Sports Hernias

What is a sports hernia?

Sports hernia, also known as athletic pubalgia, is a strain or tear of any of the muscles, tendons, or ligaments of the groin. While not a hernia in the classic sense, where there is a hole or a defect, a sports hernia can develop from a weakness or an imbalance between the muscles and connective tissue of the inner thigh and the muscles and connective tissue of the abdomen.

What causes a sports hernia?

A sports injury can result from any physical activity, however it is more common with sports that involve a lot of twisting and turning, such as soccer, football, or hockey. A sports hernia can develop as a result of a single intense action or can be a result of repetitive stress from long-term participation in strenuous sports. Neglecting to properly warm up before engaging in intense physical activity, or cool down afterward, can increase the risk of injury. Previous injuries in the hip, groin, or lower abdomen region can also predispose someone to develop a sports hernia.

How do I know if I have a sports hernia?

Diagnosing a sports hernia can be challenging because its symptoms often overlap with other groin and abdominal problems.

Symptoms generally include any or all of the following:

  • Pain or discomfort in the affected groin which often worsens with physical activity, especially movements that involve twisting or turning.

  • Pain in the groin while exercising or playing sports. It may also be triggered by movements like coughing, sneezing, or bending.

  • Tenderness in the groin. You may notice some swelling as well, but no definitive bulge such as with a traditional hernia.

How is a sports hernia diagnosed?

In most cases, a good history and physical exam by a hernia, orthopedic or sports medicine specialist can assist with diagnosis, but often times we would need additional imaging studies to help.

In some cases, imaging tests such as MRI (Magnetic Resonance Imaging) or ultrasound may be useful to see the specific injury present.

How do I treat my sports hernia?

There are many different ways to treat a sports hernia, from most conservative to most invasive, and often-times, a sports hernia does not need surgical correction.

  1. Rest and Physical Therapy: The first line of treatment for a sports hernia usually involves a period of rest, allowing the body time to heal naturally. This is often coupled with pain management strategies such as the use of ice packs and non-steroidal anti-inflammatory drugs (NSAIDs).

  2. Physical therapy is another critical component of initial management. A physical therapist can guide you through a series of targeted exercises designed to strengthen the affected muscles and restore balance between the abdominal muscles and the inner thigh muscles. Therapy may also include flexibility and range-of-motion exercises, which can help alleviate symptoms and prevent future injuries.

  3. Corticosteroid Injections: If pain continues despite rest and physical therapy, steroid injections can help reduce inflammation and provide pain relief, facilitating participation in physical therapy.

  4. Surgical Intervention: If conservative treatments fail to relieve symptoms, surgical intervention may be recommended. The type of surgery will depend on the specific nature of the injury but may involve repairing the torn or strained soft tissue. We discuss the types of surgeries below.

Post-Surgical Rehabilitation

Following surgery, a comprehensive rehabilitation program is vital to restore full strength and function to the affected area. This usually includes a graduated exercise program that starts with gentle range-of-motion exercises before slowly introducing more strenuous activities. With careful management, most athletes can return to their previous level of performance.

Prevention

In addition to treating a sports hernia, it's also essential to take steps to prevent future injuries. This includes proper conditioning and strength training, especially focusing on core stability. Warming up adequately before training or competition and cooling down afterward is crucial.

Reconstruction of the inguinal floor with sutures

Schematic of an adductor muscle group tenotomy

What surgical options are there for sports hernias?

Several different options exist for the surgical treatment of sports hernias, depending on the muscle and area affected. If one of the adducter muscles of the medial thigh is affected, by partially or fully detaching its insertion onto the pubic bone, you can have relief of the injury. More commonly, the injury is a result of imbalance of forces on the pubic bone, or weakness of the nearby fascia or muscle. In these cases, reconstruction of the inguinal floor with or without a supporting mesh may be necessary. This can also be accomplished laparoscopically in certain cases.

Next Steps

If you’re dealing with a possible sports hernia, the Hernia Experts are here for you.

  • Our team is highly experienced in all the most advanced treatment and evaluation options.

  • Our specialized pain management protocols have allowed us to avoid narcotics in over 95% of our repairs.

  • After your procedure, our surgeons and office staff will be with you every step of the way.

To set up a consultation, please call us at (212) 305-5947 or use our online appointment request form. We look forward to answering your questions and meeting your hernia care needs.