Diagnosis & Treatment of Sports Hernia

The diagnosis of a Sport Hernia is based on:
1. The patient’s history
2. Clinical signs
3. Magnetic Resonance Image (MRI) Test

The most notable clinical signs:

1. Dilation of the superficial inguinal ring on the affected side,
which can be palpated by the examining doctor when the scrotum is inverted with the little finger.
2. Pain on coughing and sneezing
3. Pain while sitting up and squeezing the legs together

Most common findings during surgery are:

1. Torn external oblique aponeurosis
2. Tear in the conjoint tendon
3. Conjoint tendon torn from pubic tubercle
4. Dehiscence between conjoined tendon and inguinal ligament
5. Tear in the fascia transversalis
6. Abnormal insertion of the rectus abdominis muscle
7. Tear of the abdominal internal oblique muscle from the pubic tubercle
8. Entrapment of the ilioinguinal nerve or genitofemoral nerve
9. These lesions may occur at the same time
10. Also, many athletes have weakness or tearing of the adductor muscles or labral tears of the hip
11. When the adductor muscles are tight post injury, that can be enough to trigger symptoms.

Treatment

The first conservative treatment option should be to restore normal motion after the adductor has begun to heal (usually 6–8 weeks post injury).

Sleeping in a prone position with the hip on the affected side flexed and externally rotated
can help in some athletes.

Some believe it is the most common cause of chronic groin pain in athletes

Conservative therapy like gentle stretching and a short period of rest may temporarily alleviate the pain, but definitive treatment consists of surgical repair followed by a structured rehabilitation

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References
1.^ a b c Meyers, William C.; Yoo, Edward; Devon, Octavia N.; Jain, Nikhil; Horner, Marcia; Lauencin, Adam; Zoga (October 2007). “Understanding “Sports Hernia” (Athletic Pubalgia): The Anatomic and Pathophysiologic Basis for Abdominal and Groin Pain in Athletes”. Operative Techniques in Sports Medicine 15 (4): 165–177. doi:10.1053/j.otsm.2007.09.001. ISSN 1060-1872. Accessdate used without URL
2.^ Omar IM, Zoga AC, Kavanagh EC, et al. (2008). “Athletic pubalgia and “sports hernia”: optimal MR imaging technique and findings”. Radiographics 28 (5): 1415–38. doi:10.1148/rg.285075217. PMID 18794316.
3.^ Ahumada LA, Ashruf S, Espinosa-de-los-Monteros A, Long JN, de la Torre JI, Garth WP, Vasconez LO. “Athletic pubalgia: definition and surgical treatment”. Ann Plast Surg 2005;55(4):393-6. PMID 16186706
4.^ “Sports Hernia”. Orthopedics.about.com. 2005-12-16. Retrieved 2011-11-13.
5.^ “Pence and Polanco have MRIs for sports hernia”
6.^ Joesting DR. “Diagnosis and treatment of sportsman’s hernia”. Curr Sports Med Rep 2002;1(2):121-4. PMID 12831721
7.^ a b sports/162 at eMedicine
8.^ Fredberg U, Kissmeyer-Nielsen P. “The sportsman’s hernia–fact or fiction?” Scand J Med Sci Sports 1996;6(4):201-4. PMID 8896091
9.^ 53477314 at GPnotebook
10.^ “The Gilmore Groin & Hernia Clinic”. Retrieved November 24, 2006