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Sportsman's hernia is a condition characterized by chronic inguinal pain. Although a complete hernia cannot be detected, it can be described as a weakness of the posterior wall of the inguinal canal or often as a muscle or tendon tear in the inguinal canal. It is an important problem frequently seen in professional athletes.
In scientific terminology, it has many names such as inguinal disruption, sportsman's hernia, osteitis pubis, pubic symphysitis, athletic pubalgia, inguinal pain syndrome, or point hernia. There is no consensus on the name.
Who is it seen in?
Elite and young athletes often come to the doctor with this pain. It is especially common in athletics, football, weightlifting, tennis and cycling. Normal walking usually does not cause pain, but excessive stretching increases the pain.
In order to make the diagnosis, first of all, it is necessary to listen to the complaints well, and after a detailed physical examination, especially Magnetic Resonance Imaging (MRI), it is often necessary to look for a possible hernia or muscle tear. MRI is very useful in revealing pathologies that may cause pain in the groin such as osteitis pubis, adductor tendonitis, and labral tear.
How does it manifest?
Sportsman's hernia always manifests itself with inguinal pain. The pain worsens with physical activity and disappears at rest. No swelling or fullness can be noticed on physical examination.
The diagnosis is made clinically if at least three of the following five symptoms are present:
How is it treated?
Chronic groin pain should be treated by an organized team. Rest and physiotherapy, non-steroidal anti-inflammatory drugs, local anesthetic and steroid injections can be done initially. Orthopedic pathologies should be tried to be revealed, if necessary, a competent orthopedic physician should be asked for evaluation.
Surgery is the last option. But it may be necessary for persistent ongoing pain after all other treatments have failed. The surgery is performed by open surgery or by a laparoscopic approach, strengthening the weak inguinal canal with a synthetic patch. In some cases, it may be necessary to loosen the conjoint tendon in the groin. After the operation, rest and physiotherapy are applied.
Recovery after inguinal hernia surgery does not take long, it is a daily procedure. Patients are encouraged to mobilize immediately after surgery and not lift heavy objects for at least a month. A return to full sports activities is allowed within 4-6 weeks.
Osteitis Pubis
This is an athlete's diseasecharacterized by inflammation around the pubic bone. There is pain in the groin area, especially over the symphysis pubis. Pain is detected as tenderness over the pubic bone during clinical examination. It can also be experienced by coughing or sneezing. Diagnosis is made by MRI or scintigraphy.
Treatment includes rest, pain relievers, physiotherapy, dynamic stabilization techniques, and injection therapy. Sometimes a combination of these treatments is necessary.
Adductor tendinitis
Edema, inflammation or tears occurring in the tendons of this triple muscle group, which is located on the inner part of the thigh and enables the inward movement of the leg, shows the pain in the deep inner part of the groin. Diagnosis is made by MRI.
In treatment; rest, adductor physiotherapy, injection therapy, PRP, prolotherapy treatment are tried. If unsuccessful, adductor tenotomy is an option.
