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What is a Sports Hernia?
A sports hernia is pain in the groin due to injury of a muscle within the abdominal wall (like the soft tissue around your six-pack muscles) or an inner thigh muscle (adductor longus).
The true nature of the condition is still poorly understood, but doctors believe its caused by multiple small injuries (“micro-tears”) to an overused muscle.
The injury is most common in hockey players. The injury can be very problematic, and very persistent. Its common for an athlete to sit out most of the season only to re-injure the muscle the every day they return. This is an important consideration when we talk about treatment.
How is a Sports Hernia diagnosed?
A sports hernia is suspected based on the story of the injury. The major symptom is groin pain or pelvic pain. People have tenderness along the inner thigh, and sharp pain when doing sit ups.
Its important to rule out an inguinal hernia (a different type of hernia) which is caused by a weak spot on the side of the abdominal wall that can entrap a piece of intestine (this requires a general surgeon to repair the injury).
Also rule out Osteitis pubis, which is a condition seen in young athletes that complain of dull aching groin pain caused by excessive repetitive strain on the pubic bone (front of the pelvis). Widening of the front of the pelvis or bone erosion is sometime seen on x-ray. Treatment is anti-inflammatories and physical therapy, rest from aggravating activity.
X-rays and MRIs are sometimes ordered to rule out other problems, however, they are rarely successful in identifying a specific “sports hernia”. Some doctors are able to use the ultrasound machine to show a weakness in the abdominal wall which is believed to be the source of pain.
How is a Sports Hernia treated?
Treatment of a sports hernia depends on a person's expectations, and their athletic schedule.
Some cases may improve with rest and physical therapy for 6 to 8 weeks, giving the body time to heal from the overuse injury.
However, more commonly, the injury will recur shortly after an athlete returns to play. For this reason, many doctors are aggressive with initial treatment, and recommend surgery at the outset. Surgery involves repair of the abdominal wall, and occasional repair or resection of the adductor longus muscle.
What is the long term outcome?
The good news is that theres good treatment options and the vast majority of people heal. Unfortunately, this injury can linger for an entire season, and because its most common in athletes, many patients are motivated to treat the injury quickly. There are effective surgical options, although initial nonsurgical treatment is always a good initial treatment.
The key is to discuss expectations with your treating doctor.