Sports hernia repair

A sports hernia is a complete or partial tear to the oblique abdominal muscles and is one of the least understood sports injuries because it differs so much from traditional hernias. The treatment and surgery that may be best for your sports hernia repair is determined based on important factors including your age, past and present health, the extent and exact location of the hernia and your history with other medications and treatments.

Diagnosis

A sports hernia can cause significant pain, and while painkillers may dull the pain temporarily, it can return once medication has worn off. If you are having recurring pain in your abdomen, it is important to seek medical treatment. To help diagnose your condition, your doctor will ask you questions related to your activities and perform a physical exam on the affected area. To better diagnose this injury, your doctor will use one of the following techniques:

  • X-ray (radiograph) – This test is used more as a preventative test to determine that no other injury is present. It does not show ligaments, and therefore cannot be used to diagnose a sports hernia. It is performed by sending radiation through the affected area. The radiation is then absorbed by the bone, which allows it to create a black-and-white image of the skeletal structure.
  • Magnetic resonance imaging (MRI) – This test increasingly is being used to help diagnose sports hernias. Because many doctors have relied solely on a physical exam in the past and have missed this unique injury, now more and more of them are using MRI to help determine the diagnosis. During this test, you are placed in a vessel with electromagnetic radio waves. These waves generate a resonance which is then transferred to an image.

Nonsurgical treatment

In some instances, sports hernia repairs can be done without the need for surgical intervention. This is done by using physiotherapy and rest to allow the body to heal naturally. Anti-inflammatory medications are also used during the healing process to reduce symptoms. Even though with the use of painkillers symptoms may not be present, to heal faster it is important that you follow the doctor’s guidelines and do not continue to exercise. In many cases, the injury still returns eventually, making surgery necessary.

Surgery

In most cases, sports hernia repairs require surgery. The aim is to sew the injury back together so that the nerve endings are not being pulled and ligaments can strengthen without pain. Most sports hernia repairs are performed surgically, using one of the following techniques:

  • Open surgery – Depending on the location of the injury, a long incision may be necessary to reach the affected area. This is the traditional approach to this type of surgery and is still performed because it allows the surgeon to sew the ligaments back together without the need for mesh or other additives that may cause later complications.
  • Laparoscopic surgery – In some cases, a smaller incision may be adequate for repairing the injury. This is determined by the doctor based on the extent of the hernia. This approach uses an endoscope. A small incision is created and a camera inside the scope enables the doctor to see the target area and use mesh to help repair the hernia.
  • Adductor tenotomy – When a hernia is severe, it may spread to the groin and adductor muscles. When this happens, a secondary surgery may be required. Because of reduced blood flow to these muscles following the hernia, it may be difficult for them to fully repair. In this situation, the secondary surgery sews the adductor muscles back together, increasing blood flow and allowing the tendons to heal faster.

The multidisciplinary team of musculoskeletal experts at Northwell Health Orthopaedic Institute performs sports hernia repair surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the muscles. 

Research

A significant portion of sports hernia repair research investigates various approaches to surgically fixing the injury. Because so many people who suffer from this injury are athletes who rely on their physical abilities to earn their living, making it back to the field, track or other environment in a timely manner, with an injury that will not resurface, is crucial to their professional lives.

As research on treatment is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.            

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