You may have heard that surgery is the only way to effectively treat most hernias. That’s true, but what about a sports hernia?
That’s a little more complicated for a key reason: A sports hernia isn’t actually a hernia. Yes, you read that right. While a sports hernia can sometimes lead to the development of an inguinal hernia, the condition itself is not a hernia.
A sports hernia won’t heal on its own, but surgery may not be required. Because the injury doesn’t involve herniation, it can sometimes heal with rest, physical therapy, and the use of anti-inflammatory medications. That’s not always the case, though, and surgery may be necessary to fully resolve the injury.
What is a sports hernia?
The medically correct term for this type of injury is “athletic pubalgia.” With that name, is it any wonder that people continue to call it a sports hernia?
Athletic pubalgia is a soft tissue injury affecting the groin. Unlike an inguinal hernia, which occurs when abdominal tissue pushes through (or herniates) an opening in the lower abdominal wall, a sports hernia is a strain or tear of a muscle, tendon or ligament in the lower abdomen or groin.
The injury is most common in the oblique muscles of the abdomen, along with the tendons that attach the obliques to the pubic bone. While sports hernias can affect both men and women, they’re more common in men due to anatomical differences.
When athletic pubalgia occurs, it usually causes severe groin pain at the time of the injury. Pain may diminish with rest and return with activity, and it can radiate down into the genitals and the inner thigh. Unlike an inguinal hernia, a sports hernia does not cause a noticeable bulge.
Who’s at risk of a sports hernia?
A sports hernia occurs when soft tissue in the groin tears. This type of injury is most common in sports that require twisting, turning, or sudden changes in direction, such as:
- Football
- Hockey
- Hurdling
- Rugby
- Skiing
- Soccer
- Tennis
- Wrestling
We mentioned above that sports hernias are more common among men. In part, that’s because the sports most associated with this type of injury are more frequently played by boys and men.
You don’t have to be involved in a sport to develop a sports hernia. In some cases, sudden changes in direction during other movements can cause the injury.
How is a sports hernia treated?
A sports hernia is what’s known as “a diagnosis of exclusion.” That means that it is diagnosed after a medical provider has ruled out other potential causes of groin pain, including an inguinal hernia. To determine a diagnosis, a provider may recommend imaging scans such as X-ray or MRI to get a good look at the groin.
Unlike hernias, which typically require surgery, sports hernias can be treated both nonsurgically and surgically. If you’re diagnosed with this injury, your provider may recommend you first try nonsurgical treatment options, including a period of rest. In addition to rest, your treatment plan may also include physical therapy, over-the-counter or prescription anti-inflammatory medications, and corticosteroids.
If nonsurgical treatment doesn’t alleviate your pain, your provider may recommend surgical treatment after a few months. The specific type of surgery needed will depend on which soft tissue is injured and the severity of the injury.
After surgery, physical therapy may be recommended to help strengthen your abdominal muscles, restore range of motion, and minimize the risk of reinjury. According to the American Academy of Orthopedic Surgeons, more than 90 percent of patients who undergo surgery after nonsurgical treatment are able to successfully return to sports.
What if a sports hernia leads to an inguinal hernia?
When left untreated, athletic pubalgia can weaken the tissues in the abdomen. In some cases, this weakening of the abdominal wall can cause an inguinal hernia, where the intestines or other tissue push through the groin.
When this happens, you’ll develop the telltale bulge that’s usually palpable from outside the body. If you develop an inguinal hernia, surgery is the only definitive treatment for resolving the condition.
During surgery, the abdominal wall will be repaired and fortified using stitches and mesh. Hernia repair surgery can be performed as an open procedure or using minimally invasive techniques. In most cases, you’ll be able to return to normal activity within a few weeks.
Next steps
As Georgia’s first accredited Hernia Surgery Center of Excellence, the Hernia Center of NGMC offers access to hernia specialists and the most advanced robotic and minimally invasive surgical techniques for hernia repair. Call 770-212-3109 to learn more or schedule an appointment.
