NAME: Robert Smith
TEAM: Minnesota Vikings (Football)
POSITION: Running Back
OTHER ATHLETES AFFECTED
Scottie Pippen, Portland Trail Blazers; Marty McSorley, Edmonton Oilers (retired); LaPhonso Ellis, Atlanta Hawks; Chris Wells, Florida Panthers
HOW IT HAPPENED
Smith was diagnosed with a sports hernia after complaining of pain, soreness, and weakness in the abdomen. It may have occurred in any of a number of different situations. He required minor surgery and was slated to miss 3-6 weeks. He missed three complete games and was hindered in others. He returned on October 19, 1999, two weeks ahead of schedule.
Smith is the starting back for the Minnesota Vikings. He has the highest average yards per touchdown run in the history of the league (25.8). He holds the Vikings' record for most rush yards in a single season with 1,266 in 1997 and was named to his first Pro Bowl in 1998. He has had a history of injuries and has never started more than 14 games in a season (not including playoffs).
WHAT IS A SPORTS HERNIA?
A sports hernia is a vague term describing types of weakness in the anterior (front, outside) abdominal wall. As a result of this weakness, contents of the abdomen push out through the lining. An opening or gap in the wall, called a hiatus, forms from the pressure of the abdominal contents. A sports hernia is defined by abdominal contents moving through the hiatus and causing an abdominal bulge that results in a pinching pain. It results in pain and swelling in the lower abdominal muscles and the lower abdominal region. An athlete can acquire a sports hernia in two ways: 1) there can be inherent weakness in the lining of the stomach wall; then, when the athlete exerts large forces on his body, the weakness can stretch and become a hole; 2) it is possible that one dramatic strain can pull or tug on a region of the abdomen and result in such a weakness.
An athlete will describe a sharp, pinching pain. In a clinical exam, the physician will feel the abdomen trying to find a bulge. Then the physician will have the patient bear down (bend over), take deep breaths, and tighten the abdominal muscles. In this scenario, there would be a worsening of the pain as the patient inhales. It can also be diagnosed through an MRI. The physician can look at the images of the abdominal wall and find any holes or weakened portions.
The treatment plan depends on the severity of the injury. In most cases, the treatment is rest, combined with an anti-inflammatory drug, ice, and a strengthening program. This allows most athletes to fully recover and return to their sports. If this fails and surgery is necessary, as in Smith's case, the hiatus is closed surgically and then the patient can again rest the area, use the anti-inflammatory drugs, ice, and the strengthening program. This will obviously keep the athlete out of his sport for a longer period of time.
Fear of hernias is the main reason that athletes exercise the abdomen. The stronger an athlete's abdominal musculature is, the more stable the lower abdominal wall is and, as a result, the lesser the chance of injury. However, if the player has a pre-existing weakness, there is little that he can do to avoid an injury.
The recovery program and period vary depending on the athlete. For minor sports hernias, an athlete may miss just 2-4 weeks. But if it is slightly more serious, he may miss six weeks. If a surgical procedure is necessary, an athlete may miss the entire season, and it may take 6-12 months before he is back to full strength. It is a slow and gradual recovery. Smith has return to playing but may still feel pain and weakness in the area, as with any other athlete who suffers this injury.
Many athletes suffer no lingering effects from this type of injury. If the athlete is treated properly, rests well, and lets the injury heal, he will most likely be able to return to pre-injury form. If the athlete rushes back into play too soon, he may hinder both his recovery and his play. Once an athlete does return, however, he has a slightly increased chance of suffering a sports hernia in the future.