Sports Hernia Specialist

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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What is Sports Hernia?

A sports hernia, known medically as athletic pubalgia, is a type of soft tissue injury predominantly occurring in the groin area. Characterised by a strain or tear, it primarily affects the oblique muscles in the lower abdomen and the tendons that attach these muscles to the pubic bone. Despite its name, a sports hernia does not involve the formation of an actual hernia, which typically involves the protrusion of an organ through a tissue opening. Instead, this condition is marked by the stretching or tearing of soft tissue, leading to pain and discomfort.

Athletes, especially in sports requiring rapid, forceful movements, frequently sustain this injury. These activities put stress on the lower abdomen and groin, leading to potential soft tissue injuries.

Causes of Sports Hernia

Sports hernias arise from a combination of physical activity and underlying physiological factors.

  • Repetitive and Forceful Movements
    Athletes participating in sports that require repetitive, forceful motions, especially those involving twisting the pelvis, are at a heightened risk. These movements can lead to tears in the soft tissue of the lower abdomen or groin.
  • Sports Involving Sudden Changes in Movement
    Specific sports activities, such as ice hockey, soccer, football, wrestling, rugby, skiing, tennis, and hurdling, are particularly associated with sports hernias. They often involve planting the feet and twisting with maximum exertion, which can strain the soft tissues.
  • Muscle Weakness and Imbalance
    A lack of proper sports conditioning or an imbalance in strength between the hip and abdominal muscles can predispose athletes to sports hernias. Weak abdominal muscles are less capable of withstanding the stress of high-intensity sports, leading to a higher likelihood of injury.

Symptoms and Signs

Those with sports hernia may experience severe pain in the groin area at the time of injury. This pain characteristically becomes less intense with rest but reemerges upon returning to sports activities, particularly those involving twisting movements. This pain can radiate downward, affecting the scrotum and inner thigh.

A sports hernia can impair athletic performance, sometimes necessitating reduced activity or a temporary halt to sports participation.

Unlike traditional hernias, a sports hernia usually does not result in a visible bulge in the groin area. Over time, the weakened abdominal muscles may lead to an inguinal hernia, manifesting as a visible bulge.

Diagnosis

Diagnosing a sports hernia involves a multi-step process:

  • Initial Consultation and Symptom Review: During the first appointment, the symptoms and circumstances of the injury will be discussed with the hip specialist.
  • Physical Examination: A physical examination will be conducted, where the hip specialist checks for any tenderness in the groin or above the pubic area. Patients may be asked to sit up against resistance or perform other physical movements to assess for pain associated with sports hernia.
  • Imaging Tests: X-rays or MRI scans are often employed to confirm the diagnosis and rule out other conditions. These tests provide detailed images of the soft tissues, revealing any tears or strains.

Other conditions, such as adductor muscle tears, can also cause groin pain and present symptoms similar to sports hernia. Diagnosis, particularly the use of MRI scans, can help differentiate between these conditions.

Non-Surgical Treatment Options

Non-surgical treatments for sports hernia aim to relieve pain, restore range of motion and strength, and facilitate a return to sports and other activities.

Rest and Activity Modification

In the initial phase, hip specialists may suggest rest and activity modification to reduce pain and swelling. Rest paired with ice application can be beneficial for the first few days post-injury. Reducing the intensity of sports or temporarily avoiding certain movements can help minimise stress on the injury area.

Physical Therapy

About two weeks after the injury, hip specialists may suggest engaging in physical therapy. Exercises focus on improving strength and flexibility in the abdominal and inner thigh muscles. This often includes core exercises, stretching, and other targeted activities.

Anti-Inflammatory Medications

Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen or naproxen, are commonly used to alleviate swelling and pain.

Corticosteroid Injections

In cases where standard anti-inflammatory medications are insufficient, corticosteroid injections may be considered to further reduce inflammation and pain.

Surgical Treatment Options

In situations where non-surgical treatments do not yield sufficient improvement, surgical intervention may be considered.

Endoscopic Surgical Procedure

This minimally invasive surgery involves making small incisions and using a slender tool equipped with a camera. The surgeon operates through these small incisions, repairing the torn muscles or soft tissue.

Open Surgical Procedure

In more severe cases, open surgery might be necessary. This involves a larger incision, allowing the surgeon direct access to the affected area for repair.

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Prevention Strategies

Certain strategies can be employed to mitigate the risk of developing a sports hernia.

  • Engage in Warm-ups to Prepare Muscles - Engaging in adequate warm-up exercises before intense physical activity helps prepare the muscles and reduce the risk of injury.
  • Strengthen the Core Muscles - Strengthening the core muscles, including the abdominal and hip muscles, provides better support and reduces strain on the lower abdomen and groin areas.
  • Exercises to Increase Flexibility - Incorporating exercises that enhance flexibility, particularly in the lower abdomen, can help minimise strain across areas where core muscle injuries commonly occur.
  • Using Proper Techniques to Reduce the Risk of Injury - Use correct techniques during sports and exercise to prevent undue strain on the body, reducing the risk of a sports hernia.
  • Gradually Increase Activity Intensity - Gradually increasing the intensity of physical activities helps in conditioning the body and avoiding sudden strains that could lead to injury.
  • Wear Appropriate Sports Attire to Avoid Injuries - Appropriate sports attire, especially supportive clothing, can reduce the risk of sports hernias.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore

 

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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
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Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed

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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    How Long Does Recovery from a Sports Hernia Take?

    Recovery from a sports hernia varies based on treatment type and injury severity. Typically, improvement is observed within six to eight weeks with physical therapy. Post-surgical recovery generally takes between six to twelve weeks. Follow all rehabilitation guidelines for effective healing.

    Is Sports Hernia a Life-Threatening Condition?

    While not life-threatening, a sports hernia can affect quality of life and athletic performance. Timely management may assist in mitigating the risk of chronic pain and complications. Reach out to our hip specialist for a personalised treatment plan tailored to your specific condition.

    Do Sports Hernias Hurt to Touch?

    Sports hernias may cause tenderness in the groin area, particularly when pressure is applied. If you experience pain upon touch, consult a hip specialist for a thorough evaluation.

    Does Massaging a Sports Hernia Help?

    It is generally not recommended to massage the affected area, due to the risk of exacerbating the condition. Our hip specialist can help suggest more suitable treatment options, to promptly and effectively relieve any symptoms.