Martin Havlat's pelvic floor problems

After Martin Havlat's strange and disappointing performance down the stretch and in the post-season for the Sharks, some fans were hoping that the team would explore buyout options for the struggling, often-injured winger. This seemed even more likely once the season was over, and details emerged regarding the seemingly-contentious relationship between Havlat and the team:

Havlat was seen walking from the locker room on his way out of HP Pavilion less than 10 minutes after Game 3, and in the coming days, lost his locker stall at the practice rink, moving to a temporary stall. Meanwhile, AHL call-ups Matt Pelech, Freddie Hamilton and Matt Tennyson all had regular locker stalls, which could be viewed as an indication that the team wasn’t happy with Havlat’s disappearing act. At Game 7 in Los Angeles, rather than sit with his fellow Sharks scratches in the press box, Havlat sat on the complete opposite side, away from everyone.

As soon as a buyout started to seem like a realistic possibility, however, the option left the table:

Marty Havlat had surgery, no timetable on his recovery. Makes him ineligible for buyout. #sjsharks

— Brodie Brazil (@brodiebrazilCSN) June 24, 2013

So...no buyout then. Okay, fair enough. Hopefully the surgery was minor, at least?

General manager Doug Wilson said Monday that Havlat had a bilateral pelvic floor reconstruction earlier this month and will be sidelined indefinitely.

-CBCSPORTS

Holy crap! That sounds serious! Is it serious?

"It's not an uncommon injury for hockey players," Wilson said. "The severity, both sides, time will tell. I don't have a crystal ball to it."

Havlat, however, does have a crystal ball now. Two of them in fact.

Okay, sorry, this isn't a joking matter. This whole thing seems really terrible.

I didn't even know there was a part of a body called the "pelvic floor," let alone that it was something you could hurt so badly playing hockey that you would need it completely reconstructed. A couple of weeks ago if you had talked to me about reconstructing the Pelvic Floor I would have thought you were talking about rebuilding my favorite nightclub. Now I feel like I need to learn all about this whole surgery thing, since it (and Havlat's $5 million cap hit) are suddenly playing a major role in the near future of the San Jose Sharks.

To the Knowledge Mobile!

The pelvic floor or pelvic diaphragm is composed of muscle fibers of the levator ani, the coccygeus, and associated connective tissue which span the area underneath the pelvis.

The "coccygeus"? Damn it, I'm trying not to laugh here, Wikipedia!

The pelvic diaphragm is a muscular partition formed by the levatores ani and coccygei, with which may be included the parietal pelvic fascia on their upper and lower aspects. The pelvic floor separates the pelvic cavity above from the perineal region (including perineum) below.

Alright then. Um. This really isn't helping me all that much. I guess it's just the muscles that form the base of the pelvic area? Okay. What else do you have?

The right and left levator ani lie almost horizontally in the floor of the pelvis, separated by a narrow gap that transmits the urethra, vagina, and anal canal.

Some fibers are inserted into the prostate, urethra, and vagina. The right and left puborectalis unite behind the anorectal junction to form a muscular sling. Some regard them as a part of the sphincter ani externus.

Posteriorly, the pelvic floor extends into the anal triangle.

Hahahahaha oh my god. I'm dying. The anal triangle!

I'm never going to be able to get through this without giggling. I need something to sober me up.

Gah! Okay, that'll do it. I'm fine now.

So what does the pelvic floor do?

It is important in providing support for pelvic viscera (organs), e.g. the bladder, intestines, the uterus (in females), and in maintenance of continence as part of the urinary and anal sphincters. It facilitates birth by resisting the descent of the presenting part, causing the fetus to rotate forwards to navigate through the pelvic girdle.

Hmm. So it supports the bladder and intestines and will help Havlat give birth if that ever comes up. Okay. But...but did I read the rest of that correctly? Is it implying what I think it's implying?

maintenance of continence as part of the urinary and anal sphincters.

Martin Havlat's injuries may have caused him to lose control of his bodily functions. I'm not even saying that as a joke, and I'm not making fun of him for it - that's just the awful, horrible truth. Everyone who likes hockey should be aware of this. We're all fine with injuries that cause players to lose their eyes, get severely brain damaged, and puncture their lungs, but can we REALLY support an activity that could cause injuries like THIS?

This is just ghastly. What else does Wikipedia have to say?

Damage to the pelvic floor not only contributes to urinary incontinence but can lead to pelvic organ prolapse.

Jesus noooooo

Surgery can be performed to repair pelvic floor muscles. The pelvic floor muscles can be strengthened with Kegel exercises.

Okay, so it's not all bad news then!

Pelvic floor exercise (PFE), also known as Kegel exercises, may improve the tone and function of the pelvic floor muscles, which is of particular benefit for women (and less commonly men) who experience stress urinary incontinence

Great news, Marty! Just do these clenching exercises and you'll be able to reduce how often you pee yourself during stressful situations!

It has been reported that patients who have overly-toned musculature may suffer from inability to relax the pelvic floor muscles - in effect, Kegel exercises would only exacerbate the problem.

Son of a bitch! Never mind those clenches, Marty, you're too strong! You'll just squeeze the piss right out of yourself!

In doing my research for this article, I examined Doug Wilson's claim that this "isn't an uncommon injury for hockey players." I think he's referring to a "sports hernia" here, which is definitely common in hockey. Normally, though, that kind of injury can be treated with rest, physical therapy, medication, or minor surgery. It seems VERY likely that Havlat aggravated his injury by coming back too early, did serious damage to himself in the process, and needed major surgery to fix the problem. And so now we're left with this:

Surgical outcomes. More than 90% of patients who go through nonsurgical treatment and then surgery are able to return to sports activity. In some patients the tissues will tear again during sports and the surgical repair will need to be repeated.

What terrible, terrible news. This sounds like a brutal problem, and I'm sure the surgery to have it repaired isn't pleasant at all. As a Sharks fan I hope Havlat can either get healthy enough to play very quickly or that he sits out the season so the Sharks can write-off a bit of his salary. As a fellow human being, though, all I can do is wish him a full and speedy recovery, even if he never plays another game for the Sharks again.