A Sports hernia is not a true hernia but a tear or disruption of the muscles and tendons in the groin. It typically occurs in athletes, hence the name Sports hernia. The condition is also called a Sportsman’s Hernia or Gilmore’s Groin. The latter term may be more accurate as the condition is not a true hernia. The injury may include any or all or the following:
- A tear in the external oblique aponeurosis
- A tear in the conjoined tendon
- Separation of the conjoined tendon from the pubic tubercle
- Separation between the conjoined tendon and inguinal ligament
- Many patients have an associated injury or tear to the adductor muscle
Who gets a sports hernia?
The injury is relatively common in athletes who participate in those sports which involve twisting movements or sports which place strain on the groin. Playing football is the most common cause of this injury. However, it is seen in athletes who participate in everything from running to ice-hockey. It is much more common in men compared to women.
What are the symptoms of a sports hernia?
No two individuals will have identical symptoms. However, those with the condition typically complain of some or all of the following symptoms:
- Pain in the groin that is brought on by running, sprinting, twisting and turning
- Pain may not come on until 10-20 minutes of activity
- Exercise may be followed by stiffness and soreness which may persist into the following day
- Following exercise, getting out of bed or a car may cause pain and discomfort
- Some may notice that coughing and sneezing also causes discomfort and pain in the groin
- Symptoms may start suddenly. However, most athletes feel that the discomfort comes on gradually
How is the condition diagnosed?
In most cases, a diagnosis is reached after taking a history and performing a thorough examination. Tenderness is frequently elicited by gently pushing the little finger up through the scrotum in to the superficial inguinal ring which is tender and wider than normal. Adductor weakness is also present in 40% of cases. On occasion this may also require surgical treatment.
X-rays or scans of the pelvis are also usually performed in order to exclude hip problems or inflammation of the pubic bone.
How is the condition treated?
- Continued vigorous exercise usually makes the condition worse. The initial treatment is specialist physiotherapy to strengthen the muscles in the groin and pelvis.
- If a specialized program of rehabilitation does not help, surgery may have to be considered to strengthen the groin. Before surgery it is likely that specialized investigations are performed in order to exclude other causes of groin pain.
- Successful surgery is dependent upon accurate diagnosis, meticulous repair and adherence to a strict post-operative rehabilitation program. This prohibits sudden twisting and turning movements and promotes a gradual progression of pelvic muscle stability, flexibility and strength.
- Surgery has a high success rate and most athletes can return to their previous level of activity after a 4 to 6 week period of rehabilitation.
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