Dr Imtiaz Ahmed Wani Commonly
Sports hernia is a least diagnosed hernia presenting as exercise-related groin pain. In laymans term, sports hernia or athletic pubalgia is misdiagnosed commonly as a muscle strain in groin. An injury to core muscles of groin is considered to occur in this hernia.
There is stretching of core muscle beyond its limit with tearing of muscle fibers usually at tendons. Soccer, rugby, ice hockey, martial arts are commonly involved sports where there is risk for sports hernia.
These sports involve high velocity, rapid acceleration with repetitive twisting and turning, cutting and kicking having predilection for athletic pubalgia.
A sudden tearing sensation just giving out way is felt at the time of injury is recalled by few athletes. Pain persists for weeks to months, with accompanying stiffness.
This pain gets aggravated by sudden coughing, sneezing, acceleratory, declaratory ,rotatory and kicking movements of groin. There is a paucity of findings on physical examination.
No grossly visible groin hernia is seen. An expansile cough impulse diagnostic of hernia is lacking. A subtle bulge on skin surface can occasionally be seen over the involved inguinal region.
Points of tenderness may be felt on groin and thigh. A resisted abdominal ‘crunch’ (Valsalva manoeuvre) may evoke tenderness. Imaging have obscure role in diagnosis of Atheletic Pubalgia.
In a minority of cases there is an objective surgical finding of non-acute conjoint tendon tear or external oblique aponeurosis tear producing dilatation of the superficial inguinal ring.
A compression of the nerve is see in some cases explaining pain. Conservative measures like rest, limiting athletic activity and exercises that impart strength to pelvic muscles may heal otherwise this might run into career-ending’ injury. Anatomical repair of groin wall or mesh repair is used if conservative methods fail.
The author is a surgeon specialist; DHS, Kashmir and can be reached at email@example.com