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Sports Hernia: Thigh and Abdominal Muscles Overuse Can Cause Sports Hernia

January 10, 2008 11:44 AM
[Adapted from an American Academy of Orthopaedic Surgeons press release]
Repetitive twisting and turning by hockey, soccer and tennis players, as well as those who ski, run, or hurdle, may cause a sports hernia, according to a recent study in the Journal of the American Academy of Orthopaedic Surgeons. The exact incidence of sports hernias is unknown, but previous studies have indicated that 40 to 85 percent of chronic groin pain may be due to the condition.

Researchers from Johns Hopkins Bayview Medical Center in Baltimore reviewed the diagnosis and treatment for sports hernias, which are often initially dismissed by athletes who think they may just have chronic pain. According to the study’s co-author, John H. Wilckens, MD, sports hernias can occur after overuse of the thigh and lower abdominal muscles resulting in a weakness or tear of the posterior muscle wall of the groin.

Diagnosis
“Initial examination or imaging are not specific enough to provide information about sports hernias because of complex anatomy and biomechanical considerations that accompany this injury,” said Dr. Wilckens. He added that surgical exploration is the only sure method to confirm diagnosis. Other tests, however, can be performed to eliminate other diagnoses and determine if other orthopaedic conditions exist. Diagnosis tools include imaging, training history, observation of specific movements, checking for muscle tears, strains, stress fractures, bursitis, and pain levels. Sports hernia pain is created by quick movements, twisting, turning, running and bending forward, kicking, sprinting, and sit-ups.

Treatment
Non-surgical treatments of sports hernias include rest, ice packs, physical therapy, anti-inflammatory medications, and cortisone injections. Return to training should always be a gradual process.

Co-author of the study, Adam L. Farber, MD, an orthopaedic resident at the Johns Hopkins Center noted that if nonoperative approaches do not work within three months, laparoscopic or open surgery is recommended. “After laparoscopy, athletes can return to sport within two to six weeks, while open surgery requires one to six months of recovery,” he said.

Dr. Farber added that with both conventional and laparoscopic techniques, success rates are typically 80 to 97 percent. “Due to the potential underlying pelvic imbalance that can occur from sports, treatment of a contracted or overdeveloped adductor muscle should not be neglected. This can sometimes be corrected before surgery. if not, some clinicians recommend that the muscle be cut to allow it to lengthen and stretch in conjunction with the sports hernia repair.”
 

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