Ingen bildrubrik

1

2
Sportmans hernia

Jan Ekstrand Professor Linköping University
3
Sportmans hernia

• Imbalance in muscle strength with weak abdominal
  muscles in relation to strong leg muscles

4
Etiology
Capacity
Load
5
Groin pain
lt 3 months
gt3 months
Acute
Chronic
Core stability Surgery?
Load!
6
Strength co-ordination (core stability)

• Static training adductors
  (ball between knee)
• Sit-ups
• Balance board
• Slide-board
• Dynamic training, abb-add
• No stretching

2-3 months
80 improved
Hölmich et al Lancet, vol 353, 439-443,1999
7
Anatomy
M external oblique
M internus oblique m. transversus
8
Anatomy
Hesselbachs triangle
9
Entrapment abdominal nerves
10
Radiology

• X-ray pelvis
• (Herniography)

11
MRI inguinal hernia
Klinisk misstänkt ljumskbråck.
Ljumskbråck påvisad under krystning.
M 40 år
Under krystning
För krystning
12
Radiology

• MRI pelvis with dynamic analysis at coughing
  (video)
• MRI spine

Radiology department Sabbatsberg 300 (rupture
or tendinos rect abd, rect fem,
add? Stressfracture? Bone marow oedema? Manifest
or incipient hernia? Coxartrosis?)
13
Operation (sportmans hernia)
Hesselbachs triangel
14
Repair
Hesselbachs triangle
15
Side effects

• Loss of skin sensitivity

16
Op sportmans hernia
Bilateral open procedure, Mesh
Muschaweck-Shouldice, open procedure, unilateral,
neurotomy
17
Rehabilitation

• 1 week cycling
• 2 weeks jogging
• 3 weeks football practice
• 4-5 weeks match

18
Average nr of days from surgery to football
27
28
19
Je vous remercie de votre attention !
Thank You
20
(No Transcript)