Surgery: Was it Successful?

I noticed the new message request in Facebook messenger as I perused the daily pictures of people’s dinners, cats, and children. I have becoming pretty good at scrolling past narrow-minded political views and have learned to limit my own. The brief summary of the message request said something about surgery. I knew what the message was before I even opened it.

I’m not sure why people post adamant political posts on social media.

Since I had core muscle repair surgery with Dr. Meyers at Vincera Institute almost 5 years ago, I have answered dozens and dozens of e-mails, messages, and phone calls from prospective patients struggling with the same decisions. “Should I get the expensive surgery offered, and will it solve my problems?” I get it. It’s a difficult decision especially when dealing with a hard-to-diagnose injury. Even when I was deciding on the surgery, I had people advise against it. “They are making it up. They can’t really prove you have this injury.”

Sports Hernia, or Core muscle injury, or athletic pubalgia or whatever other name this sports-related injury is given is indeed difficult to diagnose. But it isn’t fake. It comes with real pain and a real limit to mobility. Phils slugger Rhys Hoskins can attest to this as he suffered the same injury in 2021 and it ended the great season he was having.

Rhys Hoskin’s 2021 season was shortened by the same type of injury I suffered. Sure he’s great at the plate but has he ever run Boston?

Before I talk about whether my surgery was effective or not, let’s dispel one myth. Vincera Institute is not making vast quantities of money from people like me or other normal patients when performing this surgery. Organizations like the Phillies and other pro sports teams all send their prized assets to Vincera for the same treatment. They do it because they know it works and they don’t care how much cash they shell out to get their player back on the field. Dr. Meyers dove into trying to understand this injury while on staff at Duke University. While other doctors were insisting the injury was all in the athlete’s head, Dr. Meyers tackled the problem head on and developed his unique surgery to repair and prevent future re-injury.

Dr. William Meyers. Vincera Institute founder.

The new message in Facebook was just like all the other messages I’d gotten previously. The writer wanted to know “Did the surgery help?”. My answer to him, and every other person that has followed up with me is an unequivocal ABSOLUTELY, POSITIVELY, FOR SURE YES!

As a refresher, my injury first began on or about the 2016 Boston Marathon. It was my first time in Boston and I overcooked the start and started having some serious form issues. Things deteriorated as the day went on and I began to feel something locking up in my left hip. As it turns out, this was likely the malformed left hip ball catching the labrum and eventually tearing it. The human body is a wondrous, complicated system and compensates for injuries. But the system performing the compensation probably isn’t really built for its new tasks and expects us as intelligent organisms to rest and heal so that the primary system can recover. When we don’t do that (like continuing to run marathons as an example), the backup system begins to fail.

I googled “injury chain” hoping to find an image depicting a series of physical compensation injuries. Note to self: Do not google “injury chain”.

In my case, this is exactly what happened and a solid lesson in why we shouldn’t workout through injury. Of course, aside from the weird locking sensation at Boston, I didn’t really have any pain with the hip labrum tear so continued to run including re-qualifying for Boston a month later at The Run for the Red in the Poconos. I chalked Boston up to a bad day in the heat and continued training and racing. But slowly throughout 2016 a dull ache began to appear deep in my groin. The pain was occasional at first, but became more and more regular. It was not intense pain and I discounted it as simply soreness from the large amounts of swimming, biking, and running that defined my life at the time.

Sure it hurts. But what the hell. Just keep running marathons.

Fast forward to a cold, blustery day in the early spring of 2017. My training plan called for an interval workout of some sort. I believe it was something along the order of 1/2 mile intervals with a short duration of rest between. I left work at lunch to execute my plan on the paved, well-marked Chester Valley Trail. Given the cold day and choice of light clothing I brought to work, I’ll admit I had some misgivings but my training plan could not be denied so off I went. Partway through one of the early intervals I began to feel a lot of groin pain. Being the hard-headed runner I pressed on and completed the workout. It was a big mistake. If I had had a phone with me I may have called an Uber to get a ride to get back to work. As it was, I limped the mile or so back to the locker room.

From that day forward, life was not without pain. Something as simple as mowing the grass or walking up a few flights of steps created a dull ache that I couldn’t deny. Something was wrong. I won’t re-bore you with the long search for answers that ensued but it is well documented throughout older blog posts from 2017. The search for answers ultimately led me to having dual surgery in October for both a severe, bi-lateral core muscle injury, and a repair of the hip labrum and reshaping of the hip ball so the injury wouldn’t reoccur.

The thing to realize is that the surgery performed at Vincera institute is still considered by Medicare (and therefore all insurance) to be experimental. This, gives people pause for two reasons. First, if it is so good, why is it experimental? Second, because it is experimental, the patient has to pay up front and then fight with their insurance for compensation.

The reason this surgery remains experimental is strictly a numbers game. For any medical procedure to be accepted by insurance, there are requirements around lots of studies and large number of patients to prove effectiveness. The problem here is the largest population of patients receiving this surgery are still professional athletes. MLB, NHL, NBA, and NFL teams are not interested in participating in studies. They just want their expensive assets back on the field. They throw a big wad of cash at the doctors and expect results. Otherwise, the patient population is limited to those willing to shell out the comparatively nominal fees that Vincera charges us normal people. The end result is an overall lack of numbers to satisfy the bureaucrats at Medicare.

The leather of the baseball represents the connective tissue that holds the adductors to the pubic bone. Rest and rehab is not going to fix this.

It is noteworthy that, despite the claims of some physical therapists, and some doctors that don’t perform the surgery done at Vincera Institute, there is not other effective treatment for athletic pubalgia. Essentially, the connective tissues that hold the adductors to the pubic bone have come loose. No amount of rest, or rehab is going to fix that and slapping any kind of surgical mesh in there just complicates things. When I was working with my insurance to try to find an effective treatment that they were willing to pay for the answer was nothing. They more or less told me they were okay with me living in pain the rest of my life. Always remember, the for-profit company whom you have your medical insurance through is not your friend despite what they may tell you.

Nationwide or any other for profit company is not “on your side”. Unless you are a stock holder.

My options before surgery were 1) Do nothing and live with pain for the next 40 years or so. 2) Try some variety of rest and PT I knew wouldn’t work. 3) Shell out the money for the surgery and hope to get some amount back from my insurance via the appeal. Options 1 and 2 didn’t sound all that great especially since both meant giving up any sort of active lifestyle including things like hunting since that involves tons of walking and climbing that were becoming very painful. Basically, it meant staying mostly at home and popping a lot of ibuprofen. Option 3 meant spending a lot of cash and, at a minimum, hoping the surgery worked.

This post is already far longer than I intended so let me jump to the point. The surgery was an unequivocal success. After following the prescribed rehab processes, I have no more groin pain, and no more hip issues. Although my marathoning career has ended for entirely unrelated reasons, I still swim, bike, and run and do all the other activities I enjoy without pain or fear of a reoccurrence. The experience I had at Vincera was one of the best medical experiences I have had as far as the provision of information, clear and transparent pricing, and surgical and post-surgical care.

Celebrating a post-surgery day on the podium. Yes. The surgery worked!

As far as insurance, with the help of Vincera, and the Affordable Care Act, I was ultimately able to win my insurance appeal and get reimbursed at the out-of-network rate for my insurance. I know the appeals process has become easier with faster success for others that followed too.

If you have been diagnosed with sports hernia, core muscle injury, pelvic floor tear, athletic pubalgia or whatever the name, and have been told by Dr. Meyers or Dr. Poor at Vincera that you are a candidate for surgery, I highly encourage you to get it if you can afford it. For me, it was life changing. Is there a guarantee that it will work for you? Of course not but it isn’t hocum or some made-up injury they came up with to fleece people for money. It’s a real thing and the surgery can work. I don’t get any sort of compensation from Vincera Institute. In fact, I doubt they know how many people I’ve talked to and recommended to them but if they did, I might just go ask for compensation. And if you don’t believe me just ask Rhys Hoskins.

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