If you get pain in the groin or lower abdomen during or after sports you may have a ‘sports hernia’. Unlike a classical hernia there is no bulge under the skin, because there is no hole in the abdominal wall, and despite what many different doctors will tell you no-one really knows what a sports hernia is.
In reality what is diagnosed as a ‘sports hernia’ is probably a number of different conditions, ranging from strains and tears of the tendons or muscles of the lower abdomen and hip, to inflammation of bones and joints in that region.
The athlete is often given the diagnosis of a groin strain and is told to rest and that the problem will go away which it often does initially. But the pain associated with a true sports hernia always returns once physical activity resumes, leading to chronic pain and much frustration.
How can the doctor tell if I have this if there is no bulge?
Symptoms include pain during sports movements, particularly hip movements, and twisting and turning. This pain usually radiates to the groin skin crease at the top of the thigh muscle region and even the testicles, although it is often difficult for the patient to pin-point the exact location.
Following (but often not during) sporting activity the person with a sports hernia will be stiff and sore. The day after a match, getting out of bed or a car will be difficult. Coughing, sneezing, or sporting activity can cause pain. In the early stages, the person may be able to continue playing their sport, but the problem usually gets progressively worse.
As pain in the groin and pelvis can be related to a number of problems, including injuries to the lumbar spine, the hip joint, the sacro-iliac(rear pelvis / lower back) joint, the abdomen, and the genito-urinary system, diagnosis requires skillful assessment.
The diagnosis is based on the history, what is found on careful physical examination, and on an MRI scan.
The British hernia Society have chose this topic for our meeting in Manchester in 2012