The term “sports hernia” is an example of a mistake made by the medical profession. Most hernia surgeons refer to the constellation of symptoms in the groin as inguinal pubalgia or athletic pubalgia, as it is not technically a hernia. Most recently this disease has been referred to as a Core Muscle Injury.
A hernia occurs when abdominal contents protrude through a defect in the abdominal wall, but a sports hernia does not involve any contents leaving the abdominal cavity. The consensus of most hernia surgeons is that a sports hernia is a musculoskeletal injury that occurs as a result of a sport. Most patients with “sports hernia” present with groin or lower abdominal pain that is made worse with exercise. Patients often feel discomfort at night, do not notice a bulge in the groin, and do not have an inguinal hernia on physical examination.
Current treatment recommendation for sports hernia is aggressive physical therapy to treat the injury and correct any core muscle imbalance that caused the injury. If physical therapy is unsuccessful after 6 months, then surgery is occasionally recommended, though no single approach as been shown to be better than any other approach.
In our experience, correcting the imbalance in the musculoskeletal system is required for someone to have a long term recovery from a core muscle injury. Surgery may offer a quick fix to the pain, but does not address the long term core muscle imbalance. For this reason, we feel that physical therapy is the best way to heal from this musculoskeletal injury.
If you have a suspected sports hernia, one resource is Andrew Millett of Move Strong Physical Therapy in Hudson, MA. He is an expert in what he does and has worked with many of our patients to avoid surgery.
For patients where we diagnose and inguinal hernia on exam, we do recommend surgery.