Significant interest has been generated in the sports world on this topic. Several articles, the majority of which are from Europe and Australia, have appeared in the literature. The term “sports hernia” (or sportsman’s hernia) is a confusing diagnosis, including a hodgepodge of underlying pathologies and associated treatments.
Groin pain among professional athletes has an estimated incidence of 0.5 to 6.2% and is common in sports involving side to side movement, cutting, quick acceleration and deceleration, and sudden directional changes. Nearly 85% of my patients have responded to a conservative, non-surgical approach. Only 15% of my patients have undergone surgical repair.
Some facts about sportsman’s hernia
- It is not a true hernia, and there is no sac with contents like in a traditional hernia.
- All patients with sportsman’s hernia have pain, sometimes disabling, whereas a traditional hernia is painless unless it is incarcerated.
- Both conditions can co-exist, so surgery needs to be tailored.
- One does not have to be a sportsman to have a sportsman’s hernia. The majority of my patients who have undergone surgery for sportsman’s hernia have sedentary jobs and some are housewives.
- Surgery for these two types of hernia is different. There are very few surgeons in the country who have taken interest and specialized in surgery for sportsman’s hernia.
Understanding the concept that somatic pain of enthesopathy/periosteitis can manifest several inches away from bony attachments, thus mimicking visceral pain in the groin, lower abdomen and pelvis, is helpful.