Sports Hernia Background
“Sports hernia” is a broad term that is used to describe pain in the lower abdominal or upper groin region, however it may or may not actually involve a hernia. Different structures can also be involved such as the abdominal wall, groin musculature, and pelvic floor muscles. A sports hernia should not be mistaken with an inguinal hernia, which is when part of the intestine pushes through the abdominal wall. The medical term for a sports hernia is “athletic pubalgia” (AP) and it is considered one of the most common injuries to occur with sports that require kicking or cutting, such as soccer, hockey, and football. It is also not uncommon to see this injury in runners, however it is not as common as the other sports.
What Exactly IS a Sports Hernia?
Unfortunately, although this syndrome is very common, there is little that is actually known about it. We do know that athletic pubalgia is a collection of signs and symptoms that may arise from multiple pathologies, and it can either be acute (a newer injury) or it can become recurrent, or chronic. It usually involves one of the three muscles; the abdominals, adductors (muscles that are located on the inner part of your thigh), or the muscles on the front of the hip, the hip flexors. Medically, it is vaguely defined as “pain in the groin region, medial thigh, lower abdomen, or pubic region that presents in athletes and may encompass the following pathologies: damage to the tendons, fascia, or sheaths in the defined region”. The injury is usually a gradual onset and tends to be triggered by quick movements such as twisting, turning, sprinting, bending forward, kicking, and performing sit-ups. A typical history of an individual with a sports hernia would be a young, athletic male who reports groin or lower abdominal pain.
Treatment Options
Since sports hernia has a very vague definition, it is extremely important for a physical therapist or physician to rule out other potential problems and injuries first before making a diagnosis. Other issues that should be ruled out include: fracture, hip or back injuries, infection, and urological or gastro-intestinal issues. A full examination should include observation and palpation of the area, strength testing, range of motion testing, and possibly functional performance testing. Treatment, such as physical therapy, should then be directed toward either pain control, regaining range of motion, or strengthening around the area depending on where the individual falls in the recovery process and their specific needs.
Returning to Sport
Similar to the diagnosis of AP, more research needs to be done in order to determine the best way to know when an athlete is ready to return to their sport after injury. Sport specific testing and functional outcome measures can help provide the clinician with objective information, and allow them to compare scores to normative values. As mentioned before, this is a problem that can occur over and over again so it is important to seek professional management in order to return to sport safely and decrease the likelihood of reoccurrence. For more information visit Total Performance Physical Therapy or www.totalperformancept.com.
