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Understanding sports hernias

FitnessUniversity of Maryland Medical Center

That chronic groin pain sometimes felt by athletes may be called a sports hernia, but it's not really a hernia at all, according to Dr. Katherine G. Lamond, assistant professor of surgery at the University of Maryland School of Medicine and a surgeon at the University of Maryland Medical Center. She said they are different from what's normally thought of as a hernia and sometimes tough to diagnose. But once doctors determine that this is the cause, there is effective treatment.

What is the difference between a sports hernia and other types of hernias?

The classic definition of the word hernia is a protrusion of tissue through an opening. Hernias can occur in a number of places, but most commonly in the umbilicus and inguinal canal or after previous abdominal surgery.

A sports hernia is not in fact a hernia, but rather a term that refers to chronic groin pain typically found in athletes. A region of the inguinal canal, which is a tunnel in the lower abdominal muscle wall, becomes weakened and causes pressure on nerves and therefore debilitating pain. An inguinal hernia also causes groin pain, however it is also associated with a bulge or swelling along the groin or in the testicle.

Because the term sports hernia is a misnomer, it can make the explanation and description fairly complex.

Are sports hernias common, and who is most prone to have one?

Sports hernias are much less common than a classic inguinal hernia. Male athletes are more likely to be diagnosed with a sports hernia than females, and this is probably because the inguinal canal and pelvis are formed differently in women.

Sports hernias are extensively described in professional soccer players in Europe. Lacrosse, football and ice hockey are other common sports that may make athletes more susceptible to having a sports hernia. We may see more of these types of injuries in young athletes as the fall sports season gets under way.

How do you know if you have one? What are some of the symptoms?

It can be difficult to diagnose a sports hernia; however, a thorough history and physical exam by a physician familiar with sports hernia is usually sufficient. Sometimes imaging studies, such as an MRI, X-ray or ultrasound can be helpful, especially to rule out other injuries, such as muscle strains or hip abnormalities. It is crucial to undergo a thorough evaluation, because symptoms of sports hernia can be similar to other medical problems. Often patients will complain of a sharp pain while kicking, running or pivoting, which may subside with rest. Discomfort with sit-ups and when getting in and out of a car is also frequently described.

Will it go away on its own or does it require treatment?

Because a sports hernia is not a true hernia, it is possible for some athletes to recover from this condition with a combination of rest, physical therapy and anti-inflammatory medication, such as ibuprofen. However, a sports hernia can also be a debilitating problem which forces athletes to remain on the sidelines. In these cases, surgical treatment may be required.

If an athlete has surgery for sports hernia, how long might recovery take?

Surgical therapy of sports hernia is typically an outpatient procedure. It is performed either through an open procedure or laparoscopically. In either case, one of the major goals besides pain relief is to return athletes to training and practice. With an appropriate rehabilitation program, athletes can often be competing within two weeks. Ideally, surgery is performed while athletes are "off-season," to allow for appropriate rehabilitation.

How can athletes prevent a recurrent injury?

A thorough stretching routine performed before and after exercise is a good habit to instill in athletes to prevent injuries. Hip flexibility and strength are specifically critical in prevention of sports hernias and recurrence. When weight training, it is imperative to use a sensible routine for both flexion and extension muscle groups. Finally, core stability and strength will assist with balance and can help prevent sports-related injuries.

meredith.cohn@baltsun.com

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