If you are active in sports and experience a painful tearing sensation in the lower abdominal or groin area, there's a good chance you have what's called an athletic pubalgia or sports hernia. It isn't like a run-of-the-mill, everyday hernia (discussed below), but it can be just as painful. In fact, it might be more difficult to know what you have is a sports hernia because of the deep nature of the injury.
How does a person get a sports hernia? What are the symptoms and signs? Is there any successful treatment that completely rids your body of the affliction?
What Is a Hernia?
Abdominal hernias occur when a piece of an organ or muscle protrudes through a weak spot in the abdominal wall. The bulge may contain a portion of the intestine or even a part of the fatty lining that surrounds the colon. While this might sound extremely alarming, it's entirely a common condition. How exactly does this happen?
The walls of your abdomen are made up of a network of muscles that are banded across. It isn't just one or two large muscles. These bands of muscles are interspersed with tissue to create what can be a strong abdominal wall. However, over time, these bands can grow weak and stretched due to age, weight gain and loss, etc. These weak spots allow organs, tissues and muscles of the stomach cavity to poke through or protrude through. This is a hernia. A hernia is almost always visible through the skin.
The most common hernias
This is the most common type of hernia. These usually occur in the groin region of men due to the way the muscles of the pelvic floor stay more open during fetal development.
This is the most common type of hernia in women. It occurs where the femoral artery passes through the floor of the stomach cavity from the upper leg. Women have a broader bone structure in this area due to fuller hips and pelvis that allow for pregnancy and childbirth.
These hernias occur in women who have experienced multiple pregnancies or who have gained and lost significant weight. The hernia can also happen in the obturator canal, which is another path of connection between the leg and the abdomen. This is the least common of the abdominal hernias.
How Do You Get a Hernia?
You know that hernias develop when the wall of the abdomen grows weak and allows protrusions from inside to poke through. How do these protrusions happen? Is there any one thing you can do to prevent them?
There are a few ways that a hernia can form. The common cause is an increase in pressure throughout the abdominal cavity. The reason for this increase in pressure can vary. This increase in pressure can form for many reasons:
- Increased fluid in the abdominal cavity
- A chronic cough
- Kidney failure and dialysis
The pressure eventually continues to increase and build due to lifting or carrying excess weight, straining to have a bowel movement or urinate, or trauma to the abdominal area. Excess weight in the abdomen, such as that which occurs during pregnancy or obesity centered in the stomach, can also increase the pressure.
What Are the Risk Factors for Developing a Hernia?
While some things can't be helped, certain risks can increase your chances of developing a hernia.
– A chronic cough which can occur during respiratory illnesses or diseases such as COPD and emphysema.
– Chronic constipation which forces you to bear down to have a bowel movement.
– Recurrent vomiting which happens due to illness or an eating disorder.
– Obesity due to the constant strain on the abdominal walls.
– Pregnancy due to the growing fetus and stretching of the pelvis and abdominal walls.
– Weightlifting which can increase the build-up of pressure from the constant strain that occurs when lifting weights.
While some of these things can be prevented, others are just side effects that can't necessarily be helped. Just know that if you are suffering from any of the above issues, your chance of getting a hernia increases.
How Can You Get a Sports Hernia?
While sports hernias can be similar in nature to abdominal hernias, they typically don't happen in the same place or the same way. A sports hernia is a pull, strain or tear of the soft tissue (tendons, ligaments or muscles) of the lower abdominal area or groin. This type of injury is usually the result of repetitive twisting motions or sudden changes of direction. Some of the highest incidents of sports hernias happen in soccer, football, wrestling and ice hockey. That's because these sports depend on constant and often jarring changes in speed and sudden changes in direction after planting of the feet.
The tissues typically afflicted with a sports hernia are the oblique muscles.
These are located in the lower abdomen and are attached to the pubic bone by thin tendons. It is usually these thin tendons from the oblique muscles to the pubic bone that are injured and the source of a sports hernia. In some instances, the muscles in the thigh that connect those muscles to the pubic bone are also affected. These are known as adductors. They can be very prone to stretching or tearing.
What Are the Symptoms of a Sports Hernia?
A sports hernia causes extreme and searing pain in the groin and lower abdominal area. Unlike a traditional hernia, there is no tell-tale bulge visible. Over time, if left untreated and unhealed, a sports hernia can morph into an inguinal hernia and will thus become visible.
If there is no bulge, how do you know you have suffered a sports hernia?
- Sudden pain in the groin while engaging in an activity. (At the time of injury)
- The pain goes away with rest but comes back as soon as the activity is resumed.
- The pain is felt on one side of the groin and never travels across to the other side.
- A twisting motion causes pain to that area.
- Pain in the injured area while doing sit-ups or push-ups, coughing, or bearing down during a bowel movement.
- Visible bruising to the injured area that may extend up into the abdomen. The area will also be very tender to the touch.
If left untreated long enough, a sports hernia can make it impossible to enjoy any physical activity, especially the one that led to the injury in the first place.
How Is a Sports Hernia Diagnosed?
If you believe you have suffered this type of injury, it's important to seek medical assistance. Upon explanation of the onset and persistence of your symptoms, the doctor may perform the following exams:
Your doctor may ask you to attempt a series of physical activities to diagnose you accurately. One such action will be to lie flat on the table and try to sit up against the resistance the doctor places on your shoulders or abdomen. This activity will be extremely painful and nearly impossible to do with a sports hernia because of the pressure this puts on the oblique muscles.
Your doctor may then have you get X-rays and an ultrasound. At times, a CT scan is needed. These will give the doctor a peek inside and confirm whether a sports hernia exists.
Once your doctor confirms you have suffered from this type of injury, a recommendation for a course of treatment will be made.
What Is the Treatment for a Sports Hernia?
There is a course of non-surgical treatments your doctor will first want you to attempt.
This is probably the most important and often most challenging way to help you heal after enduring a sports hernia. If you are an active and athletic person, the prospect of being relegated to being out of the game for a few weeks may seem like torture. However, the alternative is you continue straining and reinjuring it. If there is a bulge in the groin area, compression treatment may also be useful in helping to ease the pain and inflammation associated with a hernia.
A couple of weeks after injury, after you have rested the area sufficiently, a course of physical therapy might be prescribed. This will help strengthen the injured muscles and the areas around the injury to keep it from recurring.
Anti-inflammatory medications called NSAIDs (non-steroidal anti-inflammatory drugs) may be prescribed as needed for pain and inflammation. These include over-the-counter options such as Advil and Aleve. Your doctor may even feel as though a prescription-strength medication is warranted.
If four to six weeks of rest, physical therapy and medication don't ease your symptoms, surgery to repair the tear may be needed.
In any event, a hernia is never something to take lightly. In the case of a sports hernia, especially, it is crucial that you seek medical help as soon as you suspect you have torn the ligament. While many people find great success with rest and therapy, some intervention may be warranted. If you want to continue your active lifestyle, ignoring a hernia is never a good idea as it may cause long-lasting and permanent damage.
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