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View Full Version : Breaking News! Mario has a sports hernia.


dalemurphy
12-03-2010, 03:13 PM
Well, breaking news for some. Some assumed it, others thought it possible... I guess the breaking news is that the team has released that information. I think the Texans horribly mismanage player injuries and we have one of the worst training/medical staffs in the NFL. Here's a quick story I just posted on the subject with some links to other related stories from this off-season. I'm contacting Cloak and Dagger to continue a detailed discussion we had earlier in the off-season for a more extensive article on the subject:

Texans Bull Blog (http://www.texansbullblog.com/finally-truth-mario-williams-revealed/featured-articles/)

Blake
12-03-2010, 03:16 PM
Well then its time to shut him down for next season.

dalemurphy
12-03-2010, 03:21 PM
Well then its time to shut him down for next season.

They could've shut him down in July or August and had him back healthy in October... Not only that, but I think this is an injury lingering from the '09 season. So, he could have had it dealt with in March and been healthy for camp. Unfortunately, none of that got down and the coaching staff and GM are fighting for their jobs. They believe a crippled Mario gives them a better chance to keep their job than a rotation that includes Tim Jamison and Mark Anderson... I disagree, actually, but this organization is always very slow to make the appropriate personnel decisions.

wagonhed
12-03-2010, 03:22 PM
And all the shit talkers now look like huge assholes. Imagine that.

fiasco west
12-03-2010, 03:23 PM
Mario is a tough dude. He's quiet too maybe he's the one begging to play these games?

I also think Andre is still dealing with injuries himself, That last big play he caught he just didn't have the speed I expect to see out of Dre.

b0ng
12-03-2010, 03:24 PM
And all the shit talkers now look like huge assholes. Imagine that.

You can't really hold anybody responsible for down talking a guy who is not performing as he has in the past. Not unless they knew this beforehand and decided he was lazy anyway.

8.5 sacks and a sports hernia, yikes.

HuttoKarl
12-03-2010, 03:26 PM
You can't really hold anybody responsible for down talking a guy who is not performing as he has in the past. Not unless they knew this beforehand and decided he was lazy anyway.

8.5 sacks and a sports hernia, yikes.

It's pretty good production for a guy who's hobbled. All I want for Christmas is a new coach and a healthy Mario Williams in 2011.

wagonhed
12-03-2010, 03:27 PM
You can't really hold anybody responsible for down talking a guy who is not performing as he has in the past. Not unless they knew this beforehand and decided he was lazy anyway.

8.5 sacks and a sports hernia, yikes.
Except that he is performing as he has in the past, that is, performing very well. DESPITE this injury. Yet some people insist he sucks, has sucked since he's been here, and doesn't try. Nice.

hot pickle
12-03-2010, 03:28 PM
i knew that there was a reason for his play! ill admit even last night i thought maybe mario doesnt care anymore! but love live super mario! come back next year for out play off run

burro
12-03-2010, 03:29 PM
:kubepalm:

If it were up to me, should we be mathematically eliminated from the playoffs - I would seat Mario and AJ for the rest of the season and let them heal up fully. We definitely need a new wellness staff for next season, no question about that.

dalemurphy
12-03-2010, 03:30 PM
Except that he is performing as he has in the past, that is, performing very well. DESPITE this injury. Yet some people insist he sucks, has sucked since he's been here, and doesn't try. Nice.


I spear-headed a lot of that discussion a few weeks ago. Not that he has always sucked, but that he was playing with a lack of effort that was infuriating... However, I also acknowledged that my opinion is based on the assumption that he is reasonably healthy. It is unfortunate that the organization handled things so badly that I actually had to hope that the top pick of the draft in 2006 was seriously injured.... yippee, I got what I was hoping for. uggh.

wagonhed
12-03-2010, 03:30 PM
:kubepalm:

If it were up to me, should we be mathematically eliminated from the playoffs - I would seat Mario and AJ for the rest of the season and let them heal up fully. We definitely need a new wellness staff for next season, no question about that.

sit Foster as well. RBs can typically only handle so many carries in a season.

Mr teX
12-03-2010, 03:30 PM
Except that he is performing as he has in the past, that is, performing very well. DESPITE this injury. Yet some people insist he sucks, has sucked since he's been here, and doesn't try. Nice.

Don't mind them, those are the undercover VY fan boys. Currently, they don't have anything to say about their boy b/c he's done for the season. In that regard, they just try & find any opportunity to criticize our LEGIT multi pro bowl DE.

Blake
12-03-2010, 03:32 PM
And all the shit talkers now look like huge assholes. Imagine that.

I was thinking the same thing. But some of these Texans fans will turn on our stars in a heartbeat. You only have 8.5 sacks?! Corners getting sliced and diced? Mario, you asshole! Lets cut him! :bat:

Still think they need to just shut him down and get him healthy. We are done in 2010 anyhow. :pissed:

Hardcore Texan
12-03-2010, 03:38 PM
I knew there was something going on with him besides the hip injury, glad it's something with a good prognosis.

Jackie Chiles
12-03-2010, 03:38 PM
Shut him down asap, his long term health is more important than a shot at a couple meaningless wins down the stretch this year. His health is also certainly more important than saving someone else's job.

Hardcore Texan
12-03-2010, 03:39 PM
I was thinking the same thing. But some of these Texans fans will turn on our stars in a heartbeat. You only have 8.5 sacks?! Corners getting sliced and diced? Mario, you asshole! Lets cut him! :bat:

Still think they need to just shut him down and get him healthy. We are done in 2010 anyhow. :pissed:

Yep. We have been done, I first thought that right after the MNF debacle and was certain of it after the SD game.

texanhead08
12-03-2010, 03:41 PM
He hasn't been able to change directions for a couple months and its obvious to me. The guy is basically the only playmaker on the defense and it sucks that he has to play hurt because of this. The guy has played hurt every year and people still rag on him. I guess its just the number one pick factor that no matter what he does it will never be good enough for some people.

dalemurphy
12-03-2010, 03:41 PM
I knew there was something going on with him besides the hip injury, glad it's something with a good prognosis.

I'm not so sure of the "good prognosis". Sports hernias are tricky things and, especially since they have been treating it all season with steroidal shots, they may have done further damage to it. I've got a call into CloaknDagger and am in the midst of some other research as well... but, he may be damaged goods, at this point.

dalemurphy
12-03-2010, 03:43 PM
He hasn't been able to change directions for a couple months and its obvious to me. The guy is basically the only playmaker on the defense and it sucks that he has to play hurt because of this. The guy has played hurt every year and people still rag on him. I guess its just the number one pick factor that no matter what he does it will never be good enough for some people.

No, it's the very pedestrian performance. When the team asserts that he's healthy and fans watch him simply engage TEs and stand still on consecutive plays in big games, some fans are going to think he's not giving good effort. That is something fans care about. I sure do.

hookinreds
12-03-2010, 03:47 PM
:kubepalm:

If it were up to me, should we be mathematically eliminated from the playoffs - I would seat Mario and AJ for the rest of the season and let them heal up fully. We definitely need a new wellness staff for next season, no question about that.

The hell you say! I'm going to the game on the 19th....EVERYBODY PLAYS!

Blake
12-03-2010, 03:53 PM
The hell you say! I'm going to the game on the 19th....EVERYBODY PLAYS!

Hate to break it to you but the defense hasn't been playing all year.

Hardcore Texan
12-03-2010, 03:55 PM
I'm not so sure of the "good prognosis". Sports hernias are tricky things and, especially since they have been treating it all season with steroidal shots, they may have done further damage to it. I've got a call into CloaknDagger and am in the midst of some other research as well... but, he may be damaged goods, at this point.

Didn't Mcnabb have this a couple of season back and waited til the offseason for surgery?

And at the bolded, let's not be that speculative.....I am already depressed enough.

hookinreds
12-03-2010, 03:57 PM
Hate to break it to you but the defense hasn't been playing all year.

Ha! Good one!

Ole Miss Texan
12-03-2010, 04:02 PM
Doesn't he have like the 4th most sacks of any DE since 2006 (when he joined)??? Tough crowd.

HuttoKarl
12-03-2010, 04:04 PM
Doesn't he have like the 4th most sacks of any DE since 2006 (when he joined)??? Tough crowd.

Yes, but he doesn't get one every single snap so he suxx!!!!!!!!!!!!!!!!

dalemurphy
12-03-2010, 04:06 PM
Didn't Mcnabb have this a couple of season back and waited til the offseason for surgery?

And at the bolded, let's not be that speculative.....I am already depressed enough.

How do you see McNabb as an athlete now compared to prior to that injury? any deterioration?

I don't have all the medical information yet and I am not trying to suggest doom, but I am hinting that the organization has handled this situation, and many other injury situations, very poorly and it is having a detrimental effect on the team this season and potential for future seasons.

The1ApplePie
12-03-2010, 04:13 PM
So its official:

The Texans are playing from dem draft picks.

Sadly there is no "Bush Bowl this year in the Texans future

dalemurphy
12-03-2010, 04:21 PM
Yes, but he doesn't get one every single snap so he suxx!!!!!!!!!!!!!!!!

There is a reality in today's NFL: High draft picks and players with high salaries must perform at elite levels if teams are going to be successful. Because of the nature of the salary cap and the rewarding of draft picks, teams can not afford to get solid play from their prime players. Given Mario's age, salary, and draft position, this team will not be successful if he is simply the best DE on the Texans. He needs to be an elite player. That doesn't mean he needs 15 sacks every year. But, it means that teams need to fear his impact on the game to a degree that opens up opportunities for other players. Simply put, that has not been the case most of this season. In the SD game, for instance, the Chargers were content to block Mario one on one with a TE quite a bit... sometimes, they did so, and also sent the ball to his side of the field.

Blake
12-03-2010, 04:44 PM
Yes, but he doesn't get one every single snap so he suxx!!!!!!!!!!!!!!!!

lol! Must spread rep. Funny shiznit.

HOU-TEX
12-03-2010, 04:46 PM
I'd take an injured and stoned to the bone Mario over your boy Jamison. Sorry

dalemurphy
12-03-2010, 05:10 PM
I'd take an injured and stoned to the bone Mario over your boy Jamison. Sorry

I'm not talking about the future. If you watched the two players perform over the course of one game, stripped them of their jerseys and any other recognizable features, I seriously doubt anyone would be identifying Mario Williams (as he is currently performing) as the better DE.

kiwitexansfan
12-03-2010, 08:22 PM
Yes, lets shut them all down and tank for draft position.

NitroGSXR
12-03-2010, 09:47 PM
Shut him down asap, his long term health is more important than a shot at a couple meaningless wins down the stretch this year. His health is also certainly more important than saving someone else's job.

Andre Johnson and his bruised lung scoffs at Mario Williams.

Shut them down? Bullshit. I paid good money for them.If they can't go that's something else but shutting them down for next year? Nah.

silvrhand
12-04-2010, 09:25 AM
FYI: depending on how bad it is, people have to go under the knife for this and it may be that he may never be able to recover.

Not good revelation folks..

ObsiWan
12-04-2010, 10:03 AM
FYI: depending on how bad it is, people have to go under the knife for this and it may be that he may never be able to recover.

Not good revelation folks..

Where's our resident physician, CNNND? I want to know what he thinks on the subject.
What say you?

mattieuk
12-04-2010, 10:11 AM
And all the shit talkers now look like huge assholes. Imagine that.

Not really?

If he and the Texans have been hiding an injury, then fans not being happy at a players performances is perfectly justifiable.

Damn. I wish I could hate on Kubiak, but I'm not sure if he has some hidden ailment, so I can't say anything, otherwise I'd be a huge asshole.

;)

JB
12-04-2010, 10:14 AM
Not really?

If he and the Texans have been hiding an injury, then fans not being happy at a players performances is perfectly justifiable.

Damn. I wish I could hate on Kubiak, but I'm not sure if he has some hidden ailment, so I can't say anything, otherwise I'd be a huge asshole.

;)


Do you mean he might have had a frontal lobotomy all this time and didn't tell anyone? :eek:

TimeKiller
12-04-2010, 10:19 AM
Ah....the patterns continue. We had a decent start, followed by a long losing streak pushing to the point where anyone still rooting for the team has to use the phrase "mathematically eliminated". Now comes the part of the season where MW is revealed to have a pretty serious injury even though he's still playing (faker), the team will find some fire in games that don't matter anymore, they'll go 8-8 and Kubiak will keep his job.


It's almost like reading a book....again and again....and again.....and again.....

Hardcore Texan
12-04-2010, 10:52 AM
Do you mean he might have had a frontal lobotomy all this time and didn't tell anyone? :eek:

I'd rather have a bottle in front of me than a frontal lobotomy.

infantrycak
12-04-2010, 12:27 PM
Learn something new every day. Apparently losing makes some fans stupid.

TexansSeminole
12-04-2010, 12:49 PM
They believe a crippled Mario gives them a better chance to keep their job than a rotation that includes Tim Jamison and Mark Anderson...

They'd be right. Mario at his current health status is better than every defensive lineman that we have except MAYBE Antonio Smith.

Just shut the guy down for the rest of the season. Let him get healthy and ready to be coached by a new/real staff. Maybe we can get Will Smith over to the training facility so he can use his MIB flashy thing on Mario's memory, he needs to forget all the horrible coaching he has received in his NFL career.

JB
12-04-2010, 01:21 PM
Learn something new every day. Apparently losing makes some fans stupid.

Hey I was just funnin' :bender:

dalemurphy
12-04-2010, 02:11 PM
They'd be right. Mario at his current health status is better than every defensive lineman that we have except MAYBE Antonio Smith.

Just shut the guy down for the rest of the season. Let him get healthy and ready to be coached by a new/real staff. Maybe we can get Will Smith over to the training facility so he can use his MIB flashy thing on Mario's memory, he needs to forget all the horrible coaching he has received in his NFL career.

I think you guys are watching him and thinking about his potential or his play early in the season and in seasons previous. He has been an average player for the past 6 or 7 games.

TexansSeminole
12-04-2010, 03:29 PM
I think you guys are watching him and thinking about his potential or his play early in the season and in seasons previous. He has been an average player for the past 6 or 7 games.

Not saying you aren't correct but so have our other defensive lineman outside of Smith. He's still better than Jamison and Anderson IMO.

sandmanx
12-04-2010, 03:38 PM
Just another reason Bob needs to come out this week and tell Gary that it's over, and shut down Mario and Dre for the season. By the time we play next Monday the playoff possibility will be on life support if Indy wins both games.

Tailgate
12-04-2010, 04:25 PM
You know. I remember finding it curious why they had Mario on the sideline on a 3rd down in the first quarter. I guess it all makes more sense now, especially on 5 days rest.

ArlingtonTexan
12-04-2010, 04:41 PM
Learn something new every day. Apparently losing makes some fans stupid.

I have grown to hate losing more for this reason than anything else.

b0ng
12-04-2010, 04:41 PM
Just another reason Bob needs to come out this week and tell Gary that it's over, and shut down Mario and Dre for the season. By the time we play next Monday the playoff possibility will be on life support if Indy wins both games.

That's not going to happen I'm willing to bet. If he's already been playing with this injury he'll probably play until the seasons over. I hope it gets corrected in the offseason, but I just don't see this organization shutting him down right now, and probably not until after the last game is played barring any more significant injuries.

I would rather them shut him down, and Andre too since he's had ankle problems, but with the looming CBA stuff owners will let the coaches play whatever players are viable.

steelbtexan
12-04-2010, 11:11 PM
I wonder if playing with a sports hernia can contribute to long term injury problems?

Norg
12-04-2010, 11:38 PM
with COnar barwin and BUllman coming back next year i wonder if mario will be the odd man out

BullNation4Life
12-05-2010, 01:12 AM
:kubepalm:with COnar barwin and BUllman coming back next year i wonder if mario will be the odd man out:kubepalm:

Learn something new every day. Apparently losing makes some fans stupid.

guess Trycak was on to something....

Dude, you get bookend face-palms for that comment....

281
12-05-2010, 11:28 AM
with COnar barwin and BUllman coming back next year i wonder if mario will be the odd man out

:wadepalm:

silvrhand
12-05-2010, 12:05 PM
What I find surprising is that this has taken so long to come out and why he hasn't gone for surgery last year. We know for a long time that he has been having hip problems, did this go undiagnosed for that long?

Texecutioner
12-05-2010, 05:04 PM
Except that he is performing as he has in the past, that is, performing very well. DESPITE this injury. Yet some people insist he sucks, has sucked since he's been here, and doesn't try. Nice.

No one in this forum has ever insisted that he sucks. Only you actually. You in your typical over exaggerated claims of what other people have said when they hadn't just because you couldn't handle the fact that certain fans are critical of Mario's play despite what's expected of him. Mario's gotten criticized in here over the years because he's not the dominant DE that he's was drafted to be and he's never been a guy that applies constant pressure that effects other team's offensive chemistry. Why this is so hard for you to understand is beyond me, but it's not that difficult to grasp really. The excuses for Mario's lack of constant pressure at being the #1 pick of the draft and the "alleged enforcer" of this defense will probably never stop. He's a good DE that's vastly overrated by Texans fans for the most part, but around the rest of the league he's hardly mentioned as an Elite top 5 type of DE. And this injury is just another typical injury of his that he seems to deal with every season.

At the end of the day our D line sucks with or without Mario Williams playing and so does our defense as a whole and that can't be disputed.

Texecutioner
12-05-2010, 05:07 PM
There is a reality in today's NFL: High draft picks and players with high salaries must perform at elite levels if teams are going to be successful. Because of the nature of the salary cap and the rewarding of draft picks, teams can not afford to get solid play from their prime players. Given Mario's age, salary, and draft position, this team will not be successful if he is simply the best DE on the Texans. He needs to be an elite player. That doesn't mean he needs 15 sacks every year. But, it means that teams need to fear his impact on the game to a degree that opens up opportunities for other players. Simply put, that has not been the case most of this season. In the SD game, for instance, the Chargers were content to block Mario one on one with a TE quite a bit... sometimes, they did so, and also sent the ball to his side of the field.

Pretty much spot on Dale.

CloakNNNdagger
12-05-2010, 08:19 PM
I'm not so sure of the "good prognosis". Sports hernias are tricky things and, especially since they have been treating it all season with steroidal shots, they may have done further damage to it. I've got a call into CloaknDagger and am in the midst of some other research as well... but, he may be damaged goods, at this point.

Where's our resident physician, CNNND? I want to know what he thinks on the subject.
What say you?



****************************A little background trivia:*************************

Having been first described by Mr. Gilmore (In England, only surgeons are addressed as “Mr.” Being called “Dr.” would be an insult........that title reserved for plain old medical physicians) as “Gilmore's Groin” in 1980, then “Sportsman's Groin” in 1992, “Sports Hernia” has evolved as a layman's term (first coined by South Australian Dr. Greg Lovell).

************************************************** *********************

A SPORTS HERNIA (more correctly referred to in medical terms as “Athletic Pubalgia,” translated as athletic pubic pain) isn’t a true hernia at all. You aren’t going to find a “hole” in the abdominal wall with abdominal contents pushing through. It extremely uncommon in the weekend athlete and not uncommon in the athlete at the professional football, hockey and soccer level where there are extreme levels of exertion. It’s a tricky diagnosis where you have to have significant sense of suspicion because it can mimic symptoms of a groin pull, hip injury or muscle strain. It can very typically present with no symptoms with simple walking activities, but can create excruciating pain when an athlete repeatedly goes from a full stationary position to sudden pushoff acceleration. This along with over and over again twisting and turning maneuvers at high speed (overuse) are closely associated with this condition. An elite, high exertion professional athlete will without doubt see a notable negative effect on his performance.

What’s interesting is that this condition, which was first described in 1980, has only recently been linked to the approach to strength training. Today, especially in football, attention is mainly focused on the upper body chest and arms and the lower body thighs and legs. There is universally relatively less attention to the abdominal trunkal musculature........a perfect setup for a sports hernia. This not uncommonly creates an imbalance of the usually very strong thigh muscles and relatively weaker lower abdominal wall resulting in inordinate stresses to this area. This can weaken the attatchments of the lower abdominal muscles to the pubic bone. A tendonitis of this attachment (the conjoined tendon) is not unusual. Not uncommonly associated with a sports hernia is hypertrophy (heavy development), shortening of the adductor muscles, with inflammation of the of their tendinous attatchment to the pubic bone.

All this puts further significant strain on the lower abdominal wall. Also, it is not uncommon for the athlete to develop a true inguinal hernia, especially if the abdominal wall is not rested or repaired. It is also accepted that a sports hernia can be a reaction of the abdominal muscles to a change in the mechanics of the hip joint. In other words, injury or pain of the hip can actually lead to transfer of undo stresses to the lower abdominal muscles.

Imaging such as x-rays, ultrasounds, and MRI’s are seldom helpful in the diagnosis except as a means for excluding other conditions. As I mentioned before, physical exam will not reveal a distinct hole or bulge in the abdominal wall, but tenderness may be present. However, a high level of suspicion is absolutely mandatory when there is no other obvious explanation for the history of pain in the context of specific circumstances and tenderness on exam.

How is it treated? With any treatment course, the longer and more severe your symptoms prior to seeking treatment, the longer the recovery. The old saying, “If it hurts, don’t do it” holds true; this is not a “no pain, no gain” scenario. Conservative treatment mandates REST and response is most likely determined by how well you can avoid aggravating activities. Four weeks of no athletic activities is the typical......then rehab. Healing takes anywhere from several few weeks to several months and will likely be longer if there is continued participation in the offending activity. The physical therapy regimen to promote healing of sports hernia focuses on stretching the lower abdominal muscles and lower extremity muscles and tendons. In addition, strengthening of the core muscles is utilized to correct the unbalanced muscle strength between the legs and the core muscles, the importance of which I have already mentioned

If the conservative approach fails (by 6 months) for whatever reason, surgery is usually performed. An exploration proceeds in order to identify and repair the weakened and/or torn areas. It used to be advocated that in order to have a shorter recovery (~5-6 weeks), a “least invasive” laparoscopic approach would be best. However, today it is pretty well accepted that a direct incision approach, even though the recovery may be closer to 8-16 weeks, is more prudent since the laparascopic approach has a significant recurrence rate. The direct minimal invasive incision (only ~2 inches) is advocated with or without mesh repair. Following the surgery, a similar approach to conservative non surgical techniques as I already have described are incorporated in the postoperative rehab period.

************************************************** **************************************************

I offer a simple anatomic reference to what has been covered (the black box within the larger picture is the are where sports hernias can occur).

http://orthoinfo.aaos.org/figures/A00573F01.jpg

Sports hernias often occur where the abdominals and adductors attach at the pubic bone. Traditional hernias occur in the inguinal canal.
************************************************** **************************************************

Close to 90% of athletes can be expected to return to play and probably around 80-85% of those to previous performance levels. Keep in mind that this does not take into account other associated injuries such as concomitant hip injuries, etc, which must also be addressed appropriately if treatable.

After surgery, I have seen quite a few athletes, even serious weekend athletes that have be debilitated for many many months by prolonged postoperative lower abdominal or groin or testicular pain (which is not an unusual preoperatively noted pain since the sensory nerve to the testicle runs right near this area). Recurrence with the open incision is seldom an occurrence. However, whatever the approach, it is not terribly unusual for continued inner thigh pain to ultimately necessitate the release of a tight adductor tendon. With this maneuver, this tendon that attaches the inner thigh muscles to the pubis is cut. The tendon will heal at a greater length, releasing tension and giving the patient a greater range of motion.

I hope that I have given to you some insight into what Mario is dealing with, and what he likely will require to return to his optimum self.

Brisco_County
12-06-2010, 11:40 PM
Mario, I feel for you my man.

I dedicate this to you. (http://www.youtube.com/watch?v=HjM8Qn5XmAE&playnext=1&list=PL2688F8AEF1639F90&index=71)

TimeKiller
12-07-2010, 07:44 AM
****************************A little background trivia:*************************

Having been first described by Mr. Gilmore (In England, only surgeons are addressed as “Mr.” Being called “Dr.” would be an insult........that title reserved for plain old medical physicians) as “Gilmore's Groin” in 1980, then “Sportsman's Groin” in 1992, “Sports Hernia” has evolved as a layman's term (first coined by South Australian Dr. Greg Lovell).

************************************************** *********************

A SPORTS HERNIA (more correctly referred to in medical terms as “Athletic Pubalgia,” translated as athletic pubic pain) isn’t a true hernia at all. You aren’t going to find a “hole” in the abdominal wall with abdominal contents pushing through. It extremely uncommon in the weekend athlete and not uncommon in the athlete at the professional football, hockey and soccer level where there are extreme levels of exertion. It’s a tricky diagnosis where you have to have significant sense of suspicion because it can mimic symptoms of a groin pull, hip injury or muscle strain. It can very typically present with no symptoms with simple walking activities, but can create excruciating pain when an athlete repeatedly goes from a full stationary position to sudden pushoff acceleration. This along with over and over again twisting and turning maneuvers at high speed (overuse) are closely associated with this condition. An elite, high exertion professional athlete will without doubt see a notable negative effect on his performance.

What’s interesting is that this condition, which was first described in 1980, has only recently been linked to the approach to strength training. Today, especially in football, attention is mainly focused on the upper body chest and arms and the lower body thighs and legs. There is universally relatively less attention to the abdominal trunkal musculature........a perfect setup for a sports hernia. This not uncommonly creates an imbalance of the usually very strong thigh muscles and relatively weaker lower abdominal wall resulting in inordinate stresses to this area. This can weaken the attatchments of the lower abdominal muscles to the pubic bone. A tendonitis of this attachment (the conjoined tendon) is not unusual. Not uncommonly associated with a sports hernia is hypertrophy (heavy development), shortening of the adductor muscles, with inflammation of the of their tendinous attatchment to the pubic bone.

All this puts further significant strain on the lower abdominal wall. Also, it is not uncommon for the athlete to develop a true inguinal hernia, especially if the abdominal wall is not rested or repaired. It is also accepted that a sports hernia can be a reaction of the abdominal muscles to a change in the mechanics of the hip joint. In other words, injury or pain of the hip can actually lead to transfer of undo stresses to the lower abdominal muscles.

Imaging such as x-rays, ultrasounds, and MRI’s are seldom helpful in the diagnosis except as a means for excluding other conditions. As I mentioned before, physical exam will not reveal a distinct hole or bulge in the abdominal wall, but tenderness may be present. However, a high level of suspicion is absolutely mandatory when there is no other obvious explanation for the history of pain in the context of specific circumstances and tenderness on exam.

How is it treated? With any treatment course, the longer and more severe your symptoms prior to seeking treatment, the longer the recovery. The old saying, “If it hurts, don’t do it” holds true; this is not a “no pain, no gain” scenario. Conservative treatment mandates REST and response is most likely determined by how well you can avoid aggravating activities. Four weeks of no athletic activities is the typical......then rehab. Healing takes anywhere from several few weeks to several months and will likely be longer if there is continued participation in the offending activity. The physical therapy regimen to promote healing of sports hernia focuses on stretching the lower abdominal muscles and lower extremity muscles and tendons. In addition, strengthening of the core muscles is utilized to correct the unbalanced muscle strength between the legs and the core muscles, the importance of which I have already mentioned

If the conservative approach fails (by 6 months) for whatever reason, surgery is usually performed. An exploration proceeds in order to identify and repair the weakened and/or torn areas. It used to be advocated that in order to have a shorter recovery (~5-6 weeks), a “least invasive” laparoscopic approach would be best. However, today it is pretty well accepted that a direct incision approach, even though the recovery may be closer to 8-16 weeks, is more prudent since the laparascopic approach has a significant recurrence rate. The direct minimal invasive incision (only ~2 inches) is advocated with or without mesh repair. Following the surgery, a similar approach to conservative non surgical techniques as I already have described are incorporated in the postoperative rehab period.

************************************************** **************************************************

I offer a simple anatomic reference to what has been covered (the black box within the larger picture is the are where sports hernias can occur).

http://orthoinfo.aaos.org/figures/A00573F01.jpg

Sports hernias often occur where the abdominals and adductors attach at the pubic bone. Traditional hernias occur in the inguinal canal.
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Close to 90% of athletes can be expected to return to play and probably around 80-85% of those to previous performance levels. Keep in mind that this does not take into account other associated injuries such as concomitant hip injuries, etc, which must also be addressed appropriately if treatable.

After surgery, I have seen quite a few athletes, even serious weekend athletes that have be debilitated for many many months by prolonged postoperative lower abdominal or groin or testicular pain (which is not an unusual preoperatively noted pain since the sensory nerve to the testicle runs right near this area). Recurrence with the open incision is seldom an occurrence. However, whatever the approach, it is not terribly unusual for continued inner thigh pain to ultimately necessitate the release of a tight adductor tendon. With this maneuver, this tendon that attaches the inner thigh muscles to the pubis is cut. The tendon will heal at a greater length, releasing tension and giving the patient a greater range of motion.

I hope that I have given to you some insight into what Mario is dealing with, and what he likely will require to return to his optimum self.

That's really, really weird to read for me because I think I may have had that in high school. I wasn't the biggest kid ever but I played a bass drum...basically think of it like this, strap a 30 pound drum on a 120 pound kid and make him march around for several hours a day. I used to get the worst pain right exactly where the diagram shows, never knew what it was or thought much of it so I guess it went undiagnosed. Didn't know it was really a problem. Oh well, I haven't felt that since about my senior year and I have definitely continued to be extremely active....

I have self healing powers!

BigBull17
12-07-2010, 11:22 AM
I think you guys are watching him and thinking about his potential or his play early in the season and in seasons previous. He has been an average player for the past 6 or 7 games.

He dominated the Jets game. Just sayin.

dalemurphy
12-07-2010, 12:26 PM
He dominated the Jets game. Just sayin.

I think we have lowered the bar for "dominated" as Texan fans... Compare his performance against the Jets with some of the following:

T. Suggs vs. Pittsburgh on Sunday
D.Freeney vs. anyone
J.Harrison vs. anyone
Ngata vs. anyone
J. Tuck vs. the Texans and others
O. Umenyiora vs. the Texans and others
C. Matthews most of the season
Peppers since about week 3 this season

I've seen guys like Tamba Hali... Jason Babin whipped up on Winston pretty good a couple weeks ago.

Mario was excellent against Indy to start the season... He had an awesome second half against Washington and also was very good against Oakland... outside of that, he has flashed some but has been inconsistent at best (and not because he's drawing double teams)

hradhak
12-07-2010, 09:21 PM
I'm not so sure of the "good prognosis". Sports hernias are tricky things and, especially since they have been treating it all season with steroidal shots, they may have done further damage to it. I've got a call into CloaknDagger and am in the midst of some other research as well... but, he may be damaged goods, at this point.

I've done a bunch of hernia operations. There's absolutely no reason to ever give anyone steroids. The treatment is and always will be surgery. If he's really in that much pain, he should get it operated on right away. He won't be able to play for the rest of the season, and the risk of it strangulating his bowel is very low, but it is still worth it to get it taken care of now.

Whoever gave him the advice to play through it, and control it with steroids is performing below the standard of care of medicine. It's malpractice.

CloakNNNdagger
12-07-2010, 10:35 PM
I've done a bunch of hernia operations. There's absolutely no reason to ever give anyone steroids. The treatment is and always will be surgery. If he's really in that much pain, he should get it operated on right away. He won't be able to play for the rest of the season, and the risk of it strangulating his bowel is very low, but it is still worth it to get it taken care of now.

Whoever gave him the advice to play through it, and control it with steroids is performing below the standard of care of medicine. It's malpractice.

When his problems first arose, it seemed that the injections were to the hip. Then out of the clear blue, the sports hernia subject came up. He was seen by a sports hernia specialist who said that he would not need surgery.......NOT that he did not have a sports hernia. There was careful couching of words in all team reports. Evidently, someone or "someones" made the decision for him to continue playing despite the fact that total rest from football should have been the course pursued. My guess is it started off as a hip problem (possibly labral tear) that then changed the mechanics and led to the sports hernia. It is likely that he is now dealing with two problems........both getting aggravated by the continued trauma of playing.

As far as strangulation of the bowel, a true hernia carries that risk. When dealing with a sports hernia, which is not a true hernia at all, strangulation is not a consideration, although it can occur if accompanied by a true inguinal hernia. I have operated on both. Surgery is the only answer to a true inguinal hernia. With a sports hernia, PROLONGED rest from sport along with concentrated rehab may lead to a "cure"............or surgical repair can be undertaken. One approach or the other. The continued trauma of playing can do nothing to help any condition(s) present and can do a great deal for its progression.

BTW, as I have mentioned in many other threads over the years, I stronly share the view of hradhak concerning steroid injections. They do bring down inflammation, but simulateously weaken and destroy tissues they are exposed to............they "repair" nothing.

97roc
12-08-2010, 05:27 AM
When his problems first arose, it seemed that the injections were to the hip. Then out of the clear blue, the sports hernia subject came up. He was seen by a sports hernia specialist who said that he would not need surgery.......NOT that he did not have a sports hernia. There was careful couching of words in all team reports. Evidently, someone or "someones" made the decision for him to continue playing despite the fact that total rest from football should have been the course pursued. My guess is it started off as a hip problem (possibly labral tear) that then changed the mechanics and led to the sports hernia. It is likely that he is now dealing with two problems........both getting aggravated by the continued trauma of playing.

As far as strangulation of the bowel, a true hernia carries that risk. When dealing with a sports hernia, which is not a true hernia at all, strangulation is not a consideration, although it can occur if accompanied by a true inguinal hernia. I have operated on both. Surgery is the only answer to a true inguinal hernia. With a sports hernia, PROLONGED rest from sport along with concentrated rehab may lead to a "cure"............or surgical repair can be undertaken. One approach or the other. The continued trauma of playing can do nothing to help any condition(s) present and can do a great deal for its progression.

BTW, as I have mentioned in many other threads over the years, I stronly share the view of hradhak concerning steroid injections. They do bring down inflammation, but simulateously weaken and destroy tissues they are exposed to............they "repair" nothing.

Love your insights on the subject. Excellent having two resident docs on this forum.

CloakNNNdagger
12-08-2010, 09:55 PM
Not just a “boo boo” for Mario (http://www.foxsportshouston.com/12/07/10/Texans-Notebook-12710/landing.html?blockID=368674&feedID=3714)

Earlier in the season, defensive end Mario Williams missed some practice time because of an injured groin. Williams had called the injury “just a boo boo”, but now the Pro Bowl defensive end is playing through severe pain each week with a sports hernia.

Kubiak is doing his best to help save Williams’ body each week for game day.

“Mario probably won’t practice until Thursday, Kubiak said. “He’s been dealing with it all year long. He’s been playing with it. We have our routine on how we get him to each Sunday.”

This last week has been tougher on injured players like Williams because of the quick turnaround between the Sunday victory over the Tennessee Titans and the Thursday-night loss against the Eagles in Philadelphia.

“In the position where the [hernia] is at, it affects a lot of things,” Williams said. “I just have to fight through it.”

Smart, Texans. Very smart.:shades:

HuttoKarl
12-09-2010, 09:53 AM
Mario's basically gutting it out for the team and he's still better than our other Defensive Linemen....If we had a decent front office he could be resting and getting healed instead of probably damaging his body further.

CloakNNNdagger
12-09-2010, 01:50 PM
I've done a bunch of hernia operations. There's absolutely no reason to ever give anyone steroids. The treatment is and always will be surgery. If he's really in that much pain, he should get it operated on right away. He won't be able to play for the rest of the season, and the risk of it strangulating his bowel is very low, but it is still worth it to get it taken care of now.

Whoever gave him the advice to play through it, and control it with steroids is performing below the standard of care of medicine. It's malpractice.


My fellow “grasshopper” and I share the same aversion to the approach to Mario’s problem(s). However, “malpractice” may be pushing the extent of this questionable treatment. Malpractice?.......possibly not, if Mario was informed of his alternatives, and the important potential risks involved with the proposed approach..........and still agreed to pursue the course. Somewhat breeching ethics?..........probably so, when you keep in mind the physicians’ oath...................”First do no harm!” It appears that when it comes to the NFL, rules seem to be manipulated not only on the field, but also in the doctors’ offices.

otisbean
12-10-2010, 06:49 AM
My guess is it started off as a hip problem (possibly labral tear) that then changed the mechanics and led to the sports hernia.


Question, what makes you think it is an injury to the joint itself vs an injury to an adductor or hip flexor?

http://www.performbetter.com/catalog/matriarch/OnePiecePage.asp_Q_PageID_E_290_A_PageName_E_Boyle SportsHerniapt1

CloakNNNdagger
12-10-2010, 08:02 AM
Question, what makes you think it is an injury to the joint itself vs an injury to an adductor or hip flexor?

http://www.performbetter.com/catalog/matriarch/OnePiecePage.asp_Q_PageID_E_290_A_PageName_E_Boyle SportsHerniapt1

Back in August, steroid injections instead of anesthetic injections to the hip.

BrandonLwowski
12-10-2010, 09:43 AM
How does babin our "leftovers" have more sacks than mario "superman" williams?

Big Mistake???:kubepalm:

Battle Red Flash
12-10-2010, 02:55 PM
Mario. Hurt again.
Shocking.
On one hand, I want to be happy we have a player that plays hurt.
On the other hand, I don't remember Deacon Jones, Mean Joe Greene, or Alan Page being described like this: "They would have been great if they weren't hurt every year."
Houston gets all the bad breaks. The Charlie Brown of NFL cities.

hradhak
12-12-2010, 09:36 PM
My fellow “grasshopper” and I share the same aversion to the approach to Mario’s problem(s). However, “malpractice” may be pushing the extent of this questionable treatment. Malpractice?.......possibly not, if Mario was informed of his alternatives, and the important potential risks involved with the proposed approach..........and still agreed to pursue the course. Somewhat breeching ethics?..........probably so, when you keep in mind the physicians’ oath...................”First do no harm!” It appears that when it comes to the NFL, rules seem to be manipulated not only on the field, but also in the doctors’ offices.
I suppose if I were suggesting steroid injections to one of my regular patients, it'd probably be malpractice. Most of my patients are also close to 300 pounds, but my patients get short of breath reaching for their beer. I have a feeling Mario doesn't have that problem.

As far as it comes to the NFL, I've seen a lot of questionable things. The ordering of overly expensive tests when a cheaper test will do (and in some cases is more effective). The MRI for Mike Vick's ribs comes to mind. For major traumas we always use a CT scan with 3D reconstruction. We use those 3D recon's for rib plating, which is rarely done. I can't imagine the thought process for some of the decisions they make when it comes to NFL athletes, but my impression is that with the NFL players, the wallet biopsy comes back positive so they order whatever expensive test they can.

edo783
12-12-2010, 09:47 PM
I can't imagine the thought process for some of the decisions they make when it comes to NFL athletes, but my impression is that with the NFL players, the wallet biopsy comes back positive so they order whatever expensive test they can.

Not sure how this works. I always thought the team picked up all the medical stuff, so it wouldn't come down to the players wallet size. Naturally they would be very willing to charge a team with Billions available. Don't the team doctors handle all of this and then the team just pays for any facilities, tests or specialists that are used?

hradhak
12-12-2010, 09:58 PM
Not sure how this works. I always thought the team picked up all the medical stuff, so it wouldn't come down to the players wallet size. Naturally they would be very willing to charge a team with Billions available. Don't the team doctors handle all of this and then the team just pays for any facilities, tests or specialists that are used?

Of course. The wallet biopsy thing is a joke we docs have. There are many doctors out there who change their practice based on the wallet size of their patients. Sometimes it is warranted, but it can get excessive. Someone is paying for the tests for those players, and regardless of who is paying, you can bet the hospital is making a lot off of it.

edo783
12-12-2010, 10:42 PM
Of course. The wallet biopsy thing is a joke we docs have. There are many doctors out there who change their practice based on the wallet size of their patients. Sometimes it is warranted, but it can get excessive. Someone is paying for the tests for those players, and regardless of who is paying, you can bet the hospital is making a lot off of it.

Got it. After the biopsy thing, it sure seems to me that groups of doctors are getting together to just pass around patients with referrals for this and that. I can't believe how many tests and doctors I saw when I was injured. Test after test (some the same ones), sent to different clinics. Just seemed like they were just in agreement that they would pass me around so everyone got a piece of the action.

steelbtexan
12-12-2010, 10:59 PM
I'm no doctor but letting Tate walk off the field after breaking his ankle makes me question the Texans medical staff.

Common sense says you dont let a player walk on a hurt ankle.

CloakNNNdagger
12-12-2010, 11:08 PM
I'm no doctor but letting Tate walk off the field after breaking his ankle makes me question the Texans medical staff.

Common sense says you dont let a player walk on a hurt ankle.

Evidently, the foot has to be folded over on itself like with Barwin, before our staff recognizes a severe ankle injury let alone a fractured ankle.