Sports hernia: a clinical update

Abstract

Chronic groin pain in young athletic patients poses a difficult diagnostic and therapeutic challenge, especially with such a wide variety of potential causes. Sports hernias were first described in the early 1980s, and are an increasingly recognised cause of chronic groin pain. Injury to a number of high profile athletes has raised the public awareness of this condition. Typically occurring in young athletic males, sports hernias usually present with insidious onset exercise-related groin pain. It is often disabling and results in cessation of participation in sport. The diagnosis often goes unrecognised for several months or even years. Many patients with sports hernias will have made several visits to their GP and physiotherapist with the pain that often gets branded as a ‘groin strain’. However, early detection and instigation of the correct treatment is essential in the management of sports hernia. The diagnosis and appropriate treatment requires a high index of suspicion and a multiprofessional approach, consisting of GPs, surgeons, physiotherapists, and radiologists. The term sports hernia is in fact a misnomer as there is no classical herniation of soft tissue.1 However, ‘sports hernia’ has been so widely popularised by the media that it is now commonly used by the medical profession, media, and public alike. It is also referred to, and synonymous with, sportsman’s hernia, athletic pubalgia, and Gilmore’s groin, as well as others. Sports hernia is in fact a poorly understood phenomenon, and as such the exact definition, aetiology, and pathophysiology vary widely …