Explaining sports hernias

In recent years, sports fans who follow their teams closely may have noticed the rash of sports hernias occurring, which seem to be more common now than ever before. Though sports hernias are not new, their nature and a shift in how men and women exercise makes sports hernia injuries, which are more common in men than women, seem to be more prevalent now than they used to be.

While there's no telling if sports hernias are more common now than in years past, they do seem to garner more headlines than they used to. According to the American Academy of Orthopaedic Surgeons, sports hernias, known to medical professionals as athletic pubalgia, most often occur during sports that require sudden changes in direction or intense twisting movements.

The growing popularity of core exercises, which require twisting movements, among fitness enthusiasts is one possible reason why there seem to be more sports hernia injuries now than in years past. When done properly, core exercises should reduce the likelihood of sports hernias. However, many people do not use the proper form when exercising, and poor form during core exercises could result in injury, including a sports hernia.

What is sports hernia?

A sports hernia is an injury to the soft tissue in the groin area. Often painful, a sports hernia is most likely to occur during sports that require a sudden change in direction or intense twisting movements. When a person has a sports hernia, any soft tissue, be it a muscle, tendon or ligament, in the lower abdomen or groin area is strained or even torn.

Is sports hernia an actual hernia?

Sports hernia can cause an abdominal hernia, but the sports hernia itself is not actually a traditional hernia. When a person has a typical hernia, abdominal contents protrude into the inguinal canal. No such protrusion occurs during a sports hernia, but the name has stuck because many of the surgical treatments associated with sports hernias are similar to those associated with traditional hernias.

Who is most likely to get a sports hernia?

Sports hernias most often affect male athletes who participate in sports that involve lots of repetitive twisting, such as ice hockey, soccer and tennis. In fact, sports hernias are often referred to as "slap shot gut" by hockey players, as the pain is said to intensify when a player with a sports hernia attempts to take a slapshot.

Are there symptoms of a sports hernia?

Sports hernias do exhibit some symptoms, most notably pain. Severe pain in the groin area is a common symptom of a sports hernia. This pain will likely disappear during rest or periods of inactivity, but the pain is likely to return when you return to playing a sport, especially if that sport requires twisting movements.

Unlike a typical hernia, a sports hernia does not cause a physical bulge in the groin. This might happen over time, but that bulge is not the sports hernia; it's the inguinal hernia that developed while you had the sports hernia.

How is a sports hernia diagnosed?

Once a doctor has spoken to you about your symptoms and your physical activity, he or she might conduct a physical test to determine if you have a sports hernia. The doctor might ask you to do a sit-up or flex your body's trunk against resistance. These tasks will be considerably painful if you have a sports hernia.

The doctor also might order an MRI or X-rays. In addition, the doctor will likely conduct a physical examination to see if there is any tenderness in the groin or above the pubis.

What treatments are available for a sports hernia?

Sports fans know that sometimes their favorite athletes get treated for a sports hernia and their return for the remainder of the season is questionable. The timetable for returning depends on the treatment option chosen and how well the body responds.

Treatment options can be broken down into two categories: Nonsurgical and surgical. Nonsurgical treatments include rest, physical therapy aimed at improving strength and flexibility in the abdominal and inner thigh muscles and anti-inflammatory medications to reduce pain and swelling.

Surgery aims to repair torn tissues in the groin. A surgical treatment might involve an open procedure with one long incision or an endoscopic procedure where smaller incisions are made and the surgeon uses a small camera to see inside the abdomen. In some instances, the surgeon will cut off the inguinal nerve, a procedure known as an inguinal neurectomy, in the groin to reduce the patient's pain.

Once the surgery has been performed, your doctor will give you a rehabilitation plan aimed at increasing strength and endurance, and the AAOS notes that most athletes can return to sports within six to 12 weeks.

More information about sports hernias is available at www.aaos.org.