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Sports Hernia & Running

By Lee Simmons

A sports hernia is a specific condition that occasionally afflicts runners and other athletes. It often causes severe pain and necessitates time off from training. Sports hernias are difficult to diagnose; the great majority occur in males. Depending on its severity, a sports hernia can be treated at home or, in extreme cases, by surgery.


A sports hernia occurs when one of the structures in the inguinal canal ruptures. This 2-inch canal runs across the top of the leg where it attaches to the trunk of the body. Its walls consist of abdominal muscles, tendons and fascia. A disruption in one of these areas can prompt a sports hernia.


Although sports hernias often result from sudden force, such as a hard twisting motion, the injury's onset is more gradual in runners. In most cases, repetitive shearing forces of the hip abductor muscles where they connect to the pubic bone are the likely culprit. Lack of flexibility and strength in the pelvis and hips can create optimal conditions for incurring a sports hernia.


Most often, sports hernia pain occurs on one side of the groin, although occasionally it appears on both sides. Initial symptoms typically appear at the conclusion of a run, although they can persist into successive runs. Coughing and sneezing are enough to induce pain, which can radiate into the abdomen, scrotum or inner thigh.


Unlike other hernias, sports hernias do not present an easily identifiable bulge at the location of injury. X-rays, bone scans and MRIs do not accurately diagnose sports hernias but can rule out other problems. Identification is often achieved by palpation, in which pain is produced when a doctor feels along the surface of the inguinal canal with his hands.


Runners diagnosed with sports hernias are generally referred to up to six weeks of physical therapy to improve hip and pelvic strength and flexibility. Severe cases can be treated by outpatient endoscopic surgery, during which a small piece of mesh is applied onto the injury to provide support. Post-op rehab can include daily treadmill walking and continued hip and pelvic exercises.

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