Sports Hernia

What is a sports hernia?

A sports hernia is a tear in the muscles of the lower belly. It causes pain in the lower belly or groin.

The medical term for a sports hernia is athletic pubalgia.

What is the cause?

The pain from a sports hernia usually starts slowly. Doctors aren’t sure of how it happens. It’s possible that tight or strong hip flexor muscles tilt the pelvis forward and stretch the muscles in the lower belly. Over time, this may lead to small tears in the muscles and tissues. Sometimes hernias happen after a sudden injury.

Activities that require a lot of bending over and leaning forward can lead to this problem. Athletes who play soccer, ice hockey, rugby, field hockey, tennis, or run track are most likely to get a sports hernia.

What are the symptoms?

Symptoms may include:

• pain on just one side of the lower belly
• groin pain
• pain that is usually worse with sudden movement, such as sprinting, kicking, side-stepping, sneezing, or coughing

How is it diagnosed?

Your healthcare provider will ask about your symptoms, review your medical history, and examine you. There are no specific tests to diagnose this condition. You may have tests, such as an X-ray, MRI, or bone scan, to rule out other conditions that could cause groin pain.

How is it treated?

You will need to rest until the symptoms markedly improve. This may take weeks to months. Healing will take longer if you continue activities that cause pain.

To reduce swelling and pain in the first day or two, your provider will probably tell you to:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth, on the painful area every 3 to 4 hours for up to 20 minutes at a time.
• Take an anti-inflammatory medicine, such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

Your healthcare provider may recommend physical therapy.

It may take a few weeks to a few months for symptoms to go away. People who have had sports hernias sometimes keep having pain in their lower belly and groin.

If rest and physical therapy do not relieve symptoms, your provider may suggest surgery. During surgery, muscles and tissue in the lower belly are released and reattached. Some hip muscles are loosened.

How can I take care of myself?

• Follow your treatment plan.
• Keep all appointments for provider visits or tests.
• Contact your healthcare provider if you have new or worsening symptoms.

When can I return to my sport or activity?

The goal of rehabilitation is to return to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity depends on how soon the muscles in your belly recover, not by how many days or weeks it has been since your injury. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may return to your activity when:

• You can bend at the waist to touch your toes and straighten back up without pain.
• You can do a sit-up or abdominal crunch without pain.

How can I help prevent a sports hernia?

It may help to tone your stomach muscles by doing sit-ups or abdominal crunches. Make sure that you don’t overdo it when you start an exercise program.