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Originally Posted by Grondar
Maybe he was trying to lift his truck for some reason and got a hernia as a result? The "sexual way" could refer to his privates, and that would likely be the area that he could have blown out if he was straining enough.
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That's pretty much what I was thinking. Maybe he was just too shy to come out and say "I have a hernia in my groin area." And didn't realize that trying to explain it some other way sounded worse than what actually happened.