Is It a Sportsman’s Hernia? (2024)

A sportsman’s hernia, despite its misleading name, is not your typical hernia. Often overlooked and misunderstood, this condition affects athletes across a wide range of sports, causing persistent groin pain that can be debilitating if left untreated.

Football players, Rugby players, runners, and athletes who rely on quick turns, sprints, and sudden changes of direction are especially at risk. Yet, despite its prevalence, many athletes push through the pain, unaware of the long-term damage they may be doing.

The condition, also known as athletic pubalgia or inguinal hernia, presents a unique challenge for athletes and medical professionals alike. Unlike a traditional hernia, a sportsman’s hernia doesn’t create a visible bulge, making it difficult to diagnose without expert knowledge. What starts as a subtle pain can quickly escalate, leaving sports people side lined or unable to train.

What Causes A Sportsman’s Hernia?

A sportsman’s hernia can sometimes strike suddenly, but in most cases, it develops gradually, getting worse over time as athletes continue to push their bodies to the limit. This injury builds up as athletes engage in explosive movements like sprinting, twisting, kicking, and quick direction changes. These high-intensity actions put repeated strain on the groin and lower abdominal muscles, leading to small tears that slowly accumulate. If you’re involved in high-energy sports, you’re already in the danger zone.

If you play football, rugby, hockey, tennis, or American football, you’re no stranger to high-speed direction changes, quick sprints, and powerful kicks. But these same movements are what make sportsman’s hernia such a common injury in these sports. Take football players, for example. They’re constantly twisting and turning and launching powerful shots—perfect conditions for a sportsman’s hernia to develop. The rapid deceleration and acceleration paired with constant lateral movements can tear the muscles around the groin and lower abdomen.

Symptoms and Diagnosis

Recognising a sportsman’s hernia can be tricky because the symptoms often mimic other groin injuries. What begins as a slight discomfort can gradually escalate into debilitating pain that interferes with exercise.

At first, the pain might appear mild, showing up only after a hard training session or game. You might notice discomfort when sprinting, twisting, or making quick turns. But as time goes on, the pain becomes more persistent, creeping into your training sessions and eventually affecting daily activities. What begins as soreness after physical activity can turn into a sharp, localised pain during movements like accelerating, kicking, or even simple actions such as coughing or sneezing.

Common Symptoms Experienced by Athletes

  • Chronic Groin Pain: This is the hallmark of a sportsman’s hernia. The pain typically starts in the groin area and may radiate to the lower abdomen or inner thigh.
  • Pain During Specific Movements: Activities that require high-impact movements—such as sprinting, turning, twisting, and kicking—trigger sharp, stabbing pain. Even coughing or sneezing can be painful.
  • Radiating Pain: Athletes often report discomfort that extends to the inner thigh (adductor area) or the lower abdomen, especially near the rectus abdominis muscle.
  • Worsening Over Time: Without proper treatment, the pain progressively worsens, affecting not only performance but also simple day-to-day activities.

Clinical Examination and Diagnosis

Diagnosing a sportsman’s hernia can be challenging because there’s no visible lump like a traditional hernia. However, a skilled clinician can often detect the condition through a detailed clinical examination. Key signs include a dilated external inguinal ring, indicating a potential weakness in the inguinal canal. This subtle finding, when combined with the patient’s history and symptom pattern, can help guide the diagnosis.

While imaging isn’t always necessary, it can help confirm the diagnosis in some cases. Many patients who come to us have often already undergone MRIs, CT scans, or ultrasounds, only to be told that they do not have a hernia. However, these tests often fail to identify a sportsman’s hernia simply because the right investigation wasn’t performed by a specialist trained to recognise the condition.

Unlike traditional hernias, a sportsman’s hernia doesn’t typically present with a visible bulge. Standard imaging techniques will often miss this nuance, but experienced radiologists using ultrasound will usually detect an inguinal hernia.

Treatment for Sportsman's Hernias

When it comes to managing a sportsman’s hernia, the treatment approach is critical to ensuring a successful recovery and return to sport. While non-surgical options may seem appealing, most cases ultimately require surgical intervention to address the underlying issues effectively.

Many athletes initially turn to non-surgical treatments in hopes of alleviating their pain through rest, physiotherapy and medication. While some individuals may experience temporary relief, these methods often fall short of resolving the underlying condition. Non-operative treatments, such as anti-inflammatory medications and physiotherapy aimed at core and adductor strengthening, can provide short-term comfort but rarely address the root cause of the injury. Unfortunately, the chronic nature of a sportsman’s hernia means that athletes frequently find themselves unable to return to their sport without experiencing recurring pain.

Surgical Treatment

Given the limitations of non-surgical options, surgery is often the most effective and reliable solution for managing a sportsman’s hernia. Surgical intervention aims to repair the torn structures in the groin area, restore stability, and alleviate pain. The majority of athletes diagnosed with a sportsman’s hernia will require surgery for a successful recovery. There are two primary surgical approaches:

  • Open Repair: This technique involves making a larger incision to directly access and repair the affected tissues. Open repair has been shown to provide more predictable outcomes and greater success in addressing the underlying issues of a sportsman’s hernia.
  • Laparoscopic Repair: This minimally invasive technique uses small incisions and specialised instruments to repair the injury. While laparoscopic treatment can yield excellent results for some patients, it may not fully address all aspects of the injury. For instance, while it effectively repairs the posterior wall weakness, it may overlook issues such as the tear in the fascia of the external oblique.

Recovery from surgery typically follows a structured timeline. Most athletes can expect to resume their competitive activities within 4 to 6 weeks, provided they adhere to the rehabilitation guidelines and listen to their bodies.

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Am 47 years old and had a car accident 13 years ago leaving me with a plate in my wrist , nerve damage and Thoracic outlet syndrome. I had spent thousands on physio with little to no joy of managing my pain and discomfort. I could not sleep through the night , I would grind my teeth, I couldn’t get back in to a pool to swim , no one was able to touch my wrist. I didn’t let people close because I did not want people to know how much I struggled. I just couldn’t imagine growing older and coping with it all.Lucy has changed all this , she is amazing , I went swimming in the sea within 3 months of seeing her . I can let someone hold my hand , I sleep, never felt poorly after my appointments. Lucy as gave me my life back , hope , took away fear and anxiety and that ground hog day feeling.Listen to Lucy and you should go Far.Great team , great company have a lot to offer.

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After several knee dislocations, I was considering surgery on my knee. However after a block of sessions with Joe, I am now the strongest I have been and no longer need surgery. I started only being able to walk for 15 mins pain free and now can run and walk pain free. The whole team are lovely and welcoming and it’s been a fantastic experience - would hugely recommend!

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Could not speak highly enough of the team for how much they helped me. I reached out to them around a month post elbow surgery with very limited movement capability in my elbow. My injury was given a full review, after which the team put together a full exercise program for me to follow which allowed me to continue to make progress in between appointments. Even the specialist surgeons at the hospital commented on how quickly I was progressing in terms of regaining movement, all thanks to the team at Sharp. I even received scar tissue treatment as part of the sessions to help reduce sensitivity, which was above and beyond what other physio’s would generally do. Would definitely recommend!

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Could not recommend Sharp Physiotherapy enough! After my hip arthroscopy my hip didn’t feel right and Joe and Lucy agreed. The team helped me find another surgeon for a second opinion and the surgeon agreed my hip was not right. I underwent another arthroscopy to sort out the issues from the first surgery and Lucy worked alongside the surgeon and treated me weekly to help with my hip. I then underwent a major hip surgery and then got an infection and Lucy was there to help with my rehab and treatment. I could not recommend Lucy enough she has helped me through so much, treating me, being extremely patient, understanding but also very knowledgeable. Lucy has been there for me and my family every step of the way! Lucy has worked alongside my surgeon to create a successful rehab plan. The team have managed to fit me in for appointments when I’ve been struggling with pain. I would not go anywhere else for Physiotherapy and can not recommend Lucy and Sharp physio enough!

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Sharp Physio are the absolute best! I've tried several before but never stuck with it as they never solved the problem.Lucy, Joe and the whole team want to get to the root of the problem, sort that out, then work on building you up from there.I've referred several people now and they have all had great experiences for different ailments/injuries. I honestly wouldn't look anywhere else! Your'e getting local physio's who have worked at Olympic & pro sport levels.The premises are lovely too so you feel welcome and looked after but not in a hospital type environment.😊

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I had tried many different practitioners over the years to help treat my headaches and neck pain with no one seeming able to help. Having seen a physiotherapist for 6 months with no results and then finally going to my gp who seemed clueless, I decided to give Sharp Physiotherapy a go. I was skeptical and unsure that they could help after many years of unsuccessful treatments. I had a telephone consultation and session with Sam T who put me at ease telling me that he was confident he could help. After my first session my headaches were instantly better, I was not expecting that at all. For years I have been in pain which has taken over my life and now I feel like my old self again and more importantly pain free! Sam seems to know where to target the pain and release the tension in my head and neck. I would not hesitate to recommend Sharp Physiotherapy to anyone, they are a fab team and very helpful.

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Is It a Sportsman’s Hernia? (2024)
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