Six pack abs are more than just something to show off at the beach.
Just ask Greg Jennings.
And no, I'm not talking about this.
The Packers' star wide receiver remains sidelined after undergoing successful surgery last Thursday to repair a lower rectus abdominis tear, continuing the saga that began when he suffered the initial injury in Week 1.
He has not played a down since Week 4, though not without quite a bit of "will he? won't he?" speculation as to his return.
Why has this been such a difficult injury to gauge? And why was surgery ultimately necessary?
The answer lies in the nature of the injury itself.
The phrase "sports hernia" is used to describe a number of different injuries that cause weakening of the muscles or connective tissues in the lower abdomen or groin. According to Packers' beat writer Paul Imig, a second opinion confirmed a tear in Jennings' lower rectus abdominis muscle, or the muscle that forms the abs (or six pack).
Typically, this injury occurs after frequent hard exercise or forced twisting and bending of the torso—both staples of a wide receiver in the NFL.
The rectus abdominis runs from the mid-level ribs and breastbone to the lowest parts of the front of the pelvis, and one of its most important functions is to maintain posture. It allows bending forward at the waist, and it is required for hard breathing, such as during exercise.
A tear in this muscle can be a very nagging injury for an athlete.
Every time he or she bends forward, coughs, sneezes or breathes hard, the tear can be worsened. This causes extreme pain that limits mobility and, thus, effectiveness on the playing field.
Eventually, muscle tears heal.
Unless a muscle is completely torn apart (a grade 3 strain), muscle over-stretches (grade 1) or partial tears (grade 2) usually heal following rest, icing and physical therapy.
For that reason, Jennings was rested during Week 2 and once again following Week 4.
Unfortunately, according to Dr. Jonathan Cluett, it "is nearly impossible to fully rest" the rectus abdominis because it is used in many basic and everyday movements, not to mention during the maneuvers needed to evade NFL cornerbacks and safeties.
That is likely why Jennings' injury refused to heal, and to speed up the process, he elected to undergo surgical repair of the tear.
Though all surgeries are serious, sports hernia repair surgery, relatively speaking, is simple. The muscles being repaired are very close to the outside of the body.
Exact medical details are, of course, unavailable.
However, one can speculate that the operation was very short and consisted only of exposing the muscle and stitching together any muscle tears that were found.
In some sports hernia repair surgeries, a thin, waffle-like mesh material is sewn over a muscle tear to provide additional support, decreasing its workload and allowing it to fully heal.
Though Jennings' exact timetable to return remains up in the air, ESPN's Adam Schefter reported the following via Twitter:
Doctors expect Packers WR Greg Jennings to be sidelined about three weeks after he undergoes abdominal surgery Tuesday.— Adam Schefter (@AdamSchefter) October 25, 2012
After Jennings' surgery was delayed by two days due to Hurricane Sandy, it reportedly went well.
In the end, his return depends on how soon his surgical stitches close, how his rehab progresses and, ultimately, his level of pain.
When Jennings does return, he should do so in force and with minimal limitation.
For that reason, fantasy owners should, if they can afford the roster spot, keep him stashed on the bench until more news surfaces about the speed of his recovery.
After all, nothing tastes more bitter than the regret following a fantasy made move made too hastily.
The author is a soon-to-be Family Medicine resident physician with plans to specialize in Primary Care (non-operative) Sports Medicine. The above injury information is based on the author's own anatomical and clinical knowledge and was supplemented by Dr. Jonathan Cluett's online articles on athletic pubalgia (sports hernia) and abdominal muscle strains.