Athletic pubalgia or a “sports hernia” is a strain or tear ofthe soft tissue in the lower abdomen or groin area. Most often, the soft tissues affected are the oblique muscles in the lower abdomen. The tendons that attach the oblique and inner thigh (adductor) muscles to the pubic bone are particularly vulnerable, and in many cases are also strained or torn. Most often, sports hernias occur during sports that require intense twisting movements or sudden changes in direction. Sports hernias differ from traditional abdominal (inguinal) hernias however, over time, a sports hernia could lead to an inguinal hernia.
Symptoms
Severe groin pain- at the time of the injury.
Pain that improves with rest, but returns when you begin sports activity, especially with twisting movements.
Note: Unlike an inguinal hernia, a sports hernia does not cause a visible bulge in the groin. However, over time, a sports hernia could lead to an inguinal hernia as abdominal organs may press against the weakened soft tissues to form a visible bulge.
Causes
Violent or repetitive twisting motions that cause a strain or tear in the soft tissue of the lower abdomen or groin.
Risk Factors
High intensity sports such as ice hockey, rugby, soccer, wrestling, and football where the feet are often planted while the core is twisted.
Intense twisting movements
Sudden changes in direction
Prevention
Warming up before physical activity
Proper strengthening and stretching of the core muscles
Diagnosis
- Detailed history and physical examination to determine location of pain
- A physical test such as doing a sit up or flexing your trunk against resistance
- MRI to determine presence and location of a tear
- X-rays, bone scans or other forms of diagnostic testing may be used to rule out other causes of pain.
Treatment
There are non-surgical and surgical options for managing sports hernias. Lack of treatment can result in chronic pain that prevents you from returning to sports activities.
Non-Surgical Treatment:
Rest
Ice
Physical therapy
4-6 weeks
Anti-inflammatory medications.
NSAIDs
Cortisone injection
Surgical Treatment:
If pain does not resolve after non-surgical treatment methods or symptoms return when you resume sports activities, surgical intervention may be necessary.
Open procedure
Endoscopy