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Sports Hernia

A sports hernia is a core muscle injury commonly seen in athletes engaging in dynamic sports. While it doesn't typically involve a visible bulge, a sports hernia causes groin pain, especially during activities like twisting or sudden changes in direction. If you think you may have a sports hernia, seek medical treatment to alleviate pain, prevent further complications, and enable a return to regular physical activity. Learn more about sports hernia.

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What Is a Sports Hernia?

The groin syndrome known as sports hernia, or athletic pubalgia, is actually not a hernia at all, but rather a core muscle injury. Specifically, it's an injury to the soft tissue (muscles, ligaments, or tendons) of your lower belly or groin.

Sports hernia isn't a true hernia because there's often no visible bulge. Rather, it's a strain or tear that causes groin pain.

It's not the most common athletic injury, but it is most common among athletes in twisting sports, particularly young male athletes. Just 3 to 15% of cases are females.

While athletic pubalgia is the official medical term, the more commonly used name among patients is sports hernia.

What causes a sports hernia?

People usually get a sports hernia because of physical activity.

Twisting and sudden changes of direction are the main causes of this painful core muscle injury. Movements such as planting your feet and twisting sharply can cause a tear in the soft tissue around your groin.

Your oblique muscles, or the muscles on either side of your lower abs, are most vulnerable for a sports hernia.

What are the risk factors and complications of a sports hernia?

Playing intense contact sports such as ice hockey, soccer, wrestling, and football put athletes at greater risk for sports hernia.

A sports hernia can later lead to a more serious, and more typical, groin hernia.

This happens when the belly pushes against the weak and strained soft tissues. It then forms a visible bulge.

If the pain persists, it's crucial to get sports hernia treatment. This core muscle injury can prevent you from playing the sport you love.

Untreated, athletic pubalgia can also lead to chronic pain. This can make it harder to engage in and enjoy your routine activities.

How can I prevent a sports hernia?

Proper strength training and conditioning can help prevent core muscle injuries and groin syndromes like sports hernia. Core strengthening exercises like planks, crunches, yoga, and even Pilates are especially helpful.

Athletes in contact sports and those that require quick pivoting and twisting should be aware of staying light on their feet during practice and play. Sudden changes in direction without proper form is one of the main causes of sports hernia.

Learn about sports performance, just one of UPMC's preventive services for this injury.

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What Are the Symptoms of a Sports Hernia?

A sports hernia often causes pain in your groin or lower abs. When you rest, the pain may go away.

But for many, the pain will come back once they resume activities.

One way to know if the groin pain is a sports hernia is that sit-ups will be especially painful. Any movements where you're twisting your trunk will also cause you to wince.

If this describes the type of pain you have (and when you have it), seek sports hernia treatment. There are many ways UPMC Orthopaedic Care can help.

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How Do You Diagnose a Sports Hernia?

During an exam for sports hernia, you can expect your doctor to do a few things:

  • Ask you about when you first felt the pain. What movement were you doing, or what sport were you playing, when the problem began?
  • Check to see if you have tenderness in your groin area or lower abs.
  • Ask you to do a sit-up, or to use your abdominal muscles to flex against resistance. If you have a core muscle injury like a sports hernia, this will be painful.
  • Possibly order x-rays or MRI scans to confirm the diagnosis.

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How Do You Treat A Sports Hernia?

With a nationally recognized orthopaedics program, UPMC has the expertise you need to manage your sports hernia. Our team can diagnose, treat, and help you rehab, all inside one program.

The goal of sports hernia treatment is to get you back to doing the things you love, pain free.

Your doctor may suggest one or more of the following treatments:

Resting and reducing activity

Resting for 7 to 10 days and icing the painful area in your lower abs or groin can help relieve pain. Do your best to avoid activities that make the pain worse.

For some people, sports hernia can heal on its own with rest.

Taking anti-inflammatory drugs

Your doctor may suggest taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. NSAIDS help reduce swelling and pain.

You can buy most NSAIDS over the counter. Stronger ones need a prescription.

Physical therapy

Your doctor may prescribe physical therapy to help you strengthen your core muscles. Strengthening the muscles around your injury can help you heal.

Often, 4 to 6 weeks of PT is enough to help you return to your daily routine without pain.

Shots to relieve pain

For severe or prolonged pain, you doctor may suggest a cortisone shot.

Cortisone is a powerful and effective steroid that reduces inflammation and relieves pain.

Sports hernia surgery

If your pain continues after trying other treatments, you may want to think about having surgery. Sports hernia surgery can repair your torn tissues.

There are two types of sports hernia surgery:

  • With traditional, the surgeon makes one long cut in your abdomen. This type takes a bit longer to heal and has higher risks of infection than endoscopic surgery.
  • With endoscopic, the surgeon makes a few small cuts and uses a camera (an endoscope) to see the tissue to repair.

Your surgeon may also do an inguinal neurectomy to relieve pain. This involves carefully cutting the inguinal nerve — a small nerve in the groin. Not everyone needs this treatment.

After surgery, you and your doctor will create a rehab plan that helps you get stronger. Most of the time, athletes can resume their regular activity 6 to 12 weeks after surgery.

Outcomes for sports hernia surgery are good.

More than 90% of people who have nonsurgical treatment, then surgery, are able to return to sports.

Why choose UPMC Orthopaedic Care for sports hernia?

U.S. News and World Report ranks us as one of the best orthopaedic programs in the nation.

Here are just a few of the reasons why:

  • Experts in sports medicine. As experts in preventing and treating sports-related injuries, we know the problems athletes face. We know you want to stay active and keep playing the sport you love. We use the most advanced treatments and therapies to make that happen.
  • Interconnected services. We offer one place for all your orthopaedic needs. Our doctors, nurses, and physical therapists provide complete care — from diagnosis through recovery and rehab. We coordinate all of your care, so all you have to focus on is getting better.
  • Many ways to rehab. We have more than 70 locations throughout the region where you can go for outpatient rehab.
  • Unmatched in research. We are leaders in the western Pa. region for NIH-funded orthopaedic research and clinical trials. We're always seeking better ways to diagnose and treat conditions such as sports hernia.
  • Specialty programs. With specialists in each type of orthopaedic injury and condition, we have the experts to cater to your specific needs. The Hip Preservation Program at UPMC Orthopaedic care specializes in hip problems from the mild to the severe, including sports hernia.

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