Surgery Book


Sports Hernia

Aka: Sports Hernia, Athletic Pubalgia
  1. See Also
    1. Groin Injuries in Athletes
    2. Groin Disruption
    3. Hip Pain
  2. Pathophysiology
    1. Weakening of posterior inguinal wall
    2. Results in occult, non-palpable Hernia
  3. Symptoms
    1. Chronic deep Groin Pain in athlete
    2. Insidious onset with gradual worsening
    3. Radiation
      1. Inguinal ligament
      2. Perineum
      3. Rectus muscles
      4. Testicular Pain (30%)
    4. Provocative
      1. Increased intra-abdominal pressure (Valsalva Maneuver, coughing, sneezing)
      2. Resistance Training of abdominal muscles
  4. Signs
    1. Inguinal Hernia not detectable (affects posterior wall)
    2. Difficult to diagnose except during surgery
  5. Differential diagnosis
    1. See Hip Pain Causes
    2. Distal rectus strain or avulsion
    3. Groin Disruption (medial and inferior to Sports Hernia)
  6. Radiology
    1. Imaging rules out other diagnoses
  7. Management
    1. Conservative therapy trial for 2-3 weeks
    2. Surgical exploration if conservative therapy fails
      1. Successful return to sport in 90% of cases
  8. References
    1. Schleihauf (2019) Crit Dec Emerg Med 33(5): 19-28
    2. Hackney (1993) Br J Sports Med 27:58-62 [PubMed]
    3. Morelli (2001) Am Fam Physician 64(8):1405-14 [PubMed]

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