Dwayne “The Rock” Johnson Undergoes Hernia Surgery

You’d think becoming a major box office draw with 7 movies (including GI Joe and Pain and Gain) coming out this year alone would be enough for Dwayne Johnson.

But no, in January Johnson’s alter ego, WWE’s “The Rock” made a comeback in his first in-ring appearance since April 2012. He defeated superstar CM Punk at the annual “Royal Rumble”  winning his 8th WWE Championship, the first since he left wrestling in 2003.

He successfully defended that title in February against Punk in February, but lost it on April 7th, at WrestleMania 29 to John Cena.

It was learned the next day that Johnson had been injured in that fight, when he Tweeted:

rock tweet april

Although it was originally reported that Johnson would not need surgery, he later tweeted:

Saw my Dr. who had to push my intestines back through the tear in my abdomen. Kinda romantic. #Bringiton

Johnson underwent successful surgery Monday and he sent the picture above with the caption: “Surgery a success! Dr. repaired 3 hernial tears (fun pain). Superman is on the mend.”

What are the adductor muscles of the groin (hip)?

anatomy-of-the-groin-musclesThe adductor muscles of the hip are a group of five muscles of the thigh.

  • Adductor brevis
  • Adductor longus
  • Adductor magnus
  • Pectineus
  • Gracilis

These muscles all begin on the bones of the pelvis. They end on the thigh bone (femur).

The primary function of the adductor muscles are adduction (the movement of the leg in towards the centerline of the body). They also serve to stabilize the hip joint. During normal walking they are used in pulling the swinging lower limb towards the middle to maintain balance. They are used extensively in sprinting, playing football, and any sport which requires fast changes in direction.

Adductor muscle tears (also known as a groin strain) rank among the most common sport injuries.

What is a hernia?

A hernia happens when part of an internal organ or tissue bulges through a weak area of muscle. Most hernias are in the abdomen.

HerniasTypeThere are several types of hernias, including:

  • Inguinal, in the groin. This is the the most common type.
  • Umbilical, around the belly button
  • Incisional, through a scar
  • Hiatal, a small opening in the diaphragm that allows the upper part of the stomach to move up into the chest.

Hernias are common. They can affect men, women, and children.

A combination of muscle weakness and straining, such as with heavy lifting, might contribute. Some people are born with weak abdominal muscles and may be more likely to get a hernia.

Treatment is usually surgery to repair the opening in the muscle wall. Untreated hernias can cause pain and health problems.

A little more about inguinal hernias…

InguinalherniaAn inguinal hernia is a condition in which intra-abdominal fat or part of the small intestine, also called the small bowel, bulges through a weak area in the lower abdominal muscles.

An inguinal hernia occurs in the groin—the area between the abdomen and thigh. This type of hernia is called inguinal because fat or part of the intestine slides through a weak area at the inguinal ring, the opening to the inguinal canal. An inguinal hernia appears as a bulge on one or both sides of the groin.

An inguinal hernia can occur any time from infancy to adulthood and is much more common in males than females.

The two types of inguinal hernia have different causes.

Indirect inguinal hernia

Indirect inguinal hernias are congenital hernias and are much more common in males than females because of the way males develop in the womb.

testes descentIn a male fetus, the spermatic cord and both testicles—which form inside the abdomen—normally descend through the inguinal canal into the scrotum, the sac that holds the testicles. Sometimes the entrance of the inguinal canal at the inguinal ring does not close as it should just after birth, leaving a weakness in the abdominal wall.

Fat or part of the small intestine slides through the weakness into the inguinal canal, causing a hernia. In females, an indirect inguinal hernia is caused by the female organs or the small intestine sliding into the groin through a weakness in the abdominal wall.

Indirect hernias are the most common type of inguinal hernia. Premature infants are especially at risk for indirect inguinal hernias because there is less time for the inguinal canal to close.

Direct inguinal hernia

Direct inguinal hernias are caused by connective tissue degeneration of the abdominal muscles.  This  causes weakening of the muscles during the adult years. Direct inguinal hernias occur only in males.

A direct hernia develops gradually because of continuous stress on the muscles. One or more of the following factors can cause pressure on the abdominal muscles and may worsen the hernia:

  • sudden twists, pulls, or muscle strains
  • lifting heavy objects
  • straining on the toilet because of constipation
  • weight gain
  • chronic coughing

Indirect and direct inguinal hernias usually slide back and forth spontaneously through the inguinal canal and can often be moved back into the abdomen with gentle massage.

Symptoms of inguinal hernia include:

  • a small bulge in one or both sides of the groin that may increase in size and disappear when lying down; in males, it can present as a swollen or enlarged scrotum
  • discomfort or sharp pain—especially when straining, lifting, or exercising—that improves when resting
  • a feeling of weakness or pressure in the groin
  • a burning, gurgling, or aching feeling at the bulge

What are “incarcerated” and “strangulated” inguinal hernias?

stages of herniaAn incarcerated inguinal hernia is a hernia that becomes stuck in the groin or scrotum and cannot be massaged back into the abdomen.

An incarcerated hernia is caused by swelling and can lead to a strangulated hernia, in which the blood supply to the incarcerated small intestine is jeopardized.

A strangulated hernia is a serious condition and requires immediate medical attention. Symptoms of a strangulated hernia include:

  • extreme tenderness and redness in the area of the bulge
  • sudden pain that worsens in a short period of time
  • fever
  • rapid heart rate

Left untreated, nausea, vomiting, and severe infection can occur. If surgery is not performed right away, the condition can become life threatening, and the affected intestine may die. Then that portion of the intestine must be removed.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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