Sports Hernia (Athletic Pubalgia) - Symptoms and Treatment

 

Sportsman’s hernia has been a hot topic of discussion since Indian Cricketer K.L Rahul sustained the injury. Let’s know more in detail about the condition and role of physiotherapy in preventing the same.

                                                 Image Credits- The Economic Times

Sportsman’s hernia is a pain syndrome of the lower abdomen and groin. It is a painful, soft tissue injury that occurs in the groin area. The reason why it is defined as sportsman’s hernia is that it was originally seen in sportsmen. It most often occurs during sports that require sudden changes of direction or intense twisting movements and increased pelvic rotation that would lead to painful groin.  However, it may also develop in people who do not do sports.

What is it commonly known as….

Some common terminologies for sports hernia are athletic pubalgia, sportsman’s hernia, Gilmore’s groin, pubic inguinal pain syndrome-PIPS, sportsmen’s groin, footballer’s groin injury complex, hockey player’s syndrome, athletic hernia

What structures are affected due to sports hernia?

The soft tissues most frequently affected by sports hernia are the oblique muscles in the lower abdomen. Especially vulnerable are the tendons that attach the oblique muscles to the pubic bone. In many cases of sports hernia, the tendons that attach the inner thigh muscles to the pubic bone (adductors) are also stretched or torn.

                                           Image credits- OrthoInfo- AAOS

What are the common symptoms which any athlete can look for?

1.         Exercise-related groin pain
2.      Pain is typically localized on the lower outer end of the rectus abdominis muscle (belly muscle)
3.      Increased with sudden acceleration, turning, twisting, hitting, changing directions
4.      Sitting and getting up, coughing and sneezing 
5.      There is a feeling of hardness in the groin and difficulty getting up from bed
6.      The pain disappears upon resting for a while and then it re-starts immediately and attains the peak when resumed the sports activity at full force

Examination by expert reveals-

1.          Sensitive groin area, in proximity of painful area
2.         A slight bulge may be seen on the skin surface while the patient is standing

Diagnosis cannot be only dependent on the signs and symptoms but the patient’s history and physical examination

How to treat the condition?

                                       

Physiotherapy works on correcting the imbalance of hip region by:

1.      . Increasing hip mobility
2.      . Improving hip rotations movements
3.       . Strengthening abdominal and core, hip muscles

These factors help in controlling the rotation movements and pelvic stability which are proven to be the effective in preventing the occurrence of initial or recurrent damage in sports hernia.

In many cases, 4 to 6 weeks of physical therapy will resolve any pain and allow an athlete to return to sports.

Surgical Treatment

After the 6 weeks of non-surgical rehabilitation if the pain comes back after resuming the sports activities, one needs to consider surgery as a treatment option.

Following the surgical procedure most athletes are able to return to sports after 6 to 12 weeks.

 - Dr. Aditi Dole (PT)

Sports Physiotherapist

Team Rehab Station Pune