Jim Edmonds missed his third straight game on Monday due to a lower abdominal problem that might be considered a sports hernia. According to officials inside the organization, there is no timetable for Edmonds' return.
A sports hernia, is also known as a athletic pubalgia, and it is basically a tear in the muscles in the lower abdomen and causes pain in that area or the groin, which is why players usually think they have a groin injury initially.
The Cardinals have recently conducted tests on Edmonds to rule out any groin injury. There isn't a test that can help diagnose a sports hernia, which is why the Cardinals are saying it may be a sports hernia.
As with Edmonds, the pain from a sports hernia usually begins slowly and gradually gets worse to the point that if treatment and physical therapy doesn't work, surgery may be required.
Edmonds symptoms include; the lower abdominal and groin pain, that could worsen when he has to sprint after a ball hit into center or for that matter when he's at bat.
Keeping Edmonds off the disabled list (DL) and having him on the bench as a pinch hitter, in my opinion, based on my research, should not be an option, given that Edmonds hasn't been available to play over the past three games.
There are a variety of theories how this hernia occurs, to include that tight or strong hip flexor muscles tilt the pelvis forward and stretch the lower abdominal wall muscles that eventually can lead to small tears in the muscle and tissues. This condition could be aggravated with Edmonds being used in the role of a pinch hitter.
The problem with Edmonds is, it's not a question of a muscle or strength conditioning issue, but rather it's the abdominal wall in a particular region is too thin, allowing the hernia to form. The sports hernia does not occur in the area of the large, thick part of the muscle. So it's through no fault of Edmonds or the Cardinal trainers, or lack of training and conditioning that this condition exists.
The big question is, when will Edmonds return to the lineup and be ready to play everyday?
According to published reports at the University of Michigan Health website, typically the initial treatment for a sports hernia is just rest. For sure healing will take longer if you continue to participate in the activities that caused you pain, which is why I'm concerned with Edmonds being kept off the DL. It may take a few weeks or up to even a few months for the symptoms to go away, if they ever do, without having surgery.
The consensus within the medical community is that there is no treatments that have been shown to be effective for sports hernia other than surgery, leading me to believe, surgery may be in the Cardinal's center fielder's future.
Typically the initial treatment of a sports hernia is resting, anti-inflammatory medications (such as ibuprofen), ice treatments, and physical therapy can all be tried in an effort to alleviate the patient's symptoms.
This initial conservative treatment is the route that the Cardinals are taking with Edmonds at this time, with hopes that the symptoms will resolve.
If these measures do not relieve the symptoms, surgery may be recommended to repair the weakened area of the abdominal wall.
The surgery for a sports hernia consists basically of the release of lower abdomen muscles and connective tissues and then reattaching them, in addition, with some hip muscle tissue being loosened. It hurts just thinking about it.
The next big question is, if Edmonds has a sports hernia and is forced to undergo surgery, then how long will he be out?In number of studies have shown between 65% and 90% of athletes are able to return to their activity after surgery for a sports hernia.
Everyone recovers at a different rate. In general the longer you have experienced the symptoms before you start treatment and submit to surgery the longer it will take to get better.
In Edmonds' case, you would hope he would fall into the range of the 65% to 90% who are able to return to their activity after surgery, if so, you could expect him to be out six to eight weeks.Then there is the chance if he has to have surgery, his career may be over.
- Anderson, K, et al. "Hip and Groin Injuries in Athletes" Am. J. Sports Med., July 2001
- Rupp, TJ "Groin Injuries" http://www.eMedicine.com, Dec 16, 2005
- Cluett, Johnathan, M.D., an orthopedic surgery fellow in sports medicine
- University of Michigan Health System Sports Medicine Advisor website at http://www.med.umich.edu/1libr/sma/sma_sporthrn_sma.htm,