What is a sports hernia?
A sports hernia is different to a traditional hernia. A sports hernia is a tear or weakening in a layer of the deep abdominal muscles. Unlike a traditional hernia, the sports hernia does not create a hole in the abdominal wall and there is no visible bulge under the skin. This means making a definitive sports hernia diagnosis is difficult. It is very hard to pick up with imaging such as ultrasound and MRI.
Why does it happen?
Activities that combine strong use of the groin muscles and the oblique muscles put significant strain on the obliques. If there is a muscle imbalance or weakness this can lead to a tear or weakening in the wall of the abdominals. Athletes who participate in sports that require repetitive twisting and turning at speed, such as soccer, rugby or AFL, may be at risk of developing a sports hernia.
How is it diagnosed?
It is common for athletes to describe symptoms that have been present for a number of months. They may have initially been diagnosed with a groin strain that has not settled with other conservative management. They may have pain or tenderness in the lower abdominal wall or groin which is worse with sit ups and sudden movements such as acceleration, twisting, cutting, and kicking. Your Physiotherapist will perform a thorough assessment of the hip, back and pelvis to confirm the diagnosis.
How is it treated?
Appropriate rest, followed by progressive exercises can work to resolve a sports hernia. Your Physiotherapist will provide you with a programme to address key problems found during the assessment. The will be particular activities to avoid, such as sit ups and aggressive stretching. If conservative management fails, then there is an option for surgical intervention.
Surgery involves placing a mesh over the hernia to stabilise the tissue. Specific rehabilitation that avoids sudden, sharp movements should enable athletes to return to sport within 6 to 8 weeks after surgery. Your physiotherapist will design a specific rehabilitation program to suit your particular sport and level of participation. It is important to complete rehabilitation to ensure adequate strengthening of the groin and abdominal muscles.
Preventing this condition is easier than treating it. Prevention should be considered for those who are at risk, especially athletes involved in repetitive twisting and turning movements at speed. Particular attention should be paid to the strength and flexibility of the hip flexors, abductors, adductors, abdominals, and pelvic stabilising muscles. These exercises can be structured by your Physiotherapist.