Hernias hurt. If you or someone you know has ever suffered from one, you know it can cripple even the strongest among us. A standard hernia, also called an inguinal hernia, can make exercise, coughing, and even going to the bathroom painful. They're easy to detect, as you'll see a bulge wherever they occur, typically in the groin.
But What If You're Noticing Serious Groin Pain But Can't Detect A Bulge?
You may have a sports hernia. Though rare in non-athletes, a sports hernia, just like an inguinal hernia, can require surgery to repair, so it's important to understand what you're dealing with, from the initial symptoms to how to begin the healing process. We've got you covered.
What Is A Sports Hernia?
The main difference between a sports hernia and a regular hernia is that a sports hernia isn't actually a hernia. "Sports hernia is bit of a misnomer," says David Krpata, MD, of the Cleveland Clinic Comprehensive Hernia Center. "In the simplest terms, a hernia is a hole or weakness in the abdominal wall that allows things to go through it that should not. This typically results in a noticeable bulge to the patient."
Because there's no bulge, sports hernias can be difficult to diagnose. "In a sports hernia there is no actual defect, which is why we now refer to sports hernias as athletic pubalgia," says Dr Krpta. "Athletic pubalgia is the result of significant strain on the pubic bone where the abdominal muscles and the lower extremity muscles insert."
So What's Actually Going On In Your Body If You Have A Sports Hernia?
"If there is a discrepancy between the strength of the major core muscles, specifically, the rectus abdominis, and the upper thigh musculature there will be excessive strain on the pubic bone which can result in inflammation and/or tearing of the muscles that insert on the pubic bone." saysDr. Krpata.
How Do You Get A Sports Hernia?
The good news is that unless you're an elite athlete, you're not really at risk.
"People who are at greatest risk of developing a sports hernia are high-performance athletes that perform activities that use the core muscles and lower extremities in a high-impact fashion," says Dr Krpata.
The athletes Dr Krpata sees it happen in most includes soccer players, sprinters, football players, and hockey players. "A soccer player aggressively striking a ball or a football player, sprinter or hockey player that goes from a fixed position to a sprint or changes directions quickly," he says.
Additionally, if a sport puts more emphasis on developing the core over the lower extremities (or vice versa) there will be more instability and strain on the pelvis when these high-impact or high-exertion activities are performed, thus resulting in a higher rate of sports hernias.
What Are The Symptoms Of A Sports A Hernia?
"What makes a sports hernia a difficult diagnosis for people is there are no obvious external exam findings like we might find when someone has a bulge in their lower abdomen or groin from an inguinal hernia," says Dr Krpata.
Patients typically notice a nagging groin pain that is worse with physical activity. The strain or tear in the muscles that can result from a sports hernia can be very uncomfortable, limiting an athlete’s ability to perform high-impact or high-exertion activities that stress the pelvis.
What Do You Do If You Think You Have A Sports Hernia?
"If someone is experiencing groin pain associated with athletics, they should first confirm there is no groin bulge associated with pain. If there is, they may have an actual inguinal hernia, for which they should see a general surgeon," saysDr. Krpata.
If you don't find a bulge, give yourself seven to ten days days to see if any of your pain subsides. But if you have persistent, chronic groin pain, you should have an evaluation by a surgeon or sport medicine physician that specializes in chronic groin pain or athletic pubalgia. They'll give you a physical evaluation, which usually involves you doing a sit-up with resistance from the doctor. If this is painful, you most likely have a sports hernia.
"In addition to a physical exam, the physician may obtain imaging of the groin and pelvis with either an ultrasound or MRI to look for inflammation or tears in the muscles inserting on the pelvis," says Dr Krpata.
Your doctor will then work on getting your treatment started.
"Once the diagnosis is confirmed, most treatment will begin with a trial of rest from high-performance athletics and physical therapy for several months. If this fails there are various surgical options that can be considered," says Dr Krpata.
How Do You Prevent A Sports Hernia From Happening Again?
"The best thing any athlete can do to reduce their risk of developing athletic pubalgia is to develop their core muscles and lower extremities equally," Dr Krpata.
Step up your stretching too, focusing on your hip adductors to loosen your groin muscles.
But remember, if you're not an elite athlete, your groin pain is most likely not a sports hernia.
"For the casual athlete, a groin pain associated with athletics is more commonly a minor musculoskeletal strain that does not require a surgical intervention and will get better with rest," says Dr Krpata.