Sports Hernia Symptoms and Treatment

A sports hernia is when the lower abdominal muscles, ligaments, and tendons become weak and can easily get strained or torn. Twisting, bending, and other repetitive movements during sports can lead to a hernia.

Sports hernias are not like other kinds of hernias because you can’t feel the “outpouching” of the tissue. While sports hernias can cause groin pain in athletes, the pain could also be from a muscle injury, cartilage damage, nerve problems, or urologic conditions.

This article will go over how sports hernias happen, how the injury is diagnosed and treated, as well as steps you can take to prevent a hernia if you play sports.

What Causes Sports Hernias?

A sports hernia occurs when there is a weakening of the muscles and/or tendons of the lower abdominal wall. A sports hernia does not happen in the large, thick part of the muscle—it forms where the abdominal wall is too thin.

While they happen in the same part of the body, sports hernias are not the same as inguinal hernias. 

The inguinal canal is the part of your lower abdomen just above your groin. The muscles are prone to weakening and tearing. If a hernia happens, tissue (like your intestines) bulges through an opening in the wall. 

While they both have "hernia" in the name, inguinal hernias and sports hernias are different injuries:

• If you have an inguinal hernia, you can feel the pouch of tissue bulging through. 
• If you have a sports hernia, the same abdominal muscles are weak but there is no tissue bulging through it. Therefore, you won’t be able to feel the hernia. 

While a sports hernia is not an inguinal hernia, it can lead to one. Weak muscles in the lower abdomen can, over time, create the right conditions for an inguinal hernia to form. 

Symptoms of a Sports Hernia

You may feel severe pain at the moment that you get hurt, but sometimes, the pain from a sports hernia comes on gradually. You might have a hard time telling exactly where the pain is in your lower abdomen, but it’s often just on one side. 

Other symptoms of a sports hernia include:

• Pain in the groin
• Pain in the testicles
• Pain that gets worse with activity (e.g., running, bending, sitting up, sneezing, or coughing)
• Pain that gets better with rest

How Sports Hernias Are Diagnosed

To diagnose a sports hernia, your provider will ask you about your symptoms, your activities, and your medical history. They will also do a physical examination and diagnostic tests.

One common imaging test to diagnose hernias is magnetic resonance imaging (MRI). Along with X-rays and ultrasounds, MRIs can be used to rule out other causes of groin pain. However, some research has shown that MRIs might be useful for spotting a sports hernia.

There are other causes of groin pain in athletes, many of which are more common than a sports hernia. For example: 

• Adductor muscle strains
• Hip labral tears
• Osteitis pubis
• Stress fractures in the pelvis
  

How Sports Hernias Are Treated

Unlike a strain, a sports hernia will not get better on its own. Surgery is usually the most effective way to treat a sports hernia, but it’s not probably the first treatment your provider will recommend to help with healing. They will likely want you to use non-surgical strategies first to see if they help your symptoms. 

For example, they may have you try:

• Resting from activity
• Taking anti-inflammatory medications (e.g., ibuprofen, Motrin)
• Using ice treatments
• Doing physical therapy (particularly exercises to strengthen the pelvis and abdominal muscles) 

If these treatments don’t help, surgery can be done to fix the weak area of the muscle.

Between 65% and 90% of athletes can return to play after surgery for a sports hernia. Rehabilitation from surgery for a sports hernia usually takes about eight weeks.

A Can Sports Hernias Be Prevented?

You can’t always prevent a sports injury, including a hernia. There are, however, steps you can take to play your sport safely and reduce your chances of getting a hernia.

For example:

• Do exercises to keep your core muscles strong
• Do hip strengthening exercises
• Work on improving your flexibility 
• Make sure you’re using proper form when participating in your sport
• Always warm up before you start playing 
• Go slow and work your way up to more intense activity when you’re starting something new
• Maintain your overall health and wellness by eating a balanced diet, staying hydrated, managing your weight, and getting enough sleep

Summary

If the muscles in your lower abdomen get too weak, you could get a sports hernia. Painful strains and tears can easily happen if you have weak muscles.

If you get a sports hernia, your provider may want you to try rest, ice, and anti-inflammatory medications to see if your symptoms improve. If they don’t, the only way to fix a hernia is to have surgery.