Sports Hernia: Definition, Evaluation, and Treatment

Abstract

Sports hernia is a non-anatomic, non-diagnostic term that has been attributed to many different causes of groin pain. » Sports hernia is better described as pain localized anatomically to the inguinal region of an athlete without an actual hernia.» Nonoperative management including core stability while avoiding extreme hip range of motion should be attempted for at least 2 months prior to any operative intervention.» Associated pathology such as femoroacetabular impingement or adductor tear should be addressed. » If a sports hernia is not responsive to rehabilitation, referral to a general surgeon is appropriate.

Laparoscopic Approach to Inguinal Disruption in Athletes: a Retrospective 13-Year Analysis of 198 Patients in a Single-Surgeon Setting

“…Because of the absence of an abnormal exit of tissue through the abdominal wall in the inguinal region, ID cannot be defined as a “true” hernia [4]. Pathogenesis is multifactorial, and the final outcome is a posterior abdominal wall weakness in the inguinal area with subsequent genesis of abnormal tension in the inguinal canal [4, 9–11]. Therefore, the unbalanced force at the pelvis and the inguinal canal is the specific cause of ID [4].…”

“…Therefore, the unbalanced force at the pelvis and the inguinal canal is the specific cause of ID [4]. Weakness is due to repetitive and excessive force applied to the inguinal and pelvic region during inferior limb movements especially of adductors, caudal portion of abdominal wall muscles and hip articulation [4, 9, 12].…”

“…Patients report monolateral groin pain at the pubic symphysis radiating through the scrotum, the perineum, the rectus abdominis and the adductor tendon (according to nerve distributions) with associated resistance or pain on ipsilateral hip adduction [9, 12]. Symptoms are worsened by athletic activity such as kicking, cutting or sprinting, especially with acceleration and deceleration, and are alleviated by rest [2, 4, 9]. Examination reveals tenderness to palpation of the inguinal region just above the inguinal ligament and near the pubis, and it is worsened by coughing and by performing Valsalva manoeuvre [9].…”

“…Symptoms are worsened by athletic activity such as kicking, cutting or sprinting, especially with acceleration and deceleration, and are alleviated by rest [2, 4, 9]. Examination reveals tenderness to palpation of the inguinal region just above the inguinal ligament and near the pubis, and it is worsened by coughing and by performing Valsalva manoeuvre [9]. A visible or palpable inguinal mass, if present, points to a true hernia and not to ID [3, 4].…”

“…A visible or palpable inguinal mass, if present, points to a true hernia and not to ID [3, 4]. Differential diagnosis of inguinal pain is shown in Table 1 [9].…”