Groin injuries affect roughly 20% of soccer players due to the nature of the sport, which involves lots of kicking, cutting, sprinting and explosive movements. Research has shown that 50% of soccer players suffering from groin pain lasting longer than 8 weeks may be due to an injury called a sports hernia (Kopelman et al., 2014, Munegato et al., 2016). Unlike a traditional hernia, a sports hernia does not involve the protrusion of an organ through the muscular wall. Instead, it is characterized by weakness in the deep abdominal wall, and only occasionally will a bulge be felt during abdominal straining, as the organs push up against the abdominal wall (without pushing through). A sports hernia can also involve weakness, stretching or tearing of the abdominal muscles, fascia and/or the adductor (inner thigh) muscles on the pubic bone.
What causes a Sports Hernia?
The majority of sports hernias occur as a result of repetitive overload to the area, as opposed to a single traumatic event. Hockey, soccer and football athletes are most at risk, due to the sudden changes in direction, kicking, and sprinting seen during these sports. Other risk factors include:
- Athletes with muscle imbalances around the hip/pelvis/core;
- Individuals with a significant leg length difference;
- Athletes with decreased hip range of motion (especially internal/external rotation);
- Athletes with other underlying hip pathologies, such as labral tears and femoroacetabular impingement;
Symptoms of a Sports Hernia
- There is usually pain with activity/sports, which improves with rest;
- Pain is localized in the lower abdominal/inner thigh and groin area;
- Generally there is pain with certain movements, such as abdominal curls and resisted hip adduction;
- There is tenderness over the pubic bone and abdominal muscle insertions.
Most sports hernias can be treated conservatively with physiotherapy and rest. Physiotherapy will generally consist of manual therapy and exercise in order to address muscle imbalances, as well as core stabilization exercises. A sports hernia may lead to an inguinal hernia, and if conservative treatment is not successful, surgical repair may be necessary. Surgical repair has a high success rate; most athletes will return to sport pain-free.
What can you do to prevent a sports hernia and groin injuries?
- CORE, CORE, CORE – core and pelvic stability cannot be overlooked;
- Get your minor injuries addressed ASAP!! Soccer players tend to overwork their hip flexors and adductors, which gradually lead to minor groin strains. If left untreated, they can eventually lead to a sports hernia. Don’t let that nagging pain develop into something much bigger;
- Make sure your hip/pelvis muscles are well balanced in terms of flexibility and strength. For example, just stretching the groin muscles and letting everything else stay tight will lead to more injuries than if you didn’t stretch at all. You want to be symmetrical in all directions.
If you have been suffering from groin pain for longer than 8 weeks and think you may have a sports hernia, contact us and one of our therapists at Sheddon Physiotherapy and Sports Clinic will assess and treat your injury and get you back on the field pain-free.
Kopelman et al., (2014). The management of sportsman’s groin hernia in professional and amateur soccer players: a revised concept. Hernia.
Munegato et al., (2016). Sports hernia and femoroacetabular impingement in athletes: A systematic review. World Journal of Clinical Cases. 3(9) 823-830.