Sports Hernia: Treatment, Cost and Side Effects

Sports hernia or in other words “Athletic pubalgia” may be defined as a painful condition which involves injury or tearing of the soft tissues (such as muscles, ligaments and tendons) in the lower abdomen or groin area. The term “sports hernia”, though commonly used by people, is a misnomer because this is a completely different condition caused by straining or tearing of muscles, ligaments or tendons and may or not be associated with traditional abdominal hernia. Medical communities usually prefer the term “Athletic pubalgia” to define this condition. This painful condition is generally caused by sports activities which involve intense twisting motions or sudden changes in directions for example ice hockey, wrestling, football, gymnastics and others.

The soft tissues which are mostly prone to be affected by sports hernia include the oblique muscles present in the lower abdomen. The tendons which join the oblique muscles to the pubic bone are the most vulnerable ones. Several cases of sports hernia have also been reported where the tendons attaching the thigh muscles to the pubic bone get torn or stretched. Sports hernia generally results in severe pain in and around the groin area at the time of injury. The pain usually lessens with rest but is seen to come back when an affected person resumes his/her sports activities, especially with twisting motions.

Unlike cases of inguinal hernia, sports hernia does not lead to any visible bulge in the groin area. With time, a sports hernia may result in cases of inguinal hernia, and the abdominal organs may happen to press against the weakened or injured soft tissues and lead to the formation of a visible bulge. Without treatment, cases of sports hernia may worsen and may result in chronic, disabling pain that may prevent an athlete from performing further sports activities.

Prior to the initiation of the treatment for sports hernia, it is essential to be sure regarding the cause of pain within the lower abdomen (i.e., whether the pain is due to traditional, inguinal hernia or due to injury of the soft tissues or any other reason). Hence, diagnosis of the cause of lower abdominal pain becomes the first step for the treatment of sports hernia. During a patient’s visit, the doctor may feel it necessary to ask questions regarding the symptoms and how he/she had got the injury. At the time of physical examination, the doctor might possibly feel tenderness in the groin area or above the pubis, if the patient is having sports hernia. Although in some rare cases, traditional inguinal hernia may occur simultaneously with sports hernia; in general, no hernia can be predicted by the doctor during the patient’s physical examination.

The diagnosis of sports hernia involves physical examinations as well as imaging tests. In order to be sure whether the patient is having sports hernia, the doctor may ask his/her patients to do sit ups or flex their trunk against resistance. If the patient is having sports hernia then such physical examinations might prove to be painful. Imaging tests include X-ray imaging and/or magnetic resonance imaging (MRI) in order to be sure whether the patient is having sports hernia or not.

Once the patient is diagnosed as having sports hernia; he/she can be treated by non-surgical as well as surgical treatment. Non-surgical treatment involves taking rest for about a week or 10 days followed by physiotherapy for about two to four weeks and intake of anti-inflammatory medications such as ibuprofen, naproxen and/or cortisone injection (if the pain persists). In cases where the pain is seen to come back when the patient resumes his/her sports activities, a surgical treatment may be deemed necessary by the doctor, in order to repair the torn tissues.

Any person, who is involved in rigorous sports activities and has received severe injuries due to tearing of the soft tissues in the groin area, is said to have sports hernia and is eligible for this treatment.

People who may or may not be involved in sports activities and has not received any injury in the groin area, are regarded as not having sports hernia and are considered as not eligible for this treatment.

The treatment for sports hernia is more or less safe. However, the anti-inflammatory pain killers prescribed during this treatment may bear some side effects. The common side effects include nausea, vomiting, constipation, bleeding in stomach (ulcers), headache and indigestion. The side effect of stomach upset can be reduced by taking the medicines after meal.

On the other hand, cortisone injections used to treat problems of sports hernia, have side effects such as weight gain, elevated blood sugar levels, osteoporosis, elevated blood pressure, thinning of skin, cataracts and decreased resistance against infections. It is important to consult a doctor if any of these side effects become serious enough.

It should be remembered that the condition of sports hernia should not be confused with that of traditional inguinal hernia. Sports hernia involves injury to the muscles, ligaments and/or tendons in the groin area, due to rigorous sports activities. The post treatment guidelines for any patient having sports hernia involve taking rest for at least one week, continuing physiotherapy for at least two to four weeks and intake of anti-inflammatory medications regularly as directed by the doctor. If the pain persists in spite of all these non-surgical treatments then the patient needs to consult his/her doctor regarding this issue and ask whether he/she needs to undergo surgical treatment in order to cure this problem.

The injury of the soft tissues in the groin area, which leads to the problem of sports hernia, may range from mild to severe. Accordingly, the time of recovery of a patient having sports hernia, may vary. On an average, a patient usually recovers from sports hernia within a period of 4 to 6 weeks. For patients who have undergone surgical treatment for this condition may require longer time for their recovery.

The price of treatment for sports hernia usually varies in different parts of India. On an average, the price of treatment ranges from Rs. 3,24,480 to Rs. 6,48,950 in India. This treatment is available in almost all leading hospitals in India.

The treatment for sports hernia involves both non-surgical as well as surgical methods. Non-surgical treatment is usually based on rest, physiotherapy and medication. If the pain is seen to reoccur when then patient resumes his/her sports activities then he/she can go for surgical treatment in order to cure this painful condition. However, it is seen that 95% of the cases are solved by non-surgical treatment methods.

Sports hernia is a painful condition that occurs due to injury in the lower abdominal wall. Surgical treatment is considered to be the best way to cure this condition. However, prior to the surgery, the alternative treatment for this condition involves management of the symptoms by rest, physiotherapy and medication. In case, if the conditions do not improve by these alternative treatment methods, the doctor might feel the need for switching to surgical treatment in order to cure this condition.