What is it?
A sports hernia is a tear in the lower abdominal wall in the inguinal (groin) area. This typically initiates as groin (muscles that flex and adduct the hip) pain extending into the lower abdominal area. Unlike the classical hernia, the sports hernia does not result in a bulge.
Sports hernias are not related to a specific incident. Rather, gradual pain brought on by overuse and activity secondary to a strong adductor muscle group in the thigh compared to weak abdominals.
Symptoms are usually brought about by physical activity requiring twisting, kicking, sitting up, and quick bursts, but will abolish with rest. However, if not properly treated pain will immediately return with sporting activities even with a trial of rest.
Who gets them?
Anyone that is physically active may develop a hernia since it is a result of an imbalance between muscle groups which impairs mechanics.
However, it is most common in soccer and hockey players as these sports require hip flexion and adduction with kicking and skating. These muscle groups insert just below the abdominals (the area of the sports hernia) and overpower a weaker abdominal group.
How are they treated?
Sports hernias can effectively be treated with conservative physical therapy. With an effective screen, muscular and movement imbalances can be detected and corrected prior to pain.
If pain is already present, it can be treated with soft tissue therapy, maintaining hip capsule and internal rotation mobility, stretching, strengthening of the lower extremity (especially single leg) and core, and incorporating agility/plyometric activities.
Proper performance of these exercises is imperative as surgery is most likely the next option after 4-6 weeks of conservative treatment. 95% of athletes return within 3 months of a standard repair and 99% return in 4 weeks of a minimal repair.
Consult with your local physician or physical therapist for proper screening, evaluation, and treatment of abdominal or groin pain.
Written By: Eric Horstman, DPT, PT
Kachingwe A, Grech S. Proposed Algorithm for the Management of Athletes with Athletic Pubalgia (Sports Hernia): A Case Series. J Orthop Sports Phys Ther. 2008;38:768-781.