Introduction
Hernia is an abnormal protrusion of organs through an opening in the wall of the inguinal or femoral cavity. A sports hernia is somewhat similar to the inguinal hernia, but it is not a true hernia. A sports hernia is commonly seen in athletes. It is caused due to sudden twisting, overuse, and muscle tear. This condition is very painful in the groin area and causes lots of difficulties, such as the inability to walk, run, or perform sports. If correct treatment is not done on time, it can lead to complications like the recurrence of sports hernia and permanent restriction of the sports. There are several different treatment plans available for a sports hernia which include rehabilitation, conservative treatment, and surgical treatment.
What Is a Sports Hernia?
Sports hernia occurs in athletes and people involved with excessive fitness training. Athletic pubalgia is the other name for a sports hernia. Sports hernia/ athletic pubalgia shows similar symptoms to an inguinal hernia. It is caused due to injury of soft tissues. Sudden movements, side changes, twisting, forceful impact, and muscle tears can result in sports hernia. Athletic pubalgia causes severe pain in the groin area and creates difficulty in running, walking, and sports performance. Sports hernia can be of two types the first one is acute sports hernia, and the second is chronic sports hernia. The chances of recurrence of a sports hernia are very high if left untreated. Oblique muscles (muscles of the lower abdomen) and abductor muscles (muscles of the thighs) are most commonly affected by a sports hernia. Some strong tendons help oblique muscles to get attached to the pubic bone; these tendons are mostly affected by a sports hernia.
What Are the Causes of a Sports Hernia?
A sports hernia is caused for the following reasons-
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Any tear or weakness in the muscles around the groin can result in a sports hernia.
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Sudden twisting and bending movements result in a sports hernia.
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Contact sports involve twisting of the pelvis, which also causes sports hernia.
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Muscles and tendons, which are usually involved in sports and fitness training, get torn and stretched, which results in a sports hernia.
What Are the Symptoms of a Sports Hernia?
Symptoms of sports hernia include -
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Severe pain in the groin area.
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Pain during exercise and fitness training.
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A feeling of something not being right in the groin area.
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A soft or hard lump in the groin area.
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A sports hernia leads to an inguinal hernia.
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If not treated, a sports hernia can cause severe pain and other complications.
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Recurrence of pain.
How to Diagnose Sports Hernia?
A sports hernia is difficult to diagnose. The doctor or health professional can ask for many tests, such as.
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Physical Test - After taking the case history doctor will physically check for tenderness and the groin area. The doctor can ask to flex or do sit-ups during the physical tests. Certain movements help in the diagnosis of a sports hernia. Pain on palpation over the pubis area is one major sign of a sports hernia.
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Imaging Test - After doing the physical examination, the doctor will opt for the imaging tests such as an ultrasound, X-ray, and MRI (magnetic resonance imaging) to help make a diagnosis. Ultrasound of the groin area is helpful in the diagnosis of a sports hernia.
What Is the Treatment Plan For Sports Hernia?
It is important to provide conservative treatment for a sports hernia. Most of the cases get fully recovered with conservative treatment. In case the patient does not get conservative treatment, it leads to a surgical approach. Treatment of sports hernia depends upon age, health, medical condition, injury, and sports. Treatment also depends on whether it is an acute or chronic condition. There are many types of treatment for sports hernia present such as -
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Non-surgical treatment or conservative treatment.
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Pelvic floor repair without mesh.
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Laparoscopic mesh repair.
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Modified Bassini technique.
1. Non-surgical Treatment - Non-surgical treatments include rest, physical therapy, and anti-inflammatory medications.
- Rest - For the first week of injury, rest and ice compression will be helpful. It reduces pain and inflammation.
- Physiotherapy - After 14 days of injury, start physiotherapy to improve the strength of the lower abdomen. It will also increase the flexibility of oblique and abductor muscles.
- Anti-inflammatory Medication - To reduce inflammation and pain, anti-inflammatory medications are helpful. Non-steroidal anti-inflammatory (NSAID) drugs like Ibuprofen and Naproxen are helpful.
Non-surgical treatments are usually beneficial for most cases of a sports hernia. It provides relief within four to eight weeks. If, however, the problem continues, then consult with a medical professional for surgical treatments.
2. Surgical Treatment - If conditions of sports hernia do not get better with non-surgical treatment, then it's time to opt for surgical treatments. Surgical treatment involves two types of the treatment plan-
- Modified Bassini Technique - Open surgery or modified Bassini technique is the traditional procedure of surgery. The doctor will give a long incision and open the area to provide the needed surgery. In this technique, transversalis fascia gets sutured with the edge of the inguinal ligament. Pubis was incised to promote healing and suturing of external oblique fascia performed. An incision is made in the inguinal canal, opening the space and separating the spermatic cord. Interrupted sutures on the floor of the damaged inguinal canal.
- Minimal Repair Technique - This technique involves a smaller incision and a smaller opening in the Posterior abdominal wall. In this technique, decompression is performed for a genital branch of the genitofemoral nerve and repair of the transversalis fascia. This technique is beneficial for athletes as it is a minimal repair technique the player gets back to their respective sports earlier. In this treatment, a smaller incision in the external oblique fascia is made. Weak, and the floor of the pelvic gets repaired with sutures. Incision and repair are done in the damaged area of the posterior wall and inguinal ring. Reapproximation of oblique muscles over the spermatic cord gets done.
- Endoscopy Surgery - Endoscopic surgery involves on camera, which is known as an endoscope. One small incision should be made, and enter the endoscope inside the body. It will provide a full view of the abdomen.
- Inguinal Neurectomy - In this process, some small nerves of the groin area will be removed to provide relief from pain.
- Adductor Tenotomy - Sometimes in sports, hernia pain continues to the thighs even after surgery. To relieve this pain, the surgeon cuts the tendons of the thigh muscles.
- Rehabilitation - After surgery, surgical rehabilitation programs should be planned by the doctors; it will provide strength to the muscles and will help athletes return to sports as early as possible.
Conclusion
A sports hernia is a common condition commonly seen in athletes and fitness enthusiasts. Excessive exercise, overuse, repeated movements, injury, and muscle tears are some causes of a sports hernia. It is a painful condition that causes pain in the groin area and difficulty in movement. Early treatment and early diagnosis of a sports hernia are important for early return to the sport or normal routine. Treatment of sports hernia includes physiotherapy, conservative treatment, and surgical treatment.
