What is a Sports Hernia?
A sports hernia also known as athletic pubalgia, Gilmore’s groin, and slap shot gut, is an uncommon, but often missed cause of groin pain in high level athletes. It is poorly understood and poorly defined in the medical community. It is also very difficult to identify based on history and physical exam of an athlete with groin pain. The name sports hernia is a misnomer as well because there is no discernable hernia (or protrusion of abdominal cavity contents) present in this condition.
Who gets a Sports Hernia?
Sports hernia is a diagnosis almost exclusively of very high level male athletes. It is a common diagnosis in athletes with chronic longstanding groin pain that does not respond to a very long (often years) course of non-operative treatment. Typically athletes involved in repetitive twisting sports such as ice hockey, soccer, Australian rules football, and tennis. Recent well known athletes such as Donovan McNabb of the Philadelphia Eagles, Tomas Holmström of the Detroit Red Wings and Jeremy Shockey of the New Orlean’s Saints have all had surgery to repair a sports hernia.
Hockey player’s syndrome otherwise known as “slap shot gut” is a variant of a sports hernia unique to high level ice hockey athletes. It is due to repetitive twisting motions of the torso common in hockey such as with taking a slap shot. The result is a tearing over time of the covering (fascia) lining the lower abdominal oblique muscles. It is most often seen on the side opposite the player’s forehand slap shot. There may also be an associated inguinal nerve irritation. This may explain why the pain seen in hockey player’s syndrome often travels to the scrotal region. The treatment involves a repair similar to that in many sports hernias.
This is in contradistinction to a typical hernia where there is a protrusion of abdominal contents such as fatty tissue or bowel through a well-defined defect in the inguinal canal of the groin. Despite this, the name sports hernia has persisted because many of the surgical treatments are similar to that of a typical hernia.
How does a Sports Hernia happen?
Repetitive twisting and shear forces encountered during high level athletics can lead to injury of the lower abdominal wall. This may be exacerbated by the typical strong thigh adductors (muscles that bring the thighs closer together) compared with often weaker lower abdominal muscles.
How is the diagnosis of a Sports Hernia made?
Athletes typically complain of a longstanding history of pain in the inguinal (groin) region. They often complain simply that their performance has deteriorated below a satisfactory level. Often the pain is not present during periods of inactivity, rest or periods away from athletic involvement. However, symptoms classically reappear with return to the athletic activities responsible for the injury in the first place. The pain may travel, or radiate, from the groin into other areas like the testes, lower abdominal musculature and the inner thigh region. The pain is often exacerbated by coughing or sneezing as well as by athletic movements like sit-ups and kicking motions.
On physical examination, there may be groin pain to palpation in the region of various structures along the wall of the lower abdomen. These may include anatomic regions like the inguinal ring and canal as well as the pubic symphysis (central fusion point of the 2 halves of the pelvis in the front/center of the pelvic region). There is however no classic inguinal hernia detectable on exam as there is no defect in the inguinal wall and no intra-abdominal contents that herniated through. Patients will have pain with a resisted abdominal contraction such as with a sit-up. This may be worsened by doing so with the thighs squeezed together (adduction).
What else can masquerade as a Sports Hernia?
There are many possible causes of groin pain in athletes. Sports hernia is a rarely confirmed diagnosis, and therefore it is extremely important to be sure that other conditions are not the source of an athlete’s symptoms. Some conditions that can mimic a sports hernia include:
● Pulled Groin Muscle (Hip Flexor/Adductor Strain)
● Hip impingement
● Inguinal hernia
● Osteitis pubis (inflammation of the pubic symphysis: joint connecting the 2 halves of the pelvis)
● Stress fracture
● Snapping hip
● Labral tears
● Nerve entrapment
● Avulsion fractures in teenagers and children
● Non-orthopaedic causes of pain such as those involving the genitourinary system
How is a Sports Hernia treated?
Special emphasis should be given to core stabilization exercises as well as countering any imbalance between the various hip, pelvis and thigh musculature. An evaluation by a highly specialized physical therapist is necessary to help the athlete along with their rehab program and identify and treat these imbalances. A good example to improve this imbalance is Hip Abductor Stength
For more information on treatment including several other instructional core strength exercises as well as hip strengthening videos, please click the following link. Surgical information is also provided in this link
What is the prognosis for recover?
About 90% of athletes who have surgery for a sports hernia are able to return to competition at the same level or higher to where they were prior to their injury. The timing of return to competition for laparoscopic surgery is typically within 6 weeks while for open surgery it is usually a few months to as long as 6 months.
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Hiatal hernia- Severe Abdominal Pain & Pressure (Please ONLY serious answers)?
I was diagnosed with a hiatal hernia in 2002. I’m only 24 yr old. I have been having alot of burning pain/nausea for years. It radiates above my stomach & between my ribs. Within the last year i have been experiencing severe pain & pressure in my stomach that comes & goes. Yesterday i had the worst pain yet. My stomach started cramping really bad with sharp pains.. Hurt so bad i could barely walk. When i laid down i had so much pressure pushing up that i had shortness of breath & it was hard to breathe . I took a nexium & zantac & about 2 hours later the pressure was relieved but still had excruciating pain in my stomach & between my ribs. Then all of a sudden i got the chills really bad & was running a fever; Tylenol brought fever down in the next hour. I started to go to the ER, but decided to wait it out. Today i woke up with really bad nausea & the same stomach pain. I’m not looking to be diagnosed, just wondering from others who have a Hiatal Hernia, if this has happened to them.
You need to go to the doctor that’s been treating you for this condition…you may have a bowel obstruction…
Monitor your temperature…if it’s elevated, then go to the ER…a bowel obstruction is nothing to fool with. This is serious business.
Just because you have a hiatal hernia DOES NOT MEAN you should have fever…something else is going on for sure…
Mark Hyman, MD: 3 Simple Steps to Eliminate Heartburn and Acid Reflux
In this week’s blog, I’ll explain why, but more importantly, I will outline a simple 3-step approach that will help you prevent acid reflux and heartburn by treating its underlying causes.
From time to time we will all experience stomach pain of some sort. However, when your abdomen pain gets too severe and it starts to be sharp abdominal pain, then you will have to take action!
Good Rule of Thumb: The Internet can provide valuable information. Research leads to knowledge and knowledge could mean less visits to the doctor! Be informed before seeing your Doctor…
1. Knowing how to describe and locate the pain is the first step in diagnosing the problem. Lie on your back and push firmly on your stomach where you think you feel pain. Use the tips of your fingers to do this. Breathe normally while pushing with one hand in areas where you feel tenderness or anything out of the ordinary, such as a …Read More
2. If you are experiencing discomfort when urinating, or tenderness in your bladder area, this could be either a bladder infection, a urinary tract infection (UTI) or possibly a sexually transmitted disease (STD). You should…Read More
3. Record how often you are experiencing symptoms, the duration and the exact locations of these abdominal discomforts. If you experience sharp pains, bleeding, or numbness, you should…Read More
4. It would also be a good idea to bring any medications that you are taking when you see your physician. Sometimes, certain medications could cause cramping, and could be a side-effect of some of your pain. Don’t assume that it is just your medication, or an allergy to a food. Always get checked out by a physician if these symptoms persist, or to just make sure everything is OK.
Ways of describing pain in your sharp abdominal pain may include (but not limited too):
What Symptoms of Abdominal Pain Are Cause for Concern?
If your abdominal pain is severe or if it is accompanied by any of the following symptoms, contact your doctor as soon as possible:
These symptoms can be an indication of an internal problem that requires treatment as soon as possible.
How Is Sharp Abdominal Pain Treated?
Treating abdominal pain depends on its cause. This can range from medications for inflammation, GERD or ulcers, to antibiotics for infections, to changes in personal behavior for abdominal pain caused by certain foods or beverages. In some cases such as appendicitis and hernia, surgery is necessary.
Relieve stomach pain at home:
1. Activated Charcoal is a good way to relieve an upset stomach. If you don’t have charcoal on hand…Read More
2. Drop a mint into any type of hot tea and let it do it’s work on the tea for at least 45 seconds. Read More
Warning! Please keep in mind that the information contained within this site is not professional medical
advice, and should not be used as a substitute for such information. If you are concerned about Abdominal Pain Causes or the potential risk(s) they pose, or the other medical situation(s) mentioned, then contact someone who is qualified in this area, such as a licensed doctor or other medical professional(s).
Hello My name is Juan Im 27 years old from Texas and just want to get
more knowledge about these dieses. I have symptoms of those with
pancreas dieses. Here are my symptoms Floating stools light color, left
upper abdominal pain radiates to the back sometimes, itchy skin on my
forearms and back. I done had all these test on me and every thing for
the pancreas is normal. I have had abdominal x ray, abdominal
ultrasound, Abdominal ct scan , urine test, blood work , and a EGD and
every thing is normal except on he EGD test they found a large Hiatal
Hernia and mild Gastritis. But i dont think that gastritis or hiatal
hernia would cause floating stools. Has any one had these symptoms and if yes was it related to pancreas dieses??
Why do you seem to believe that is from a problem with your pancreas? The answerer above me explained alot of detail for you for your symptoms so, I will not repeat the obvious. If your pancreas was involved, your enzymes that are produced by the pancreas would be out of whack.As you said, your ” tests for the Pancreas, were normal “. Are you concerned because of a family history of Diabetes ?? Gastritis or inflammation of the stomach will give such symptoms then, of course, you are positive for a Hiatal Hernia, which can complicate things. I think that your Doc (s) are on the right path but, if your symptoms persist or worsen with treatment, then seek a second opinion. I hope that this helps and Good Luck.Tags: abdominal, abdominal pain, backup, hernia, hiatal, hiatal hernia, lang, mage, Most Popular, pain, sooper, source