Sportsman’s Hernia

Sportsman's hernia (Sports hernia, Gilmore's Groin) is a debilitating condition which presents as chronic groin pain (athletic pubalgia). It is caused by a set of pelvic injuries involving the abdominal and pelvic musculature outside the ball-and-socket hip joint and on both sides of the pubic symphysis making the groin/lower abductors sore.

The injuries may include:
  • Torn External Oblique Aponeurosis
  • Torn Conjoined Tendon
  • Tear of Conjoined tendon from pubic tubercle
  • Dehiscence between conjoined tendon and inguinal ligament
Some consider the condition to be an early stage of an imminent inguinal hernia that can not be detected with certainty before or after surgery.

Symptoms of Sportsman's Hernia
  • Pain in the Lower Abdomen
  • Pain in the Groin
  • Pain in the testicle (in males)
Diagnosis of Sportsman's Hernia
The diagnosis of sportsman's hernia is difficult. It is most common in athletes that have to maintain a bent forward position and in sports characterised by activity with sprinting and sudden changes of direction (soccer, hockey).
Sports hernia must be distinguished from the more common osteitis pubis (inflammation of the pubic joint). The pain in osteitis pubis is around the pubic bone and aggravated by asymmetric loading (jumping on one leg).

Investigations for Sportsman's Hernia
Plain radiography, ultrasonography and scintigraphy are used as first-line tests to supplement clinical assessment.
Magnetic Resonance Imaging (MRI) is employed in difficult cases to help defining the anatomical extent of a groin injury and to rule out articular diseases at the pubic symphysis (osteitis pubis).

Surgical Treatment of Sportsman's Hernia
Timely intervention and appropriate repair of selected injuries results in greater than 95% success.
There are no treatments that have been shown to be effective in sportsman's hernia other than surgery. The surgery is laparoscopic (keyhole) and usually involves the implantation of a thin flexible mesh to strengthen the area. The outcome of this type of surgery is excellent with a very high success rate of players returning symptom-free.

Rehabilitation following Laparoscopic Repair of Sportsman's hernia
Correct rehabilitation following laparoscopic repair of sportsman's hernia is important and involves a careful graduated 6 to 8 weeks programme from surgery to full recovery.