Introduction:
A hernia is an abnormal protrusion of organs through an opening in the wall of the inguinal or femoral cavity. A sports hernia is similar to the inguinal hernia, but it is not a true hernia. A sports hernia is commonly seen in athletes. It is caused by sudden twisting, overuse, and muscle tears. This condition is very painful in the groin area and causes numerous difficulties, including the inability to walk, run, or participate in sports.
If correct treatment is not done on time, it can lead to complications like the recurrence of sports hernia and permanent restriction of sports. There are several treatment options available for a sports hernia, including rehabilitation, conservative treatment, and surgical intervention.
What Is a Sports Hernia?
A sports hernia typically occurs in athletes and individuals involved in high-intensity fitness training. Athletic pubalgia is the other name for a sports hernia. Sports hernia/athletic pubalgia exhibits similar symptoms to an inguinal hernia. It is caused by injury to soft tissues.
Sudden movements, side changes, twisting, forceful impact, and muscle tears can result in a sports hernia. Athletic pubalgia causes severe pain in the groin area and impairs performance in activities such as running, walking, and sports.
Sports hernia can be of two types: the first one is acute sports hernia, and the second is chronic sports hernia. The chances of recurrence of a sports hernia are very high if left untreated. Oblique muscles (muscles of the lower abdomen) and abductor muscles (muscles of the thighs) are most commonly affected by a sports hernia. Some strong tendons help oblique muscles attach to the pubic bone; these tendons are affected mainly by a sports hernia.
Sports like ice hockey, soccer, football, wrestling, rugby, skiing, and tennis, which require abrupt direction changes or repetitive, powerful twisting, are frequently the cause of sports hernias. These motions place a significant strain on the soft tissues of the groin and lower abdomen, which can cause injury.
What Causes a Sports Hernia (Athletic Pubalgia)?
Causes of sports hernia in athletes include the following reasons:
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Any tear or weakness in the muscles around the groin can result in a sports hernia.
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Sudden twisting and bending movements result in a sports hernia.
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Contact sports involve twisting of the pelvis, which also causes a sports hernia.
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Muscles and tendons, which are often involved in sports and fitness training, can become torn and stretched, leading to a sports hernia.
What Are the Symptoms of a Sports Hernia?
Sports hernia symptoms include
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Chronic groin pain in athletes is a sign.
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Pain during exercise and fitness training.
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A feeling of something not being right in the groin area.
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A soft or hard lump in the groin area.
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A sports hernia leads to an inguinal hernia.
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If not treated, a sports hernia can cause severe pain and other complications.
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Recurrence of pain.
How Is a Sports Hernia Diagnosed?
A sports hernia is difficult to diagnose. The doctor or health professional may request various tests, such as.
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Physical test - After taking the case history, the doctor will physically examine the patient for tenderness in the groin area. The doctor can ask to flex or do sit-ups during the physical tests. Certain movements help in the diagnosis of a sports hernia. Pain on palpation over the pubis area is one major sign of a sports hernia.
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Imaging test - After conducting the physical examination, the doctor will opt for imaging tests, such as an ultrasound, X-ray, and MRI (magnetic resonance imaging), to aid in making a diagnosis. Ultrasound of the groin area helps diagnose a sports hernia.
How Is a Sports Hernia Treated?
It is important to provide conservative treatment for a sports hernia injury. Most cases fully recovered with conservative treatment. If the patient does not receive conservative treatment, a surgical approach may be necessary. Treatment of a sports hernia depends on age, health, medical condition, injury, and the specific sport involved. Differentiating between a sports hernia and a groin strain, as well as whether the problem is acute or persistent, will also affect how it is treated.
There are many types of treatment for sports hernia present, such as
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Nonsurgical treatment or conservative treatment.
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Pelvic floor repair without mesh.
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Laparoscopic mesh repair.
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Modified Bassini technique.
1. Non-surgical treatment - Non-surgical treatment for sports hernia includes rest, physical therapy, and anti-inflammatory medications.
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Rest - For the first week after the injury, rest and ice compression will be beneficial. It reduces pain and inflammation.
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Physiotherapy - After 14 days of injury, start sports hernia physical therapy exercises
to improve the strength of the lower abdomen. It will also increase the flexibility of the oblique and abductor muscles.
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Anti-inflammatory medication - To reduce inflammation and pain, anti-inflammatory medications are helpful. Non-steroidal anti-inflammatory (NSAID) drugs, such as ibuprofen and Naproxen, are helpful.
Non-surgical treatments are often beneficial for core strengthening in cases of sports hernia. It provides relief within four to eight weeks. If the problem persists, consult a medical professional for surgical treatment options.
2. Surgical Treatment - If the conditions of a sports hernia do not get better with non-surgical treatment, then it's time to opt for surgical treatment.
Surgical treatment involves two types of treatment plans
Modified bassini technique - Open surgery, also known as the modified Bassini technique, is a traditional surgical procedure. The doctor will make a long incision and open the area to provide the needed surgery. In this technique, the transversalis fascia is sutured to the edge of the inguinal ligament. Pubis was incised to promote healing, and suturing of the external oblique fascia was performed. An incision is made in the inguinal canal, opening the space and separating the spermatic cord. Interrupted sutures on the floor of the damaged inguinal canal.
- Minimal repair technique - With this method, the posterior portion of the abdominal wall is sliced and opened more widely. The transversalis fascia, a thin layer of tissue, is mended, and pressure on the genital branch of the genitofemoral nerve is released during the treatment. Because it is a less invasive technique that enables a quicker return to sports, it is very helpful for athletes. The external oblique fascia is slightly cut during this procedure. Stitches are used to reinforce the pelvic floor and the weak spot. The oblique muscles are meticulously sewn back together over the spermatic cord, and the injured portions of the posterior wall and inguinal ring are restored.
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Endoscopic surgery - Endoscopic surgery involves the use of a camera, known as an endoscope. One small incision should be made, and the endoscope should be inserted into the body. It will provide a full view of the abdomen.
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Inguinal neurectomy - In this procedure, certain small nerves in the groin area are removed to provide relief from pain.
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Adductor tenotomy - In some cases, sports-related hernia pain persists in the thighs even after surgery. To relieve this pain, the surgeon cuts the tendons of the thigh muscles.
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Rehabilitation - After surgery, doctors should plan rehabilitation programs to strengthen the muscles, helping athletes return to sports as early as possible. The recovery time following sports hernia surgery is necessary.
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Can I Prevent a Sports Hernia?
By strengthening your hips and core, increasing your flexibility, warming up correctly, and avoiding overtraining, you can help prevent a sports hernia. Although prevention is challenging in many high-stress sports, the risk of injury can be considerably decreased with a thorough fitness program that emphasizes core stability and appropriate technique.
When Should I See My Healthcare Provider for a Sports Hernia?
If you have a significant bulge, persistent groin pain, or symptoms that don't go away with rest, you should consult a doctor about a sports hernia. Severe discomfort, a reddish-purple protrusion, fever, nausea, or vomiting should all be treated right away, as they may indicate a more dangerous condition, such as a strangulated hernia.
Conclusion
A sports hernia is a common condition commonly seen in athletes and fitness enthusiasts. Excessive exercise, overuse, repeated movements, injury, and muscle tears are some causes of a sports hernia. It is a painful condition that causes pain in the groin area and difficulty in movement. Early treatment and diagnosis of a sports hernia are crucial for a swift return to the sport or normal routine. Treatment options for sports hernia include physiotherapy, conservative management, and surgical intervention.
Key Takeaway from iCliniq:
A sports hernia is a soft tissue injury in the lower abdomen or groin that causes pain without a visible protrusion. It is commonly seen in athletes who engage in twisting movements. In contrast, a groin strain affects the muscles rather than the tendons. During the 6–12 week rehabilitation period after surgery, hip and core strengthening exercises are advised. Early diagnosis and specialist therapy can help prevent chronic pain and improve outcomes. Here at iCliniq, our surgeon can ensure appropriate assessment, treatment, and a safe resumption of physical activity if you have limited movement or recurrent groin pain.
