Written by: Dr. David Edelman
Posted: Tuesday, 22 April 2008
What used to be a season-ending injury is now a lesser frustration.
Among the top ten peskiest injuries for runners, a hernia injury undoubtedly tops the list, as the painful condition is often overlooked and nearly impossible to prevent.
Although there are many types of hernias that afflict athletes, the sports hernia is a type found very commonly in runners. A sports hernia presents itself as a tear or strain in one of the three muscles in the lower abdomen wall and typically begins with a slow onset of aching pain in the lower abdominal region. Symptoms of a sports hernia include pain in the lower abdomen, groin and testicles. The injury can cause severe pain or discomfort to athletes, especially when lifting, running or even coughing.
Today, we are still unaware of just what causes the agonizing injury. Physicians believe it is related to genetics in most cases. Sports hernias can affect all types of athletes, too, from the average Joe to the amateur athlete to the professional all-star. Any prolonged physical activity involving twisting and straining can cause small tears in the muscles, thereby resulting in a sports hernia.
Until recently, traditional surgery was the only treatment option and meant 10 to 12 weeks of rest. The corrective surgery was invasive and often involved the use of a synthetic or plastic material to repair the muscle, which could elongate recovery time. Today, with a more modern procedure called laparoscopic or minimal access surgery and a bio-designed material that communicates with the body to remodel the host tissues, runners are returning to their exercise routine just two to three weeks after treatment.
After recognizing the shortcomings of the synthetic mesh, engineers at Cook Medical developed Surgisis Biodesign, an advanced tissue repair product. In addition to various hernia repairs, the material has Food and Drug Administration approval for use in pelvic floor repair, anal fistula repair, treating stress urinary incontinence, and replacing the dura mater during neurosurgery, among other general and cosmetic surgery applications.
During the procedure, Surgisis Biodesign is applied to repair the tear in the muscle. After the body recognizes the material as a natural tissue, Surgisis Biodesign communicates with the body, signaling surrounding tissue to grow across the scaffold. This action supports the healing process by attracting cells and nutrients to the area. The body begins to use the scaffold to heal the tear in the muscle. Over time, Surgisis Biodesign completely remodels into strong, fully vascularized tissue.
The advantage of using Surgisis Biodesign is that the body accepts the treatment more quickly, thus accelerating the healing process. The material remodels to become as strong as the patient’s own tissue. Once the healing process is complete, the material is undetectable—providing a permanent repair without a permanent material. In contrast, synthetic meshes become very tough and stiff within the body, and it can take three to six months for that stiffness to loosen up to a point where a runner can start moving normally. With Surgisis Biodesign, athletes are able to quickly return to a normal physical state within a couple of weeks.
Although laparoscopic surgery utilizing Surgisis Biodesign can offer exceptional results for any athlete suffering from a sports hernia injury, the procedure may not be appropriate for everyone. In many cases, resting, medications and physical therapy can help to alleviate the symptoms of a hernia injury. Nevertheless, surgery has consistently shown to be the most effective treatment for repairing the muscle completely.
Physicians remind athletes to stretch and warm up their muscles before any intense training. Individuals at risk for hernia should include exercises that increase flexibility and strength in their daily exercise routines.
Dr. David Edelman is director of the Laparoscopic Surgery Center at Baptist Hospital in South Florida. He is also the general surgeon for the Miami Heat, the NBA professional basketball team.
It's a really cool concept. We pick one day – Sunday, August 31 – and find out how many people around the world can lace up their running shoes and put in a whole bunch of miles. 
