Sports hernia rehab: why you should act like you had surgery

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's 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. I did another podcast recently about the biggest mistake that people make with sports hernias as they're trying to rehabilitate.

And I'm going to cover another one today on the topic of a sports hernia, aka athletic pubalgia, as well as other types of anterior chain injuries that happen in the groin, the pubic bone area, and into the abdominal area. And the topic we're gonna cover today is the idea of the virtual surgery. Now, a few months back, Dawne Costantino and myself put together the idea of the virtual surgery. Dawne Costantino recorded the video. It's public and free on YouTube at this point. The virtual surgery is we go through the first six weeks of what we would see somebody would need to do if they actually had the surgery. And so, at least in regards to rehab fashion.

And so, the idea came from Dr. Stuart McGill, where he actually had what he called the virtual low back surgery. And the basic idea is you act like you had the surgery. You don't have the surgery, but you do the things that you shouldn't be doing if you have the surgery. And I find it interesting the amount of attention and the amount of dedication that people have when they go through something so expensive and something that's so life-changing and, I don't want to say traumatic, but it's a lot of work. You know, there's pre-op stuff and, you know, you have to go in and get knocked out and so on.

It's a lot. You know, it's something that you'll always remember. But when they go into a rehab scenario or they're kind of treating it willy-nilly like on YouTube or self-treating or they go here and there to a local provider and they kind of don't take it as seriously. And I think it's because they don't have that moment where they had the quote-unquote surgery. So, with that being said, we created the Sporternia Virtual Surgery. And essentially what happens, and you guys should go watch these videos, I strongly encourage you to go to YouTube. Look up Sports Hernia Virtual Surgery Performance Place and you'll see Dawne Costantino's smiling face there.

And the first video goes over weeks one through three. And then each video after that covers weeks four, five, six, and so on. And so, when we put this thing together, it was meant to complement some of the other rehab programs that we put together for sports hernias because we see people with different severities all the time at our office. And we find that everybody and everybody has slightly different starting points. But if we were to wave the magic wand and act like they had a surgery, we would start them from square one. And that's what those videos are. But later, they get into more advanced programming for it, which is when you can jump steps and so on.

And I remember when we first put this video out, we had some comments that came through and some emails. And Dawne Costantino starts the video basically by saying, today you had a surgery. Tomorrow you're not going to the gym. You're not lifting legs. And you're probably just doing basic things like getting around the house, starting to walk, don't stretch the area, like really basic things, right? And then so one of the first emails that we got, bless their heart, they said, so this virtual surgery thing, if I were to follow it, can I still go to the gym and do squats? Squats don't hurt. And I sat there and I was thinking, this is the thing that I'm talking about.

Like not to say that every person needs to go through a quote unquote virtual surgery and just take two weeks off, which is basically what the first two weeks of video one are. And after that, start to rehab slowly. But if you were to have the surgery and actually deload the tissue, which is kind of the point of the virtual surgery in the first place, then you would not be going to the gym. You would not be going to Pilates. You would not be stretching. You would not be massaging the area. You would just be waiting, waiting for the tissue to recover. 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. And so I want to pose this idea to everybody who has been self-managing their problem for a while or if you've gone through rehab and it really hasn't worked, we got to consider the first mistake that people tend to make and I've covered this in the last short format podcast which is almost always without fail, everybody tries to challenge the symptomatic tissue too soon. And it's not to say you shouldn't do it at all. Okay, and I'm not going to go on the whole rant that I did in the last podcast for it or at least on that topic. But I want to remind them, remind you, if you're listening to this that if you haven't given your tissue a chance to recover, maybe that is the first step.

Maybe you don't do adductor squeeze exercises. You don't go to the gym and do stretching for the area. You don't do sit-ups. You don't do flutter kicks. You don't do V-ups. You don't do any of that stuff. Can you play soccer and kick? No, you had a virtual surgery. Okay, and again, this is all very extreme, but I'm hoping it kind of paints a picture for you guys of what a step-by-step scenario may look like if we had a cookie-cutter approach, which by the way, no one's really a cookie-cutter approach. So if you guys are looking for a little bit more structure with things, we do have a free PDF book that I wrote.

It is purely on a sport hernia. By the way, I should have said it at the beginning. Sport hernias, if you guys are unfamiliar because everybody's coming to these podcasts at different times, the sport hernia is, think of it as an abdominal wall strain that may go into your adductor or groin area. Everybody has slight variations on it, but generally we call it an anterior chain injury. So it would encompass the stuff of the front side of the belly wall, it's the groin, and into the adductor a little bit. Now, what it's not is a hernia. It is not a hernia. We do get a lot of people who contact us and say, I heard you treat hernias and guano hernias.

We do not treat inguano hernias. We treat sports hernias, which is not a hernia. Why is it called a sports hernia? Because someone named it really poorly a long time ago. So it's not a hernia. It's not a hernia. Okay? But read that book. I think you'll get some better context of what things are. And this is kind of the problem. It's the poor information available online and people not knowing exactly what to do. So what I would suggest everybody do is go through and watch those videos that Dawne Costantino was in and I produced. And so we tried to make it very specific. We tried to cover exercises that are safe to do and not provoking.

The ones who are actually challenging the anterior chain, such as the adductors and like flutter kicks and stuff like that. Like we do it in a fashion where we're coaching deep core pressure first, which is intra-abdominal pressure, which the whole point of reintroducing, or when you reintroduce anterior chain work, you should have adequate intra-abdominal pressure, which is a function of a good core when it functions well. So watch all those videos. I think you guys would be really interested in it. And if you watch the book, you'll see, or you look at the book, you'll see some examples of things that we do in some of the advanced programming.

We also, this is not a whole page. I'm just telling you the things we have. We also have a paid online program too, which that program is after the virtual surgery. And it covers the next eight weeks beyond those virtual surgery weeks. So I'm hoping that we have enough information out there for you guys. We're getting some clues about how to manage things. It's unfortunately, as we've seen so many people throughout the US who have called us about the poor outcomes that they've had. And they, without fail, a lot of them unfortunately make a lot of the same mistakes that are very preventable if they were educated very soon in this scenario.

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