Sports Hernia
Description
A sports hernia, also known as athletic pubalgia, is a painful soft tissue injury that results in a tear in the muscles of the lower abdomen. It causes pain in the lower abdomen or groin. It most often occurs in sports that require sudden changes in direction or intense twisting movements.
Although a sports hernia may lead to a traditional groin hernia, it is a different injury. A sports hernia is a strain or tear in any soft tissue (muscle, tendon, ligament) in the lower abdomen or groin area.
Cause
The pain from a sports hernia usually begins slowly. There are different theories about how this hernia occurs. One possibility is that tight or strong hip flexor muscles tilt the pelvis forward and stretch the lower abdominal wall muscles, eventually leading to small tears in the muscles and tissues. Activities that involve planting the feet twisting with maximum exertion can lead to this problem. Athletes who play soccer, ice hockey, rugby, field hockey, tennis, or football are most likely to get a sports hernia.
The soft tissues most commonly affected by sports hernia are the oblique muscles in the lower abdomen. Especially vulnerable are the tendons that attach the oblique muscles to the pubic bone. In many cases of sports hernia, the tendons that attach the thigh muscles to the pubic bone (adductors) are also stretched or torn.
Symptoms
Lower abdominal pain
Groin pain
Pain on just one side of the lower abdomen
Pain that is usually worse with sudden movements such as sprinting, kicking, side-stepping, sneezing, or coughing.
A sports hernia does not cause a visible bulge in the groin, like the more common inguinal hernia does.
Examination
Your healthcare provider will take a history and do a physical exam. If you have a sports hernia, you will likely have pain and tenderness in groin during the physical exam. There are no special tests that help diagnose this condition. Some test may be done to rule out other conditions that cause groin pain.
Treatment
The initial treatment for a sports hernia is rest. Healing will take longer if you continue to participate in the activity that causes your pain. It may take a few weeks to a few months for symptoms to subside. Anti-inflammatory medicines, ice and a topical anti-inflammatory will decrease discomfort. A course of therapy may be recommended to gently stretch and strengthen the area. If rest and therapy do not relieve symptoms, surgery is an option. During surgery, the lower abdominal muscles and connective tissue are released and reattached. This can be done with a traditional open procedure or done endoscopically. Some cases require cutting of the inguinal nerve to relieve pain.
Recovery/Rehabilitation
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport will be determined by how soon your abdominal muscles recover, not by how many days or weeks it has been since your injury occurred.
You may return to your activity when you can bend at the waist to touch your toes and straighten back up without pain. You should be able to do sit-ups or abdominal crunches without pain.