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Ab tendonitis - anyone had this?
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Today a MD diagnosed me with rectus abdominus tendonitis. Because you folks are a great resource of experience, I come to you and ask for advice. I’m a 48 year old male with six years in triathlon, maybe two dozen olys, a half dozen HIMs, and two IMs.
I had an laparoscopic mesh inguinal hernia repair last October. Recovery followed the typical course and I was able to race a half marathon holding nothing back in late February. I then proceeded to tri training by adding swimming and running. I noticed an inability to do any abdominal work due to what seemed a lack of strength. When I say any abdominal work, I mean not a sit up, crunch, or core exercise. Pain would be an exaggeration, more like extreme discomfort. Anyway, I blew it off and continued to train hard for a HIM in mid June. Eventually everything became uncomfortable, but mostly running. I made the decision to try and train through the discomfort.
When I went to stand up after dismounting the bike during a duathlon in late May I felt a distinct tug in my ab and was unable to stand up. I forced the issue as I was running my bike to the rack. What I felt was not unlike a snap. I did not exercise common sense at that point and finished the race, probably doing more damage.
In the coming days it was obvious my season was over. Any and all training was out of the question. Simple tasks like pulling myself upright from a lying position was difficult. It eventually got better. My family had a three week vacation coming in August so I decided to just wait til we got back to try and get healthy. During the relative inactivity from June through August my abs never got their strength back. I tried light exercises a few times but gave up due to the discomfort. Through the guidance of an Athletic Therapist , I commenced stretching and strengthening exercises (very light core stuff) and very light running and biking. Being overconfident I, pushed too hard on a few occasions and had to shut things down. After a month of seeing no improvement I finally went to the MD and got a the ab tendonitis diagnosis.
The MD indicated I’ve done some serious damage and ordered me to stop all activity involving abs, prescribed Naproxen, and said it could take 3-6 months to recover. She also said there are folks in my situation who never get back to their previous pre-hernia level of fitness.
My decision to sign up for IMC next summer now looks foolish, but I could choke it down if I knew I would some day get get my previous form back. Has anyone had a similar experience? Where you able to recover? I’m feeling kinda dispondent at the moment.
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Re: Ab tendonitis - anyone had this? [TriBiker] [ In reply to ]
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No, I haven't had this, but I thought I'd pass along what I heard. I sent your post to a friend who takes an abs class at the local Y. She asked her husband about it. (He's a general surgeon who over the years has done many, many hernia repairs.) Here's what he told her:

"Post-hernia repair pain is pretty common and a lot of times the mesh will shrink and you get fibrosis around the mesh and you lose your flexibility around the groin, have trouble flexing your hip flexors, and flexing your abdominal wall in your pelvis. He said "You can't do sit-ups".

I don't know if "You can't do sit-ups" means just in the post operative recovery phase, or forever.

This doesn't answer your question at all, but it might be of interest to you.

~~~~Healing vibes~~~~~

Jim
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Re: Ab tendonitis - anyone had this? [Jim @ LOTO, MO] [ In reply to ]
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Interesting. That sure sounds like my situation. Thanks for the info, Jim, ..and the healing vibes.
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Re: Ab tendonitis - anyone had this? [TriBiker] [ In reply to ]
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I can give you no advice on your injury, although that seems like a crappy situation. What's funny is that your doctor prescribed you Naproxen. The only reason I say that is because Naproxen is simply 2x strength Aleve. Go to any drug store and check out the aleve label and it will say "Naproxen" as the technical term.

Good luck with your recovery.
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Re: Ab tendonitis - anyone had this? [TriBiker] [ In reply to ]
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I would get a second opinion for sure.
A good Physiotherapist and Massage therapist with experience should be able to work with you on strengthening the problem areas you have and doing therapy modalities to get through the initial pain.

It may take some time but with patience you should get back in action
Andrew

C'mon legs run faster!
Being fast on a crappy bike is cool
Fueled by Guinness, Tuborg, Anchor Steam and Creemore Springs
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Re: Ab tendonitis - anyone had this? [TriBiker] [ In reply to ]
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Possibly sports hernia? Google it.
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Re: Ab tendonitis - anyone had this? [TriBiker] [ In reply to ]
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If the prescribed rest does not resolve the problem (or sooner if this sounds applicable), I would inquire of your doctor about adhesions. Adhesions are one of the most common complications of abdominal surgery, but are difficult to diagnose because they often do not show up on scans. Do some google searches, and ask your surgeon if materials such as "intercede" were used to safeguard against adhesions during your surgery. I am not a doctor, but can speak from firsthand experience. I suffered for 8 years with chronic pain following a c-section. I received misdiagnosis after misdiagnosis, and the problem began to have a ripple effect through my body orthopedically due to my extreme activity level and the need for my body to compensate and guard against the pain. I had CT scans (including with dye) and MRIs, but nothing showed up. I began to think I was losing my mind. Adhesions (in my case, the most extreme the doctors had ever seen) can form between the organs, on the one hand, and the abdominal wall and rectus abdominus muscles, on the other hand. What turned out to be a 5-hour surgery with two surgeons to sever the adhesions was successful, and intercede and proper recovery were used to prevent them from re-forming. To say I have experienced relief in every way is an understatement. It may be worth asking about this. I hope this is not TMI. Your comments about the pain you experience following the most minimal of core work just sounded way too familiar. I used to joke with my friends that I needed about 2 weeks to recover from a pilates class because my abs hurt so badly.
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Re: Ab tendonitis - anyone had this? [glbrum] [ In reply to ]
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First off I know this is a really old thread, but for people with similar problems who happen to Google this...


A previous reply said that "naproxen is just double strength aleve", just in case anyone cares...


Naproxen is the first line treatment for tendinitis along with other antiinflammatories (ibuprofen, meloxicam...). This would actually be more helpful for tendinitis pain than a strong pain medication, since these medicines actually stop the inflammation at the source, rather than through central pain receptors in your brain.

Also, naproxen is aleve and vice versa, whether or not its twice as strong or four times as strong depends on the dose prescribed.

That said, I couldn't imagine going through what the op described, that's a shitty deal for sure! But I do have some advice, which may or may not help...

As long as you don't have kidney problems, try an extended anti-inflammatoru course, like 2 weeks of taking naproxen or ibuprofen twice a day.

Get a second (and third) surgical opinion. There may be more to do here surgically (fixing adhesions may be an option).

Rest, for a long time. 6 months or so would be a reasonable amount. The reason for this is to try and completely resolve any post op inflammatory changes. Its like going back to square one, to let your body fully recover. You might worry about losing what you worked for, but trust me I've seen many athletes come back in full force after a year or more off from their sport. The potential problem is that you may have already done some permanent damage, which only time will tell. And if any doctor tries to give you a 100% answer either way on that their wrong, we don't give 100% guarantees about anything in medicine.
Last edited by: thedude87: Apr 1, 15 12:26
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