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Sports Hernias: a Common Threat


Hernias in general are a terrible thing. You can be in peak physical form when suddenly your insides seem to want to come out with an organ or tissue protruding through your muscular wall. Needless to say pain is the result.

And then we have Athletic Pubalgia, or as it is commonly referred to as a sports hernia. Although not really a hernia in the traditional sense, sports hernias occur when the injury happens in the form of tears or weakening in the deep tissue of the abdominal wall.

The reason that this ailment is so heavily related to sports is that it is usually caused by repetitive hip and pelvic movements that would most commonly be practiced in sporting activities. The area affected is normally where the abdominal muscles attach to your pelvis, which as anyone who has suffered from one can testify, makes for any day to day activities incredibly painful

According to a study, between 5% to 18% of professional athletes will suffer from a sports hernia throughout their career, and this statistic varies heavily on what sport is being played.

A baseline characteristic of sports hernias is chronic pain, which is another reason it can be so devastating to the career of an athlete, especially if they are in their prime.

Common symptoms surrounding a sports hernia include:

  • Accuse, stating pain the groin region that occurs mainly when running, sprinting, pivoting, cutting, kicking or twisting.
  • Sharp pain while perform even mild abdominal exercises.
  • Pain that radiates from the groin to the inner thigh.
  • Pain can often be isolated to one side of groin.
  • It is possible for pain to subside and even go unnoticed during rest, sitting or sleeping periods.
  • Sensitivity and tenderness to touch.

Note: It is important to remember that sports hernias and groin injuries in general can be very complicated and very few are a like. If you feel like you might be suffering from a sports hernia, we advise you to go see a healthcare professional or physiotherapist. Which nicely ties into our next point.

How to Diagnose a Sport Hernia

If you feel like you have suffered a sports hernia, then chances are your doctor or physical therapist will perform a thorough evaluation so as to best ascertain a diagnosis. This might include questions such as:

  • Have you ever had a preexisting injury to your hip, lower back or groin?
  • What actions/activities are you performing when you experience the pain? Are you kicking, twisting, jumping etc.
  • Have you, or do you regularly perform core strengthening or intense abdominal exercises?
  • Do you experience relief from your groin pain during periods of rest or when you don’t participate in your regular sport or exercise routine?
  • Do you experience pain in your groin when you cough, sneeze or are “bearing down”?
  • Can you recall the moment when you first started to notice the pain?

Following what is usually a laundry list of questions, a therapist will then follow up with standard strength tests of your hip muscles and tests to measure your flexibility. This is done in order for the physical therapist to assess how well contract or isolate certain muscles.

While a physical therapist is a great resource for diagnosing and treating a sports hernia, depending on the severity of the injury, they may choose to collaborate with a sports medicine physician or another health care provider in order to provide you with a more holistic approach.

Now What?

That is usually the question ask by most people after they receive the diagnosis of sports hernia. Thankfully though, all is not lost and there are many treatments options available without surgery.

For the most part, after ascertaining and isolating where the injury has taken place, a physical therapist will design an individualized treatment program for you that will specifically target your condition and injury, help establish goals of recovery and help you return safely to your sport or normal daily activities.

The way that the exercises are design to help treat your injury without worsening or reproducing the pain.

Your therapist will also caution you against performing certain functions and activities that they believe to be more likely to cause pain or further injury.

Here is an example of some of the more common types of treatment for a sports hernia:

  • Compression & Icing – When the injury is first treated and pain is its highest, usually the therapist will offer intermittent icing and compression to the afflicted area.
  • Strengthening – Once the pain has begun to subside, a regime of targeted hip strengthening as well as core exercises will be recommended.
  • Stretching – Under close supervision, your therapist might help you to perform lower back and hip stretches in order to gently strengthen and loosen your muscles. With a slow increases of mobility, patients usually report a decease in pain.
  • Muscles Retraining – The therapist will teach you how to activate the abdominal and kip muscles which is incredibly important as some muscles might not be ‘firing’ do to pain or inhibition.
  • Manuel Therapy – One of the more popular forms of treatment for a sports hernia is manual therapy. This occurs when the therapist will use his hands to manually stretch, perform soft-tissue mobilization and joint mobilization. This will increase the hip-joint mobility and overall range of motion.

How Can I Prevent a Sports Hernia From Happening in the First Place

The sad and short answer is you really can’t. To think about it logically, those who suffer from sports hernias are usually athletes who are arguably in the peak of physical fitness. However, when it comes to this pesky and tricky affliction, some degree of prevention is possible.

It is important to first realize where you fall into the risk of suffering such injury. If you are active and play sports such as football, hockey and soccer, then you risk is greatly increased as opposed to you being an avid poker player (apparently that’s a sport now).

Given the nature sports hernias, the best things you can is abdominal and core strengthening exercises and to recognize the start of a tear as soon as it happens. Sports hernias are often the result of wear and tear over time, so early detection is key to preventing a longstanding injury.