Sports Hernia Symptoms and Treatment

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A painful, soft tissue (muscle, tendon, ligament) injury, such as a strain or tear, that occurs in your groin or lower abdomen area is generally known as a sports hernia.

Most often, it’s the oblique muscles in your lower abdomen that are affected and the tendons that attach these muscles to the pubic bone. Also tendons that attach your thigh muscles to your pubic bone (adductors) can also be stretched or torn.

Interestingly, unlike a traditional hernia there is no hernia in a sports hernia. It does not create a hole in your abdominal wall. This has led to some debate in the medical community around it’s terminology. Also as there is no visible bulge under the skin it means that making a definitive sports hernia diagnosis is difficult.

Often doctors will use the terms inguinal disruption and athletic pubalgia when referring to a sports hernia.


What causes a sports hernia?

A sports hernia is common in sports that require sudden changes of direction and intense twisting movements and result in a large amount of stress being placed on your groin and pelvic region.

Sports that involve planting your feet, kicking, turning and twisting such as hockey, football, tennis, wrestling, distance running and, rugby are more likely to cause a sports hernia. If you participate in these sporting activities on a frequent basis you may overload your tendons and bones in the pubic symphysis (cartilaginous joint) and this may result in a sports hernia.  


Symptoms of a sports hernia

You can expect the following symptoms if you have a sports hernia:

Pain in your groin

Pain in your lower abdomen

Pain in the testicle (men)

You will usually feel severe pain in your groin area when the injury occurs. Typically, this pain will be relieved with rest but it returns when you partake in sports activities again especially those that involve running, twisting and turning. Coughing and sneezing may also increase your pain.

Over time, without treatment your pain may become chronic and disabling and your sports hernia may lead to an inguinal hernia.


How is a sports hernia diagnosed?

If you suspect you have a sports hernia you should visit your doctor for diagnosis at your earliest convenience. They will look at your medical history, perform a physical examination and they may refer you for diagnostic tests. MRI’s are commonly used to confirm a sports hernia.

Sports hernias have historically been misdiagnosed as a groin pull or strained abdominal muscle. Here at Mount Stuart Hospital we have highly trained radiographers who regularly perform MRI scans and will be able to confirm your diagnosis.


Treatments for a sports hernia

Initially resting from activity, ice, non-steroid anti-inflammatory medications and, physiotherapy may help alleviate your symptoms.  Your physiotherapist will be able to give you advice and an exercise plan to strengthen and improve flexibility in your pelvic, abdominal and inner thigh muscles that may be effective in relieving your pain.

Sometimes a cortisone injection is recommended to relieve pain and swelling if you have persistent symptoms.

If these non-surgical treatments are not effective in relieving your symptoms of a sports hernia in the long term or when you resume sports activities, then your general surgeon may recommend surgery to repair the weakened area and torn tissues of your abdominal wall.

Surgical repair can be performed by open or minimally invasive surgery. Most often, surgeons use endoscopy which requires small incisions to insert an endoscope to see inside your abdomen and perform the repair. Your general surgeon will discuss the surgical procedures that best meets your needs.

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