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Sports Hernia

See Also
1. Groin Injuries in Athletes
2. Groin Disruption
Pathophysiology
1. Weakening of posterior inguinal wall
2. Results in occult, non-palpable hernia
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
Signs
1. Inguinal Hernia not detectable (affects posterior wall)
2. Difficult to diagnose except during surgery
Differential diagnosis
1. Distal rectus strain or avulsion
2. Groin Disruption (medial and inferior to sports hernia)
Radiology
1. Imaging rules out other diagnoses
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
References
1. Hackney (1993) Br J Sports Med 27:58
2. Morelli (2001) Am Fam Physician 64(8):1405

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 5/10/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.