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As a general surgeon one of the most common complaints that patients come to see me with is groin pain. One cause of groin pain is a sports hernia, which develops among those that are very active or are athletes.
The term sports hernia, which is the term often, used to describe this condition, is somewhat of a misnomer since this condition does not actually involve a hernia. However, if left untreated the condition may progress to a groin hernia in certain situations.
A true hernia occurs when there is an actual defect or hole in the musculature of the groin wall that allows an organ inside the abdomen such as the intestine, to protrude through the hole causing pain or a visible lump.
A true sports hernia, on the other hand is not a hole, but an injury or tearing of the muscles or tendons or ligaments in the groin that attach to the pubic bone. This causes significant pain in that area. Sudden acceleration or deceleration movements associated with twisting and turning is usually the cause a sport hernia injury. It can also occur with excessive repetitive motions where the same movement is done over and over again like those seen with long distance running, swinging in golf or kicking in soccer.
The hallmark of this condition is pain that is made worse by the particular activity and then improves with rest. The area in and around the pubic bone is usually very tender to the touch. The pain usually involves one side but can spread over to the other side, down into the thigh or into the testicle in males or labia in females.
The history and physical exam is the cornerstone of diagnosing a sports hernia. The physical examination is done to determine the location of pain and to feel for any abnormalities. In the majority of cases a sports hernia came be diagnosed during the initial office visit. Occasionally, further evaluation such as MRI may be needed. Here at CH we have a very successful MRI protocol that is specifically designed for sports hernia evaluation.
Once the diagnosis of a sports hernia has been made, then a comprehensive treatment plan will be developed for the specific injury. Most patients can be successfully treated with a short course of physiotherapy, which is designed to promote healing of the injury but also to assess for and treat any precipitating factors such as a previous groin injury or muscular imbalance. If the injury is more extensive then surgery may be indicated.
The type of procedure used is determined by the location and extent of injury. The surgery is typically done as an outpatient procedure and is followed by a short course of physiotherapy. Most patients can return to his or her sport 6-12 weeks after surgery.
So if you do have groin pain, especially after an injury please get evaluated. You can find additional information on physical therapy on our website.
Sten Kjellberg, MD