Sports Hernia (Athletica Pubalgia)
What is it: A weakening in the posterior abdominal wall, resulting in a non-palpable defect or occult hernia.
How does it present: Patients report an gradual onset of vague groin pain that may radiate to the lower abdomen or thighs. Valsalva maneuvers such as coughing and bearing down may increase pain. Radiation of pain to the testicles is present in about 30% of afflicted men.
Common exam findings: No true hernia is palpable, because only the deep fascia is involved.
Tests and treatment: Imaging studies may be useful to rule out other pathologies, but are not helpful in making the definitive diagnosis. Avoiding aggravating activities and physical therapy may lessen symptoms. Sometimes surgical repair is needed.