Coordinated Health

Sports Hernia Program

A sports hernia, also known as “Athletic Pubalgia” or “Gilmore’s Groin”, is an injury to the muscles and/or tendons of the groin that attach to the pubic bone. This condition can occur among non-athletes but is well-known among athletes who participate in sports with cutting, pivoting, kicking, and sharp turns. Sports hernias can be painful, easily misdiagnosed and sometimes even progress into a disabling condition.

At Coordinated Health, our team has developed a sports hernia program that offers patients individualized treatment plans that include both surgical and non-surgical options. Non-surgical treatment options can include physical therapy, non-steroidal anti-inflammatory medication, and physiotherapy. Surgical treatment options for patients with extensive injuries will be dependent upon the nature and location of the injury but generally consists of a preoperative MRI (designed specifically to identify sports hernias), surgery under general anesthesia, and postoperative rehabilitation. At Coordinated Health, we offer outpatient surgery that allows our patients to go home the same day as surgery.

Physical Therapy for Sports Hernias

At Coordinated Health, our team of Physical Therapists work together to ensure the best quality of care for patients and are assigned to remain with individual patients throughout the duration of their treatment. Our Physical Therapists work with patients one-on-one to ensure they receive a customized treatment plan designed around their specific needs and desired outcome. After a clear evaluation from one of our physicians, therapy will begin through four phases which will work to reduce pain and inflammation, strengthen the core, legs, and abdomen, and increase speed training to prepare you to return to your daily activities as individuals and as athletes.

Frequently Asked Questions

WHAT IS A SPORTS HERNIA?

A sports hernia, also known as “Athletic Pubalgia” or “Gilmore’s Groin,” is an injury to the muscles and/or tendons of the groin that attach to the pubic bone.  This usually happens to athletes whose sport and mechanism of injury is associated with sudden and forceful twisting, aggressive accelerations, and/or rapid decelerations.  The resulting injury typically causes pain that is made worse by activity but is improved by rest.  Left untreated, the injury may develop into a chronic pain condition.

WHAT IS THE DIFFERENCE BETWEEN A SPORTS HERNIA AND A HERNIA?

A sports hernia is an injury or disruption to the muscles and tendons of the groin whereas a true hernia is a defect in the musculature of the groin that allows internal organs from within the abdominal cavity to bulge out through the defect and present as a lump in the groin.  Under certain conditions the injury from a sports hernia can eventually lead to the development of a true hernia.  A true hernia needs to be repaired surgically to prevent further complications.

WHAT ARE THE SYMPTOMS OF A SPORTS HERNIA?

The symptoms of a sports hernia may significantly vary depending on the mechanism of injury.  Typically, there is an onset of sudden pain involving the inner groin that may radiate down into the thigh or genitals.  The pain is usually made worse by physical activity.  Often times, pain can be improved with rest.  Pain may also develop gradually over time, especially when associated with repetitive motions such as running, kicking, or rotation of the hip as seen in golf, soccer, and long distance running.

WHAT CAN I EXPECT DURING AN EVALUATION?

You will be seen by our general surgeon, Dr. Kjellberg, who is very experienced in evaluating and treating groin pain.  After a thorough history, a physical exam will be performed to determine the location of the pain and extent of injury.  Conditions other than a sports hernia, such as a true hernia will be evaluated as well.  Occasionally, imaging studies such as an x-ray, CAT scan, or MRI may be recommended.  Most patients with a sports hernia or true hernia can be diagnosed during this initial visit without additional imaging.  

WHAT IS THE BENEFIT OF HAVING MY GROIN PAIN EVALUATED?

A groin pull or groin strain is a common condition from overstretching or very mild tearing of the muscles in the groin that usually heal with rest and nonsteroidal anti-inflammatory medication such as ibuprofen.  However, other conditions such as hernias can be identified and treated and thereby prevent potentially serious complications such as incarceration (when an organ gets stuck in the hernia and cannot be pushed back in) and strangulation (when an organ loses its blood supply from being stuck in the hernia) of abdominal organs such as the intestines. In addition, predisposing factors to the development of a sports hernia can be identified and treated, such as unbalanced musculature or previous injury.  Treating a sports hernia early on can help prevent the development of chronic pain.

WHAT ARE NON-OPERATIVE TREATMENT OPTIONS FOR A SPORTS HERNIA?

The majority of sports hernias can be treated successfully with physiotherapy.  Treatments are individually designed to promote healing, correct any muscular imbalances if detected and release or soften scar tissue that has developed to restore functional balance to the groin musculature.  The physical therapy is usually set up in 3 phases over a 4-8 week period with patient’s progressing through various exercises at the end of which the patient should be able to return to his or her previous level of activity.

WHAT ARE SURGICAL TREATMENT OPTIONS FOR A SPORTS HERNIA?

Patients who have significant disruption of the musculature of the groin or tearing of the attachments to the pubic bone or failure of physiotherapy in resolving the groin pain are candidates for surgery.  The type of surgery performed is dependent on the location of the injury.  In certain situations, MRIs may be obtained to plan for surgery.  Surgery is performed with patient completely asleep under general anesthesia.  Patients go home on the same day after the surgery.  Postoperatively patients undergo a period of rehabilitation and are typically back to their previous level of activity anywhere from 4-8 weeks dependent on the extent of the injury and type of surgery performed.