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Sports Hernia Surgery

Sports Hernia CausesIn 2005, few in the sporting world had ever heard of “sports hernia.” After experiencing debilitating groin pain and five corrective surgeries, NFL quarterback Donovan McNabb put the condition on the radar. Since then, the careers of several professional athletes have been interrupted by chronic groin pain that worsens over time. The good news is that with surgery, many of these pro athletes have been able to return to play full force.

Although groin injuries account for a small percentage of sports injuries, they are responsible for more time away from competition and training, compared to other injuries. Seen most often in professional football, hockey and soccer players, sports hernia can be tricky to diagnose. The condition is more common in men, with less than 5 percent of cases reported in women.

Sports hernia, also known as athletic pubalgia, is chronic pain due to weakness of the posterior inguinal wall, often without a clinically recognizable hernia. The inguinal canal region is prone to weakening because the tissue is naturally thin. Because the sports hernia involves a tear or weakness in the oblique abdominal muscles, there is no visible bulge under the skin, as is seen with a traditional hernia.

Symptoms begin with a slow aching pain in the lower abdomen, groin or hip area, and do not generally get better on their own. If the condition does not improve with conservative treatment, sports hernia surgery may be needed to correct the problem.

“Pro athletes have strong abdominals and they often ask, ‘How can I possibly have a sports hernia?’” says orthopedic surgeon Mark Adickes, M.D., co-medical director of the IRONMAN Sports Medicine Institute. “It can be a matter of overuse and leaning forward during play in football or hockey, causing excessive strain on an area of the body that is naturally weak.”

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Sports Hernias are Usually Caused by Aggressive Twisting

Repetitive twisting and shear forces encountered during high-level athletics can lead to injury of the lower abdominal wall. Typically, strong thigh abductors can exacerbate the problem, and whenever there’s pain, the body often compensates, which can cause strains and pulls in other areas.

Pain in the groin and pelvis can be caused by a number of different problems, including injury to the lumbar spine, hip joint, sacroiliac joint, abdominal muscles or the genitourinary system.

“Misdiagnosis of sports hernia is common due to several factors,” says Dr. Adickes. “With the confluence of tissues, tendons, ligaments, muscle structures and organs coming together in this small area of the body, isolating a single cause is the challenge,” he explains.

Skillful diagnosis combines the use of MRI imaging, radiographs, bone scan and physical examination, but the true causes may not be fully evident until corrective sports hernia surgery is undertaken.

The sports hernia is not a true hernia, which in this area of the body is a protrusion of abdominal cavity contents through the lower abdominal wall. “The term hernia persists in part because many of the effective surgical treatments used to repair hernias also work well for this condition,” Dr. Adickes explains.

Concentrate on the Core - Non-Surgical Sports Hernia Treatment

Physical Therapy for Sports HerniaIf a condition of sports hernia, athletic pubalgia or inguinal hernia is present, conservative treatment may help. This usually begins with rest from all athletic activity and the addition of gentle stretching until pain and inflammation subsides. Physical therapy for six to eight weeks is targeted at correcting lower-quarter muscle imbalance and impairments identified during the physical examination. One theory is that a muscle imbalance exists between the abdominals that insert into the pubic bone and the hip adductors, and that usually the abdominals are weaker than the hip muscles. As a result, the main focus of exercise is on progressive core stabilization, making sure athletes maintain the spine in a neutral position.

Sports hernia surgery is indicated if therapy fails, or if the athlete heard a tearing or ripping in the area from the pubic bone to the tail bone during injury. Noninvasive laparoscopic surgical techniques can be used to treat and correct sports hernia problems, often allowing the athlete to return to play within six weeks.

Orthopedic doctors specializing in hip injuries & treatments »