Anatomy
The various muscles of the abdominal wall are penetrated by the inguinal canal, which contains nerves (N ilioinguinalis and the genital branch of N genitofemoralis) and in men the spermatic cord (funiculus spermaticus).
Cause
The existence of a “sports hernia” has been debated among professionals for many years (Fredberg U, Kissmeyer-Nielsen P. 1996) The current theory is that it is not a hernia, but that the pain is probably due to a bulging of a weak posterior wall of the inguinal canal (fascia transversalis), which is thought to press on the genito femoral nerve (Gamborg S. et al. 2019). The injury may be an acute injury to one of the underlying structures in the region, but it is most often an overuse injury.
Symptoms
Pain in the groin. There is often pressure soreness in the inguinal canal, with abdominal flexion against resistance or coughing. The pain often travels up the abdomen, towards the pubic symphysis and down the inner thigh.
Examination
There are no examinations (X-ray, ultrasound, MRI scan, scintigraphy) that can detect the “sports hernia. There is usually tenderness when a finger is inserted into the inguinal canal (performed by a doctor).
Treatment
Before opting for sports hernia surgery, you should have tried all non-operative options including adequate relief and rehabilitation of the structures and muscles that are most sore.
Complications
It can often be difficult to correctly diagnose athletes with long-term groin pain, so you should consider whether the diagnosis is correct, including Consider the following:
In particular, the following should be considered:
- Inflammation of the adductor of the thigh
- Tendonitis of the deep hip flexor
- Inguinal hernia
- Hip joint lobe injury
- Inflammation of the pubic joint
- Bursitis on the front on the hip joint
- Fluid accumulation in the joint
- Osteoarthritis of the hip joint
- Tendonitis of the superficial hip flexor attachment
- Inner snapping hip
- Stress facture in the femoral neck
- Nerve entrapment
