Overview

• Sports hernia or athletic pubalgia is a core muscle injury that affects the soft tissues of the lower belly or groin. The condition is not a true hernia since there is normally no visible bulge. It can be described as a tear or strain that leads to groin pain.
• A sports hernia is most common among male athletes who play twisting sports and affects just 3 to 15% of females.
• The condition can develop into a bad groin hernia when the stomach pushes against the strained and weak soft tissues, forming a visible bulge.
• Persistent pain from the injury stops athletes from playing sports and forces those injured to seek sports hernia treatment.

Percentage of Sports Hernia Sufferers That Returned to Play Sports

• According to UPMC Orthopaedic Care, "Outcomes for sports hernia surgery are good as more than 90% of people who have nonsurgical treatment, then surgery, are able to return to sports."
• A recent study also found that 50% of patients with core muscle injury similar to sports hernia recovered with conservative treatment, such as getting physical therapy for four to six weeks.
•  Sideline Sports Doc says that if an athlete followed his/her surgeon and physical therapist’s guidance after getting a sports hernia injury, "the results are typically outstanding, with most published medical studies showing a successful return to play at all levels of sports for more than 90% of people."
• A study on the performance and return to sport after sports hernia surgery in NFL that analyzed 57 hernia surgeries performed on 56 NFL athletes found that 53 players (94.7%) returned to the sport. Four players also returned to the sport and played their last game within one year of surgery.
• Another dated study that was included as it has useful data looked at athletes with sports hernia and compared physical therapy treatment with surgical repair. It found that “seven of 30 patients in the nonsurgical arm switched to the surgical arm after experiencing continued symptoms, and only 50% returned to the sport at 1-year follow-up. In the surgical arm, 29 of 30 athletes returned to full sports and were pain-free at 1-year follow-up.”
• As stated in Physiqz, sports hernia specialist and doctor William Brown has successfully treated over 150 cases of the injury every year.
•  Dr. Chanu Dasari, a top general surgeon, has performed thousands of sports hernia treatments. He uses an enhanced recovery plan to customize his patients' needs. On recovery after sports hernia repair, "between 65% and 90% of athletes who undergo sports hernia treatment return to their favorite sports within six weeks."

Examples of Athletes That Suffered From a Sports Hernia

•  Chris Diaz, a Brazilian Jiu-Jitsu fighter, underwent surgery in 2018 by Dr. Alexander Poor at the Vincera Institute in Philadelphia for a sports hernia he picked up while playing soccer. Six months later, he was back in the competition and won a Brazilian Jiu-Jitsu match.
• There is also a case study of a 27-year-old professional female weightlifter who also suffered from a sports hernia. After an emergency hernia repair was done, she recovered well. Follow-up on the patient at 36 months showed that she was well and taking part in her professional weightlifting without any further complaints.

Treatment of Sports Hernia

• Sports hernia treatment aims to get one back to doing what they love, pain-free. The following treatments can be used:
•  Resting and reducing activity: Sports hernia can heal on its own with rest. Doctors recommend that the injured person rests for 7 to 10 days and apply ice to the groin or lower abs area to relieve pain. One should also avoid activities that could aggravate the pain.
•  Taking anti-inflammatory drugs: The injured athlete can take non-steroidal anti-inflammatory drugs like naproxen or ibuprofen to help reduce swelling and pain. Most of these drugs can be bought over the counter, but one has to get a prescription for stronger drugs.
•  Physical therapy: Physical therapy can be used to strengthen the core muscles around the injury, which can help one heal. Four to six weeks of physical therapy is enough to get one back to his/her daily routine without pain.
•  Shots to relieve pain: A cortisone shot, a powerful and effective steroid, could be used to reduce inflammation and relieve prolonged or severe pain.
•  Sports hernia surgery: If the pain persists after trying other treatments, surgery could be used to repair torn tissues. Surgeons offer two types of sports hernia surgery. The traditional surgery, where the surgeon makes a long cut in the abdomen, takes longer to heal from and increases the risks of infection. Endoscopic surgery involves the surgeon using a camera to see and repair tissue after making a few small cuts.

• The surgeon could also perform "an inguinal neurectomy to relieve pain. This involves carefully cutting the inguinal nerve — a small nerve in the groin. Not everyone needs this treatment. After surgery, the injured person and their doctor could create a rehab plan that helps the athlete get stronger. Most of the time, athletes can resume their regular activity 6 to 12 weeks."
•  Sideline Sports Doc says that sports hernia injury in athletes will frequently need surgery, and the keys to a successful return to sport after surgery are finding a surgeon skilled in diagnosing and performing surgery for the injury, working with a physical therapist experienced in core muscle rehabilitation after surgery, carefully following protocols set aside for return to sport, and athletes ensuring that they are mentally confident about their return to sport.
• Most of those athletes with sports hernia injuries should strive to return to sport “at about the start of the 13th week after surgery, although some elite athletes will follow an aggressive protocol that might allow a return in the 4th to 6th weeks after surgery.” This is according to Sideline Sports Doc.

UPMC Orthopaedic Care for Sports Hernia

• The UPMC Orthopaedic Care is an example of an institution that prides itself as one of the best orthopaedic programs in the US for treating sports hernia, as ranked by US News and World Report ranks.
• The program uses very advanced treatments and therapies to treat the sports hernia injury, with over 70 locations throughout the region for outpatient rehab.

• The Hip Preservation Program at UPMC Orthopaedic care "specializes in hip problems from the mild to the severe, including sports hernia."