Sports Hernias
What is a sports hernia?
A sports hernia, also known as athletic pubalgia, involves injury to the muscles, tendons, or ligaments around the groin. While not a hernia in the classic sense, where there is a hole or a defect, a sports hernia can develop from a weakness or an imbalance between the muscles and connective tissue of the inner thigh and the muscles and connective tissue of the abdomen.
What causes a sports hernia?
These injuries can occur during many physical activities but are more common in sports that involve twisting and turning, such as soccer, football, and hockey. A sports hernia can develop after a single intense movement or repeated stress from strenuous activity. Neglecting to properly warm up before engaging in intense physical activity, or cool down afterward, can increase the risk of injury. Previous injuries in the hip, groin, or lower abdomen region can also predispose someone to develop a sports hernia.
How do I know if I have a sports hernia?
Diagnosing a sports hernia can be challenging because its symptoms often overlap with other groin and abdominal problems.
Symptoms generally include any or all of the following:
Pain or discomfort in the affected groin which often worsens with physical activity, especially movements that involve twisting or turning.
Pain in the groin while exercising or playing sports. It may also be triggered by movements like coughing, sneezing, or bending.
Tenderness in the groin. You may notice some swelling as well, but no definitive bulge such as with a traditional hernia.
How is a sports hernia diagnosed?
Diagnosis begins with a medical history and physical examination by a hernia, orthopedic, or sports medicine specialist. Imaging may help clarify the diagnosis.
In some cases, imaging tests such as MRI (magnetic resonance imaging) or ultrasound may help identify the injured tissues.
How do I treat my sports hernia?
Treatment ranges from rest and rehabilitation to surgery. Many sports hernias can be managed without an operation. Your care team will recommend a plan based on the injury, your symptoms, and your response to treatment.
Rest and Physical Therapy: The first line of treatment for a sports hernia usually involves a period of rest, allowing the body time to heal naturally. This is often coupled with pain management strategies such as the use of ice packs and non-steroidal anti-inflammatory drugs (NSAIDs).
Physical therapy is another critical component of initial management. A physical therapist can guide you through a series of targeted exercises designed to strengthen the affected muscles and restore balance between the abdominal muscles and the inner thigh muscles. Therapy may also include flexibility and range-of-motion exercises, which can help alleviate symptoms and prevent future injuries.
Corticosteroid Injections: If pain continues despite rest and physical therapy, steroid injections may be considered to reduce inflammation and provide pain relief, facilitating participation in physical therapy.
Surgical Intervention: If conservative treatments fail to relieve symptoms, surgical intervention may be recommended. The type of surgery will depend on the specific nature of the injury but may involve repairing the torn or strained soft tissue. We discuss the types of surgeries below.
Post-Surgical Rehabilitation
Following surgery, a comprehensive rehabilitation program is vital to restore full strength and function to the affected area. This usually includes a graduated exercise program that starts with gentle range-of-motion exercises before slowly introducing more strenuous activities. Your surgeon and rehabilitation team will guide your return to sport based on healing, strength, and the demands of your activity. The timing and degree of recovery vary.
Prevention
In addition to treating a sports hernia, it's also essential to take steps to prevent future injuries. This includes proper conditioning and strength training, especially focusing on core stability. Warming up adequately before training or competition and cooling down afterward is crucial.
Reconstruction of the inguinal floor with sutures
Schematic of an adductor muscle group tenotomy
What surgical options are there for sports hernias?
Several different options exist for the surgical treatment of sports hernias, depending on the muscle and area affected. For selected injuries involving the adductor muscles of the inner thigh, a tendon release (tenotomy) may be considered to relieve symptoms. More commonly, the injury is a result of imbalance of forces on the pubic bone, or weakness of the nearby fascia or muscle. In these cases, reconstruction of the inguinal floor with or without a supporting mesh may be necessary. A laparoscopic approach may be appropriate in selected cases. Your surgeon will explain the benefits, risks, and alternatives.
Next Steps
If you’re dealing with a possible sports hernia, the Hernia Experts are here for you.
Our team can assess your symptoms and discuss treatment options suited to your injury and goals.
Our pain-management approach emphasizes nonopioid options when appropriate, with medicines tailored to your needs.
After your procedure, our surgeons and office staff will be with you every step of the way.
To set up a consultation, please call us at (212) 305-5947 or use our online appointment request form. We look forward to answering your questions and meeting your hernia care needs.