'm not an expert in inguinal or femoral hernias. In fact, when people call us or email us about them, we say we don't treat those.

And I think the reason why they're asking about this is because there's so much confusion about what a sports hernia is. People believe that it's in the same category as a femoral or inguinal hernia, and they're completely different. Those are abdominal hernias, which require intestinal contents exiting out of the abdominal cavity and moving outside of the abdominal wall. A sports hernia is not that. And if you guys wonder why it's called that and why it seems the same, it's because it was poor wording when they first named it, which is why a lot of the literature is moving towards the term of athletic pubalgia.

You may not see a bunch of references online for athletic pubalgia with simple articles, but you'll see them more in literature in the peer-reviewed journals now. We're trying to not actually call it a sports hernia anymore, although the reason why we keep putting these podcasts out about it is because people keep searching for it, and we need to make sure that you guys are redirected to the appropriate things. Now, how can you tell if it's an inguinal hernia or a sports hernia? Well, I can tell you one thing for sure, that we at least use the general outline of when people call or come to see us, and they say, hey, you've got to check this thing out.

Like, look, it's like they think it's a very big thing that they're going to show us down in that region. It's probably not a sports hernia because it has a large area of swelling or a big pocket of something that's exited out of the abdominal area. I wouldn't be the one that would be able to give any advice about how to manage those conditions, but I'd usually seen a hernia specialist would be a good starting point and get their opinion on it. But usually sports hernias don't have a really large area of a lump or a swelling in the area. I have met a lot of people who say there is, but when you look at it, there's not.

So there are some cases that end up having really minor amounts of fluid accumulation there, I believe. It's not actually abdominal contents, and the reason we know a lot of people actually don't have the abdominal contents exited is because a lot of people that we've seen have actually been screened for in guinal and femoral hernias. And so they already have imaging that shows that it's not there. And so it leans towards the assumption that there's more of a swelling in the area versus actually exiting of material. Now, the next question we tend to get a lot of is, how would you successfully treat a sports hernia or athletic pubiology non-surgically?

Like, what can we do to treat it non-surgically? What are the possibilities? What may it look like? I would say, number one, it is very successful to treat it non-surgically. It's actually the preferred route. And one of the other podcasts that I suggested people listen to, I think it was the last one that I did, I made mention of another podcast, I think it was with Dr. Zolan, who said that a lot of people end up responding really well to conservative care. I'm not going to quote too much on that because you guys can just listen to that podcast. But I think the preference is that people don't go the surgical route unless typically there's a short recovery time required.

It's almost like they can't risk the possibility that over the next six weeks they improve a lot or even over the six months it improves way more just kind of by doing some strategic rest on the areas that are needed, but also keeping physically active as you can and incorporating in some rehabilitation. It's almost like they don't have time to wait on the off chance that it actually doesn't help itself. And the reason why people tend to not have the short time window or they have the short time window and they can't wait is mainly because there's something at stake. Like they're going to lose their job, like if they're a professional athlete, they'll lose their job.

I mean, they're essentially an asset, you know, they're paid to play. Other people potentially may not be able to work, wait that long, mainly not because they're getting paid to play, but they may lose their position and they have a chance to get paid to play. In my opinion, really the short recovery window that we need to consider, like press the issue of possible surgery, especially when you find things like a significant MRI findings of bone marrow edema and an actual positive, not just theoretical MRI is positive, or you maybe see a tendinopathy here and there and so on. Like you actually see bone marrow edema and bony changes.

Those people are more reserved for people who actually have the athleticism as a job. Everybody else, I think we should wait. And it's not that you can't get better. It's not that you need the surgery to get better. It's more of, are you able to wait a little longer to make sure that you have the actual need for surgery or not? Because I think in our experience at Performance Place, I'd say 90% of people get better just with conservative care. And conservative care is non-surgical, non-medical, like structured rest, structured return, making sure that we have good hip range of nerves. To allow for the pubic symphysis and some of the structures around it, like the adductor tendon and the tendons and musculature of the abdominal cavity, like that they have enough, that they're able to reduce their workload to actually recover.

Like a lot of times these issues are not trauma-based. It's not one single incident. They're actually building up for quite a long time. I know that in some of the old podcasts, I actually, I don't want to say in the old podcast, I've had a lot of people over the years that have reached out to us at Performance Place and said they're really frustrated about not having a lot of good information online about what this condition is, as well as how to solve it and so on. I would disagree. I would think if you're looking in the right spots, I think there is enough good information that gives some really good insight of how to manage these.

Almost everybody talks about hip dysfunction or range of motion related factor. Almost everybody talks about the mechanics associated with, which is hip adduction combined with hyperextension lumbar spine, which couples with an anterior tilt of the pelvis. Like everybody talks about these things. Like we kind of know the mechanics of it. So we can, in theory, reverse engineer it too. So I think most people, like you, you need to earn your surgery. Like you have to prove it's not going to help you doing the conservative care, the reasonable stuff. And I'm not going to say it's not frustrating to not have being able to participate in your sport or activity, but there's endless ways where you can keep you physically active while not provoking the area.

I play baseball recreationally. I'd be very sad if I wasn't able to play for, for six, six weeks to six months. But, you know, it comes back. It gets better. It doesn't mean I can't field balls. It doesn't, maybe I can't sprint. Maybe I can jog a little bit. Maybe instead of pulling the ball, I can probably upple the ball. So there's ways that we can actually still keep you in the game, but without provoking the issue too. I think a lot of people actually tend to get better with the idea of a virtual surgery as well. There have been a lot of people that I've talked to where they're not really, I don't want to say they're not willing to actually put a lot of stake in the recovery process, but also they're not willing to negotiate with their activity.

They're like, well, I want to get better, but I don't want to stop doing this. Or I want to get better, but I only want to, I only want to do rehab like once a week or twice a week. Sometimes we need to do something a little bit more drastic. And I've met a lot of people over the years that once they've had back pain or hip pain, all of a sudden, like, you know, work, they can't work anymore. They're off for six weeks, right? They're instructed to walk as much as possible, as long as it doesn't hurt. Like their walking time is way up. They do some hip stretches or some back ones or whatever's required in that frame of time.

And they do it on a daily basis. It's because, and personally, I think it's because they have gone through something so dramatic. They've gone through an actual surgery where they don't want to have to go through and do this again. There's a lot of steps in the process. You have to get your pre-op. You have to meet with the doctor multiple times. You're under anesthesia. Some people undergo disability. And so there's a lot of factors associated to it. And you want to make sure you don't have to do that again. And so people are very strict. They're very serious about it during that period of time.

Now, if you required them to do that forever, where they had to do exercises five days a week, get the range of motion back, walk that much, they probably wouldn't do it. But you have their attention for a very short window of time. And I think for that reason, a lot of people also get better, too, if you took that time and didn't actually do the surgery. So we call it the virtual surgery. It was, I think the concept was created by Stuart McGill associated to low back disorders. But the virtual surgery is essentially, you snap your fingers, the surgery happened. What are you required to do now?

Well, doc, can I go run today? No. Why not? You just got out of surgery. Okay. Well, what should I do? Well, do X, Y, and Z. This is on your paper. You're doing this for the next four weeks, six weeks. And then we're going to rebuild your strength in your hip and so on and da, da, da, right? So it really changes the scenario because the virtual surgery takes the seriousness of the surgery and you can implement a lot of structured rehabilitation with somebody without actually doing the surgery itself. So I know virtual surgery sounds like a ridiculous idea, but I really do think that it allows us to slow our lives down to be able to focus on the thing that's most important at that moment.

In that case, for a lot of people, it's going to be getting out of pain and feeling more physically able. And if you're not getting better, this is maybe something you may want to try under supervision. Hey, everyone. It's Sebastian. I'm going to hijack the show just for a second here to tell you about an opportunity that we have called the Discovery Session. A lot of people over the years have reached out to us from our YouTube channel because we have 150,000 YouTube subscribers at this point in time, probably more by the time you're listening to this. And we have a lot of people listen to this show and read our articles online.

They're frustrated. People are frustrated about not being able to get back to full activity. They're frustrated they can't really trust their body. They're frustrated that they have not found any long-term answers or things to make them happy. And so we're here to help. We may not be the ones to actually help you, and we're okay with that, but we're hoping that if you are able to speak with us, that we can maybe give you some insight of things that you potentially haven't tried yet, and if we know people, we'll suggest those people too. So if you want to take advantage of the Discovery Session, all you need to do is go to p2sportscare.com and find the Book Now button.

It's all in there. We have virtual or in-person options. You can go to the show notes for this show and find a link that will directly connect you to us, or you can call us, 714-502-4243. We'd love to help you the best that we can, and we're always here to serve. Now, back to the show. Now, the next question we get a lot of is, how long does it actually take to get better? I think we should separate these into two parts, mainly. First is, how long does it take to reduce pain? And the second part is, how long to improve my ability to get back into my sport without provoking it? Because sometimes, I mean, we have a lot of people who actually come in who don't have, I don't say they don't have a real big problem, but it's like, they're like, well, it feels okay right now.

It's almost like you take your car to the shop. It feels okay right now. But if I were to go out and play half of a game, then I really do feel it. Or if I run X amount of miles, I really feel it then. So, it's not like they're in pain, but they're not able to fully do their activity that they want. Pain-wise, if someone walked in or barely walked in and they had pain, even when they got out of the car, with walking into the doors of the office, they sit down, they're in pain while being in a seated position, they start squirming around and stuff, you can't sleep through the night. Like, these are things that actually are a little bit more, I guess, acute exacerbation, we say, and there's an acuteness to it.

It may not be inflammatory-based, but there's an acuteness to it. And so, for these people, normally about two to three weeks is enough to significantly reduce their pain. Some people actually fare a lot better, faster, if it's not an inflammatory-based problem. I'll explain that. So, number one is if I just burned myself on my arm, it's going to take probably like three to four days to kind of feel normal-ish. Like, it's still sensitive to the touch. I may not want to pour more warm water on it, like take a hot shower, but it's way better than what it was. Like, the first few days, it throbs, it aches, like the whole thing like really sucks.

And so, this is a really acute scenario. Other times, that acute inflammatory part is kind of gone, and it's just really sensitive or triggerable. And that may be more positional-based, like it hurts to walk in, but when you sit down, it's better. When you get out of the car, it really stabs you, but when you start walking, it feels better. When you sit down for more than five minutes, it doesn't feel good, but when you start to get up, it feels better. When you sit up out of a bed, it's not good, but when you start walking around, it feels better. So, there's endless examples of this, and these people actually get better a lot faster because a lot of the inflammatory component is gone, in my opinion.

So, again, a short answer is usually two to three weeks, but sometimes it's a little sooner than that based upon your specific scenario. If we're talking about actual return to activity, I think if there's some significant findings on your images or it's really highly sensitive, I'd say reasonably, probably about like a month and a half and back into some of the triggering activities. I'm not a fan of taking people fully out of activity. I think with every action, there's a pro and a con, right? So, if we put you on six weeks of bed rest, what does that do to our body? Well, it deconditions your foot, let's just say.

Your leg gets weaker, your bones get a little weaker too. I think it's, if I were to think about like physical abilities, I think over 30 days, you lose some strength as well. I'm sure over a week, you actually lose some ability to sprint. So, there's cons of it, right? Now, maybe you can't sprint, but maybe you're able to do some weight training. In that case, maybe we pick the weight training that's safe for you. How do you know it's safe for you? Well, if you can't figure that out, then a professional can help you based upon some of your signs and symptoms. So, we always use the scenario of red, yellow, green.

Red is like, ow, ow, ow. That hurts my problem, like my primary problem. I'm assuming for a lot of you, it's probably sit-ups and like adductor machines would probably do it. Sometimes things like lunging or split squats will bother it too. And these are red. They don't feel good. It makes me feel worse when I do it and after. There's no question about it. Just drop these. Like, these can be rehabbed or regressed a little bit or you just pause them, don't do them for now in lieu of adding them back in later. Then there's yellow. Yellow is like, I can't really tell. Like, this may hurt me. I'm not sure, which is kind of a mental yellow.

And then there's the actual physical yellow, which I say is an associated sign. It's not a symptom. It's a sign in correlation to what you may experience. And so I'll give an example of this in a moment. But I remember a long time ago, I was talking to one of my associate doctors and we discussed the idea of not being able to really track any one person's symptoms because it took them a lot of miles to be able to provoke it. And so how do you track this and know that you're actually improving the person in session, in the training session, and also not provoking their issue? Like, I know there's a big fear factor associated to, well, am I making this thing worse if I do this activity?

Maybe. Well, maybe, then I'm not going to do it. So we want to make sure that we're tracking to figure out the actual things that are safe for this person. And so for this one person, they had problems in the feet, but when they did goblet squats, they really felt their hamstrings get fatigued. Now, I'm not going to say the hamstrings don't work in a squatting pattern, but for people who are familiar with training protocols and like mechanics, and generally like a squatting pattern is typically a goblet squat is going to be a knee dominant activity. So you're probably going to feel your quads fatigue more than anything else, or if you're really out of shape, you're going to feel your cardiovascular system gas out first, but usually not the hamstrings.

So this is kind of like an aha scenario. We have an associated sign, not a symptom. And so if we can make that pattern of movement load better and actually use the quads as it's intended to, we reasonably help out to deload the structures that may be associated to altered mechanics in the first place. So I'll say that again, if your hamstrings work a lot in squats, then maybe we should try to use that as a benchmark to figure out if you have a high potential of re-injury or not, because those are obviously altered mechanics. Now, if you, let's just say you did hamstring curls before you did squats, you did a ton of them.

And then you started to do squats. Yeah, they'd probably fatigue first, but if you just first started grabbing a weight and doing 20, 25 pound goblet squats, something super light in your hamstring started to light up a little bit with activity or cramping, this is kind of odd, you know, and it's something that is reducible and trackable if you know what you're looking for. So that's a, that's a physical yellow. For a lot of people with sports hernias, they tend to have the physical yellows that I've seen is with a hip hinge or deadlifting pattern. They're going to find that they actually get their hip flexors or low back to work more than their posterior chain or glutes would.

I'm not saying that we need to isolate the glutes in a hip dominant exercise, but you'd probably see on like a banded bridge or a bridge, you'd probably find that the glutes would probably fatigue first. Now, if someone had an altered pattern, they probably had their low back or hamstrings work first. We also see this with leg lift types of assessments. I don't tend to pick hip flexor strengthening exercises for a lot of people. I know people do it. I wouldn't do it. At least for, for people with symptoms, it seems like it doesn't tend to go well for, for the people I work with. But when they do it, a lot of times people feel their groin or they feel their symptom.

So this is either yellow or red physically. And then there's green. Green is like pushups. They don't bother me. Can I do them? Yeah, sure. Can I do pull downs? Yeah. Can I do carries? Can I do sled pushes? Yeah, sure. They feel fine? Yeah, great. Is it the appropriate target tissue? Yeah. Or does it just feel hard? Feels hard. Great. Go ahead and do them. Side planks, accessory work, bicep curls, like delt work, all these may be green lights for you. And although they may not actually seem to help, they actually keep you physically able. I remember there was some research back in the day where they were talking about mainly low back disorders and associated with really generalized weight training.

And I'm going to say they picked like unilateral exercises, like for people with lower back pain, they picked like bicep curls and tricep extensions and calf raises. They just picked random things. It really helped the person. And so I think there's some magic to that. There's no need to drop everything. And you shouldn't go completely physically active unless you have a really, really severe type of scenario or unique type of scenario. Most people do not need it. And most people actually fare better if they keep some physical activity. But you need to be able to identify those reds, yellows, and greens to make sure that you feel mentally safe when you're doing so too.

Now for a quick pause before we keep going. Hey everybody, it's Sebastian. If what we've been describing in the show so far sounds very familiar and you've been dealing with some ache, pain, or stiffness that keeps coming back no matter what you do and no matter what you try, we're offering a free discovery call today where we brainstorm with you what has been working for you, what hasn't been working, and we also try to unravel what is a critical part of the puzzle that you've actually been missing that's keeping you from full recovery and getting back to full activity. The link's in the description.

It only takes a few minutes to fill out the form. Okay, back to the show. Now let me just make sure I cover that how long does it take to get better question fully now because I know I'm tangenting around a little bit. But as I said, usually pain is two to three weeks to get more physically active again. Six weeks I think is pretty fair. I have met a lot of people though who let this wait literally for six months and they're not pain-wise they're not getting better other than the acute scenario tends to dissipate. But they still have pain getting out of cars. They still can't sit up in bed. You know, when they start jogging, they feel it.

When they step the wrong way, they feel it. Like, this is too long. I'm not saying that you can't get better if you've waited six months, but it's too long. It's outside the expected recovery window. I know I've talked about this in other podcasts before as well, but like there's certain conditions with certain severities with certain populations, meaning you're very unique, not that everybody's the same, that have expected recovery times for certain things. We stress this very highly at Performance Place where we tell people that within two to three weeks, if we don't have you to X mark, let's just say in this case, our significant reduction of pain, then we're missing something or you're not doing something or there's something wrong with the recipe or we've coached it poorly.

Like there's something not working well. And it doesn't mean something won't work. It's just that this recipe is not it, unless maybe in a chronic pain type of scenario, which makes it a little bit more complicated. But let me give you a real life scenario. Let's just say that you had an oil change you're going to do with your car and you sent it into the shop and they had it for a month. Is this a realistic window of time? I don't think so. You know, like you know how long it takes. They know how long it takes. Like if they had it for a month, there's something wrong. Like your car has been stolen.

You know, your car, like something's not going right. They don't know how to do the oil change, right? So there's a lot of things in life, pretty much everything in life that we are familiar with. There is an expected recovery time. If a house cleaner comes in and cleans your house, how long do you expect? Under four hours, right? And so when we're going to paint your house, how long do you expect? I don't really know, but I would assume like a week, right? I know I've done some of my rooms in, you know, a day or two. So there's expected recovery time. And if you're not hitting that, there's something going on.

And I'm bringing this up because like how long does it take to get better? Well, it does vary from case to case and house to house with painting jobs and car to car with oil changes. But can we reasonably get an idea that like pain under a month or so, give or take couple weeks, right? It doesn't really matter unless you have a chronic pain scenario. And then in that case, it gets a little bit more complicated. I'm not going to cover that in this podcast, by the way. And recurrent return to activity. Let's just say three months, right? And this is outside of my window that I like, but that's certainly under six months.

And it's well above about a month and a half. So if you're not hitting those timelines, I really, really want you to think about finding something that's going to work better. All right. And we tell this to all of our clients that we see first is we tell them expected recovery times for different things because we want them to know that we're going to be trialing things if we don't find those timelines. Like, I would love to say that working with the human body is as simple as changing the oil on a car. It's not. We have to not only work with things that we can't physically see, but also like movement patterns or like software patterns that are hard to break sometimes.

You have a past history of things and old problems that may come up, like old ankle injuries, which may limit how much a hip works, which limits how much, or sorry, increases the amount of load that the pubic symphysis gets and increases the problem of a sports hernia. And so there's a lot of different variables associated to it. And sometimes we don't always find it right away. I know there's a house that I worked on that it was everything that you did, you know, you like you open up the drywall and all of a sudden you're like, man, there's like, it's like insulation issues here, you know, like, and then you do the insulation and you're like, oh man, this ducting looks bad too.

So like there's things that do come up and don't get me wrong, but reasonably, there should be a simple amount of time that you should be able to recover in. Can it get better on its own is one of the questions that we do get a lot of as well. I always put it like this, and this is probably a short answer. Some do, some don't, you know, and that seems pretty simple. But all I can say is that people that contact us, they're people who have not gotten better on their own. Like we really see people who, you know, hey, it happened yesterday. What do I do now? Like there are some like initial questions we get from people like that.

But a lot of times because of the, the initial inflammatory period that happens associated to a new injury, like the burn I mentioned earlier, like it usually does dissipate a lot on its own. It may not all go away on its own, but I like to, I like to put it like this simple conditions go away on its own, more complicated ones don't. And then we have those time frames that I talked about a couple, a couple minutes ago. Those still have to be in consideration. Ideally, if you remove a trigger, a lot of times things will, pain will reduce. So if kicking a soccer ball increases the pain, you remove that.

A lot of times it will reduce as well because you're not provoking the issue. Sometimes that's not always the case, but typically what we need to do when reintegrating activity back in, if the kick in the soccer ball tends to bring it back again, even after, you know, six weeks or so, we need to take a good hard look at the mechanics. We need to look at not kicking mechanics, but looking at is there a reason why that structure, the sensitive structure keeps taking the workload of a kick, which should be shared throughout the hip, the abdominal area, and even the stance leg. So there's a lot of things that we could look at to figure out how to make it so this area isn't so highly provoked.

The last two questions I'm going to cover are associated to adding things or supplemental things like over-the-counter medication, nutritional changes, supplementation. I don't tend to suggest things to people like this, not because I don't think there's not a value to it. There are supplements that I take on my own. Nutritionally, I strongly believe what you put in your body is helpful for your recovery and preventative of injuries too. I think the saying is crap in, crap out. Like, what do you really expect if you're really not giving your body the nutrition that it needs? And so over-the-counter medications, I personally don't take any.

I can't speak for like what you should do, but I've been able to get over various different types of aches and pains without having to really use over-the-counter medications. Nutritional changes, again, I have done a lot over the years. For my nutrition, I grew up eating fast food all the way until probably about the age of 25 or so, and then I really started to change things a little bit. And so we make all of our meals at home for the most part. We do go out. We're not scared of eating other food, but like really we're able to control what we eat a little bit better with doing meal prep and stuff like that.

There are some natural anti-inflammatory supplements that can be helpful. I wouldn't be the one to speak for that necessarily. But this would address, and I really want to get across with this part versus telling you what I can't, what I'm not good at is essentially, we're going to talk about spark versus fuel. And so these conditions that tend to return tend to be associated, they need to a mechanic, which is a spark. But also they need a fuel to continually burn. So imagine like if I put a spark next to no fuel, the spark burns out and then that's it, right? But if I put it next to fuel and keep feeding it fuel, then it continues to grow and become irritated.

So this would be more of an inflammatory component. The spark is the overload of tissues, poor mechanics, muscular imbalances, poor exercise programming, even poor exercise choices, like say picking sit-ups when sit-ups bother you in the first place, or poor load management. We see this all the time with recreational sports, with adults, picking poor, going into season without being physically trained or assuming that going to two practices like the weeks before is enough. It's not. So there has to be a baseline that they keep throughout the quote unquote off season to be able to perform really well in their actual season.

There's also spikes of activity too. I'm in one right now where I'm trying to mitigate some of the risks associated to it because I play one baseball game a week in the most of the time in the year. I play a little bit on Fridays as well. But we have a tournament this weekend where there's going to be at the minimum four games over the course of four days, or it could go all the way to eight games over the course of four days, which is quite a lot. I decided I'm not going to play more than one game a day. And it's not because I don't want to be part of the team or that I'm scared to get an injured, but I think reasonably that's a big spike of activity.

So I'm trying to mitigate my risk. So for me, what's more important is how will I perform during the actual season? Because this is a tangent tournament. I don't need to play it. It's optional. I want to play more baseball and I like hanging out with the people that I'm with. And so I don't need to necessarily be in all the time to accomplish that. And I like my other season more. I'm more invested into it. So there needs to be a spark and fuel to keep these conditions going. So with that being said, there may be some nutritional parts. There may not. Maybe some supplementation. Maybe not. Maybe over the counter or talking to your primary care about some medication may help you.

Maybe not. We don't know. The spark, again, is typically overload tissue principles. I think if you guys are weight training at all, some of the principles associated to bodybuilding and strength training are really, they really are helpful with understanding adaptation. I think one of the things that need to be taught in school, we talked about home ec. I talked to one of my friends about home ec. Like, you should be able to, you know, cook a meal, you know, by the time you're 18. That's pretty reasonable, right? You should be able to know about, like, finances. I think also we should know about adaptation.

Adaptation is pretty simple. But it's something I think a lot of people don't really think about when they think about their injuries and what they do to their body over time. Bone density changes, osteoporosis is pretty much a good sign of adaptation. How have you been using your body? The bone will physically grow if you challenge it chronically. Not acutely, not like this weekend, like me doing this tournament, but chronically. The more of the two day a week of how I play or do weight training is going to help me over time. The same thing happens negatively, which is going to be, say, with alcohol.

You drink too much alcohol, your liver adaptation is cirrhosis, right? As amongst a bunch of other things, body composition change and things like that, things of that nature. So there's a lot of adaptation the body does. And whether we acknowledge it or not, it's happening. So when you have a sunburn, that's an acute spike of exposure to the sun. But over time, if you get enough sun, you get vitamin D, right? You get a little bit more of a cool tan and so on. But I think we all need to understand when it comes to musculoskeletal health and like tendinopathies and tears and strains and so on, the adaptation that happens over time is how we need to manage it better.

I hope everyone understands that. I'm sure I'll do another topic on load management and adaptation at a later date. Last thing I do want to let you know is that sports hernias, addict or strains, they do have a good relationship. I'm going to probably be talking about this on a future podcast. But I really want you to go back into some of the old podcasts and skim through and understand this really well. I don't. We are going to be releasing very soon if we didn't already is a manual that we have on sports hernias. I wrote something up. I call it the sports hernias six-step recovery plan. It's going to be an e-book with a bunch of videos in it.

I'm probably going to do an audio version. I may just give away in the podcast here. Or we're going to have it as a webinar with me, Dawne Costantino, and Mandy. Right now, the book, if I'm skimming through right now, it's about 50 pages long. It has pictures and videos. And the topics that we're going to cover is, number one, what is athletic pebalgia? Number two is understanding athletic pebalgia or sports hernia. Step three is going to be circumstantial rest, which is part one of the recovery process. Number two is applying first aid or pain management. Number three is getting assessed by a professional.

And we included a self-assessment here that you guys can learn and score yourself to figure out if you're high risk of re-injury or not. And another step four is breaking movement compensation. Step five is applying strength to the frontal plane, which I'm sure a lot of people don't do. A lot of clinics don't do. But in play, you do do it. But you can regress it a little bit as you start to recover. And the last part is return to play criteria. So this is something that's going to be free and available to you guys. I don't know where it's going to be, where it's going to be distributed just yet.

We're still creating the e-manual, but there will be a link on this podcast, or you can go into our website, p2sportscare.com. And it'll probably be under webinars, if it stands correctly. We have some tabs of some content. Podcast is one of them. Webinars or articles is another. We're probably going to put it under webinars. There'll be an opt-in form there for you. If anything in today's episode resonated with you, visit the link in your podcast player. There you'll find any free resource that we mentioned in the show, any guest links, and a link for a free discovery call with us. We're licensed to work with our outdoor active people via telehealth across many states in the U.S. at this point.

In fact, we cover almost half of the population in the U.S., and we add more states every year. Thanks for listening. Subscribe to the show, and we'll see you in the next one.