A sports hernia occurs when there is an injury and resulting weakness of the muscles or tendons of the lower abdominal wall. This part of the abdomen is the same region where an inguinal hernia occurs, called the inguinal canal. When an inguinal hernia occurs there is sufficient weakening of the abdominal wall to allow a pouch, the hernia, to be felt. In the case of a sports hernia, the problem is due to a weakening in the same abdominal wall muscles, but there is no palpable hernia. Because the damage is occurring in the same region as the more common inguinal hernia pain patterns can be similar but the physical exam findings are not. More detailed about sports hernias can be found here.
What is the inguinal canal?
The inguinal canal is a region in the lower abdomen, just above the groin. The canal is formed by the insertions of abdominal muscles and tendons, as well as several ligaments. Within the inguinal canal travels the spermatic cord (in males) or the round ligament (in females). This area of the abdomen is prone to weakening of the abdominal wall, allowing an outpouching, or hernia, to form.
I have strong abdominal muscles, how can I have a sports hernia?
The problem with the abdominal wall in people with a sports hernia is not a muscle strength issue. Rather, the abdominal wall muscles and fibrous attachments of the muscles to the pelvic bones in this particular region have become injured. The sports hernia does not occur in the area of the large, thick part of the muscle it tends to occur where these muscle are attached to their anchor points on the pelvis. .
What are the symptoms of a sports hernia?
A sports hernia typically begins with a slow onset of aching pain in the lower abdominal region but depending on the nature of the activity some patients can identify a precise moment in time when the problem started. Symptoms may include:
- Pain in the lower abdomen
- Pain in the groin
- Pain in the testicle (in males)
Typically the symptoms are exacerbated with activities such as running, cutting, and bending forward. Patients may also have increased symptoms when coughing or sneezing. Sports hernias are most common in athletes that have to maintain a bent forward position, such as hockey players. However, sports hernias are also found in many other types of athletes such as football and soccer players.