After suffering a catastrophic knee injury, Adrian Peterson came back and was named the NFL's 2012 MVP. However, he now faces another challenge during this off-season.
Peterson suffered a sports hernia some time during the season. One report suggested he ran for more than 850 yards after the injury, which is incredible in its own right.
To return to top form, Peterson will again need to undergo a rigorous rehabilitation program. In my work as a physical therapist, I've helped treat athletes with injuries like these in the past, so I understand what lies ahead for AP. While I want to make it clear that I'm not the person treating Peterson, I can describe what injuries like his are like, and offer insight into how athletes can recover from them.
What is a sports hernia?
A sports hernia is not a typical hernia, where an internal organ protrudes through a muscle tear. It's a soft-tissue injury that commonly occurs from a sudden twist under resistance, like during a tackle in football. The area most often injured is at the junction of the oblique muscles of the lower abdomen and the adductor (groin) muscles. Common risk factors include lack of blood flow and tissue weakness. The immediate cause is usually two muscles pulling in opposite directions at the same time.
A sports hernia commonly presents as a "groin strain." If rest and treatment don't help, it is advisable to undergo an MRI. Pain is generally the limiting factor and will determine the need to stop playing.
Many sports hernias get better with rest, but activity quickly causes the pain to increase. As with any injury, not treating it can result in further disability and inability to progress. Due to the physical nature of sports, returning to activity too soon only exacerbates the problem, so surgical intervention is generally required in the long term.
After about two weeks, pain usually subsides and it's safe to begin activities such as walking, biking or exercising on an elliptical trainer. The progression is then to restore functional strength and mobility.
Reported success rates of return to competitive sports is from 90 to 98 percent of athletes. Complete recovery usually takes three to six months, but can be shorter.
Here are the main steps of rehab that AP, and other athletes who have suffered a sports hernia, will experience.
Functional progression for return to play
Restore hip mobility lost from inactivity
- Foam roll hip flexors, groin muscles and IT bands (mobility)
- Squat to Stand (hip mobility)
- Single-Leg RDL (improve balance and mobility of hips and hamstrings)
- Prone Press-Ups (gently stretches repaired area)
- Thoracic Rotation in Quadruped (spinal mobility)
- Lateral Lunge (adductor mobility)
Work core stabilizers to restore abdominal and low-back muscle strength
- Kneeling Single-Arm, Single-Leg Raises (progress to alternating)
- Lying Single-Arm, Single-Leg Raises (progress to Supermans)
- Plank (start with Wall Planks and Progress to Floor)
- Side Planks
- Reverse Crunches, Floor Wipers and Hanging Leg Raises
- Goblet Squats
- Front-Loaded Barbell Step-Ups
- DB Lunges (perform with a single dumbbell to further strengthen the obliques)
- Pallof Press
- TRX Push-Ups
- Lat Pulldowns
Also after six to eight weeks, depending on strength, pain level, and release by a medical professional, the athlete can begin sport-specific exercises.
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