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Sports Hernia 101: Repairing a Common Sports Injury


Athletic pubalgia, also called sports hernia or groin disruption, is a tearing of the muscles of the groin area that commonly occurs in athletes involved in sports such as ice hockey, soccer and tennis.[] Both abductor and oblique muscles are present in this part of the body, known as the inguinal area, and naturally move in opposing directions. When the muscles are forced to operate in opposition to each other, a tear may occur. Tearing of the tendons or entrapment of nearby nerves is also possible. Although this tearing differs from the tissue displacement involved in an inguinal hernia, the term “hernia” is still used to describe the injury.

Causes of Sports Hernia
Sports hernia is considered to be the probable cause of most chronic groin pain experienced by athletes. The injury isn’t limited to men; active women can also suffer from tearing of the muscles in the inguinal region.

Despite how common the condition is, the exact mechanisms that cause this type of hernia are unknown. The prevailing theory is that the high-speed twisting and turning involved in many sports causes the abductor and oblique muscles to work against each other, resulting in a tear. Sports hernia may also be caused by overuse that results from performing these same movements repeatedly.

Symptoms to Watch For
Pain in and around the groin area is the most prevalent symptom of a sports hernia. Severe pain may be present at the onset of the injury, but it often abates after a few days. This may give athletes the mistaken impression that the injury was only minor and requires no further attention. However, it’s important to pay attention to any other symptoms that may develop, including:

• Pain when performing movements that involve hip extensions
• Pain when twisting or turning
• Pain that worsens when coughing or sneezing
• Referred pain in other areas of the body
• Pain that becomes aggravated with movement
• Lingering groin pain that becomes more serious over time

Some of the confusion involved in diagnosing a sports hernia arises from the lack of the bulge most often associated with a regular hernia. Symptoms in women may also be less severe than those in men, and not all athletes report experiencing pain.

However, if symptoms continue to worsen or the pain develops into a sharp, burning or full sensation, these may be signs that the initial injury has progressed to an inguinal hernia. In this type of hernia, tissues or organs push their way through the inguinal wall, creating the classic bulge and increasing the risk of incarcerated or strangulated tissues. When this happens, the bulge is either unable to resolve itself or blood flow to the protruding tissue is cut off. The latter is a serious condition requiring immediate medical attention to prevent tissue death.

Repair and Recovery
Doctors diagnose sports hernias by performing an initial physical exam that often involves moments intended to replicate reported symptoms. An MRI may be performed to check for visible damage. Since other conditions can cause pain similar to that of a sports hernia, it’s important to rule out other potential problems before recommending treatment.

At first, athletes are usually advised to rest the area for seven to ten days, applying ice packs and taking anti-inflammatory medications as necessary. Sometimes a steroid injection is administered. Physical therapy exercises that include stretching the whole lower body and working core muscles are often recommended to restore strength and range of motion. If the hernia resolves using these methods, most athletes are able to return to sports in four to six weeks.

When surgery is required, doctors may perform:

• Laparoscopic repair of torn muscle
• Detachment and reattachment of damaged tendons
• Repair of a prolapsed ilioinguinal nerve

The American Orthopaedic Society for Sports Medicine reports that 90 of people who undergo surgery are able to resume their previous activities, and other statistics put success rates as high as 96 percent. A post-surgical treatment plan that includes low-impact exercises helps ready the muscles for more vigorous activity.

If you experience the symptoms of a sports hernia, see your doctor as soon as possible. The pain may ease over time, but leaving it alone can lead to a chronic condition that limits your ability to participate in sports and other activities. Your doctor can help you decide which treatment option is best and refer you to a physical therapist who can design a comprehensive exercise program to get you back to your favorite sports as soon as possible.