Hello Docs,
I have learned a lot from listening to the Hernia podcast and reviewing many older threads on the forum, so thank you! Regarding my current situation, I want to see my doctor (fellowship in sports medicine) on Friday and he diagnosed me with an inguinal (ring) hernia on the left side. I have a consult with the surgeon on Thursday this week to confirm and to discuss my options.
So, given that the podcast was from 2020 and the forum threads are also older, I would like to see if the recommendations and guidelines are still the same? I would like to continue training with Hip Rehab program until surgery and the recommendation seemed to be to reduce the RPE to 6-7 as a cap (Dr. Baraki on the forum). Also, would you avoid any certain exercises, like lower abdominal for example?
Regarding rehab after surgery, the podcast info stated that the current guidelines (2018) that there were NO restrictions to activity? Thus, how long should I actually wait to restart phase 1 of the Hip Rehab? I ask, because a forum post by Dr. Miles states that a return to training is usually around 6 weeks post op? So, can I actually start training pretty soon after surgery if I really ease into things? Maybe an RPE cap of 4-5 for weeks 1-3 and then 6-7 for weeks 3-6? I really appreciate your feedback on this, as I do not want to return to the Hip Rehab template sooner than I should.
Thanks for your help!
Paul Hernandez
Hey Paul,
Sorry to hear about the hernia. I understand that can throw a wrench in your plans and be frustrating.
Regarding our recommendations, the podcast is still current. I cannot specifically tell you what exercises you will be able to tolerate immediately post op and which ones you won’t, but there are no activity restrictions. Your surgeon may have a different opinion based on there experience and vibes, which is fine.
If it were me, I would likely resume activities that were tolerable immediately, gradually expanding upon them as I am able to. Again, I cannot make a specific recommendation for you through the forum. I need more information and follow up via consultation to feel comfortable doing so.
Thanks for the feedback Dr. Feigenbaum! Yeah, it’s pretty frustrating! My groin rehab was going so well, but when I worked up to week 6 on the template, the inguinal area would get really irritated. So, I just did a pivot and restarted phase 1 again. Things were going great the next time around, but in week 6 again the Copenhagen planks (iso holds) really irritated things again and my inguinal ring area felt pretty bad. So, I went to see my doctor.
I have taken a week and a half off due to the pain (ice and NSAIDS) with some light rehab isometrics. Yesterday, I started week 1 over again and put a cap of RPE 6 (4,5,6) on each lower body exercise: box squats, sumo DL, and lying abductor raises. Upper body consisted of my normal programming. Then I applied ice on the lower abdominal/groin area—I seemed to tolerate the lifting pretty well and I didn’t have any increase in pain.
It was very humbling, as my sumo DL consisted of an aluminum bar (18lbs) and 10lb bumpers for 38lbs. Then my 7 year old son came into the gym area, looked at the bar, bent down and lifted it up, set it back down, and stood up again and smiled at me!
Thanks for sharing “if it was me” pertaining to the post op activity—that was very helpful! If I decided to do some consulting, would I do that with you or say Charlie from the Rehab Team?
Paul
Yep, hernias can definitely be uncomfortable. If/when you get it repaired, you may find that you don’t need any specific type of guidance for return to activity. On the other hand, if you have continued symptoms and/or are a bit perplexed about what to do, I’d reach out to our pain and rehab team. We’re all capable of handling this sort of issue, but I do think Charlie, Derek, Cam, et al. are best suited for this application!
