Sports hernias, or athletic pubalgia, are familiar yet challenging injuries that can hinder an athlete’s sports performance. They often affect individuals who participate in sports with sudden twisting and turning movements. Fortunately, physical therapy plays a crucial role in managing and treating sports hernias, helping athletes regain their strength, stability, and confidence on the field. This blog will explore the best physical therapy treatment options for sports hernias, including effective therapeutic exercises, pain management techniques, and recovery strategies.
What is a Sports Hernia (Athletic Pubalgia)?
A sports hernia, or athletic pubalgia, is a soft tissue injury in the lower abdomen or groin area. Unlike a traditional hernia, it does not have a visible bulge; it results from tears or strain in the muscles, tendons, or ligaments in the groin. This injury is common among athletes and can cause chronic pain, affecting the athlete’s ability to perform.
Where Do Sports Hernias Occur on the Body?
Sports hernias typically occur in the lower abdomen and the groin area, where the abdominal muscles connect with the pelvis. The injury often affects the muscles, tendons, and ligaments around the pubic bone, leading to groin pain and limited movement.
What is the Difference Between a Sports Hernia and a Hernia?
Although they share the name “hernia,” a sports hernia differs from a traditional hernia. In a conventional hernia, an organ or tissue pushes through the abdominal wall, causing a visible bulge. A sports hernia, however, does not involve a protruding organ or tissue but rather a strain or tear in the soft tissue.
Which Sports Cause Sports Hernias?
Sports hernias are commonly seen in athletes with sudden twisting, pivoting, and high-intensity movements. Sports that are commonly associated with sports hernias include:
- Ice hockey
- Soccer
- Football
- Wrestling
- Rugby
- Skiing
- Tennis
- Hurdling
How Common Are Sports Hernias?
Sports hernias account for up to 5% of all athletic groin injuries and are particularly prevalent in sports that involve repetitive twisting movements, such as soccer and ice hockey. Males account for more than 90% of sports hernia cases, highlighting a significant gender predisposition.
How Do Sports Hernias Affect Movement?
Sports hernias can severely affect an athlete’s movement, particularly in actions that require twisting, sprinting, or cutting. The pain associated with the injury can limit an athlete’s ability to perform these movements and may worsen if not treated properly.
Symptoms and Causes
Sports hernia often presents symptoms such as persistent groin pain, discomfort during physical activity, and tenderness in the lower abdomen. The primary causes typically involve repetitive strain or acute injury to the muscles, tendons, or ligaments in the groin area.
What Causes a Sports Hernia?
During high-impact sports, a sports hernia is typically caused by repetitive stress to the groin area. The following actions can contribute to the development of a sports hernia:
- Tenderness on the front of the pelvis: Tenderness on the front of the pelvis can indicate various conditions, ranging from muscle strain to more severe issues. It’s important to assess any accompanying symptoms to determine the appropriate action.
- Pain with an abdominal crunch: Pain during an abdominal crunch can indicate muscle strain or improper technique. It’s important to assess your form or consult a healthcare professional if the discomfort persists.
- Groin pain: Groin pain refers to discomfort or pain in the area where the abdomen meets the thigh. It can result from various causes, such as muscle strains, injuries, or underlying medical conditions. A sharp or dull ache often characterizes it, and it may be accompanied by swelling or difficulty moving the affected leg.
- Pain when squeezing the thighs together: Pain when squeezing the thighs together often signals strain or injury to the muscles, tendons, or ligaments in the groin area, commonly associated with conditions like sports hernias. This discomfort typically intensifies during movements involving pressing the legs inward, as these actions pressure the affected tissues.
- Pain with sprinting or cutting: Pain with sprinting or cutting is a typical symptom of a sports hernia or groin injury, where the rapid, forceful movements strain the weakened or torn tissues in the lower abdomen or groin. This discomfort often worsens during high-intensity, directional changes, making it challenging to perform sudden bursts of speed or sharp pivots.
What Are the Symptoms of a Sports Hernia?
The most common symptoms of a sports hernia include:
- Chronic pain in the groin or lower abdomen: Chronic pain in the groin or lower abdomen is a persistent discomfort often associated with sports hernias, indicating ongoing strain or injury in this region. The pain may be constant or fluctuate, becoming more noticeable during certain activities.
- Pain that worsens with physical activity, particularly twisting or pivoting: This type of pain tends to increase during activities that involve sudden changes in direction, such as twisting or pivoting, due to the added stress on the injured muscles or tendons in the groin or lower abdomen. Athletes frequently experience heightened discomfort when engaging in these dynamic movements.
- Pain during movements such as sprinting, cutting, or bending: Pain during movements like sprinting, cutting, or bending is common with a sports hernia, as these high-intensity actions put significant pressure on the injured tissues. This can severely limit an athlete’s ability to perform at full strength, especially in sports that require explosive, directional changes.
Diagnosis and Tests
Diagnosis and tests for a sports hernia typically involve a thorough physical examination and medical history review to assess symptoms and identify potential soft tissue injuries. Diagnostic imaging, such as MRI, X-ray, ultrasound, or CT scans, may be used to confirm the presence of a sports hernia and rule out other conditions like fractures or traditional hernias.
How is a Sports Hernia Diagnosed?
Diagnosing a sports hernia involves a thorough physical examination by a healthcare professional. The physician will assess the patient’s medical history, evaluate their pain levels, and examine the groin and lower abdomen for signs of injury.
What Tests Are Used to Diagnose a Sports Hernia?
Imaging tests are often used to confirm the diagnosis of a sports hernia. These may include:
- MRI: Magnetic resonance imaging (MRI) is an important technique for visualizing soft tissue injuries. It provides detailed images that help diagnose and treat these types of injuries.
- X-ray: An X-ray can help identify the underlying cause of pain and effectively rule out possibilities like bone fractures.
- Ultrasound: An ultrasound is a valuable tool for identifying soft tissue damage. It can provide detailed images, helping doctors assess the extent of injuries.
- CT scan: Computed tomography can provide detailed pictures of the groin area. This imaging technique is essential for diagnosing various conditions and understanding anatomical structures.
- Bone scan: A bone scan effectively identifies abnormalities in the bones around the groin area. This imaging technique helps in diagnosing potential issues such as fractures or infections.
Management and Treatment
Management and treatment involve a comprehensive approach to addressing a specific condition or illness. This may include a variety of strategies such as medication, therapy, lifestyle changes, and support systems tailored to the individual’s needs.
How is a Sports Hernia Treated?
Treatment for a sports hernia typically begins with conservative methods, but in some cases, surgery may be necessary.
- Rest: Rest is essential for tissue healing and helps lessen inflammation. Allowing the body to recover can promote overall health and well-being.
- Physical therapy: Physical therapy is critical in helping athletes recover from sports hernias. Targeted exercises strengthen the core muscles and improve flexibility to prevent future injuries.
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) effectively alleviate pain and reduce inflammation. They are commonly used for arthritis, headaches, and muscle aches.
- Corticosteroids: Injections of corticosteroids can effectively alleviate intense inflammation and pain. These treatments are often utilized when other methods have not provided sufficient relief.
General Types of Surgical Treatment
In cases where conservative treatments fail, surgical intervention may be necessary. The two most common types of surgical procedures for sports hernias are:
- Laparoscopic surgical procedure: This type of surgery is characterized by small incisions that contribute to a less invasive approach. As a result, patients often experience quicker recovery times compared to traditional surgical methods.
- Open surgical procedure: This approach requires a larger incision, which can be more invasive. However, it may offer improved access for effectively repairing the injury.
- Surgical rehabilitation: Physical therapy is crucial for regaining strength and mobility after surgery and for preventing future injuries.
Do Sports Hernias Heal on Their Own?
A sports hernia may improve with rest and conservative treatment, but it often requires intervention such as physical therapy or surgery to heal fully.
Physical Therapy for Sports Hernia
Physical therapy for sports hernia focuses on strengthening the core muscles, improving flexibility, and enhancing stability to reduce pain and support recovery. Through targeted exercises and rehabilitation techniques at Continuous Motion Physical Therapy, physical therapy helps athletes regain strength, prevent re-injury, and return to their sport with improved performance.
What Type of Physical Therapy is Needed for a Sports Hernia?
Physical therapy for a sports hernia focuses on strengthening the core muscles, improving flexibility, and enhancing stability. Common physical therapy exercises for sports hernia include:
- Core exercises: Core exercises focus on strengthening the abdomen and lower back muscles, which are essential for stabilizing the body and reducing the risk of further injury. These exercises are particularly beneficial for recovering from a sports hernia, as they help improve muscle control and prevent excessive strain on the groin area.
- Stretching: Stretching helps increase flexibility and reduce muscle tightness, alleviating tension in the groin and surrounding areas. Incorporating regular stretching into rehabilitation can improve the range of motion and promote healing in athletes recovering from a sports hernia.
- Swimming: Swimming is a low-impact exercise that allows athletes to build strength and endurance without placing excessive stress on the injured area. The buoyancy of water supports the body while engaging the muscles, making it an ideal activity during sports hernia rehabilitation.
- Yoga: Yoga promotes flexibility, core strength, and balance, which are crucial for recovery from a sports hernia. Through controlled movements and poses, yoga helps relieve muscle tension while improving overall stability and body awareness.
- Posture stability exercises: Posture stability exercises focus on improving balance and alignment, which can help prevent further injury and aid in recovering a sports hernia. By enhancing core strength and body mechanics, these exercises support better movement patterns during physical activities.
- Using medicine balls: Medicine ball exercises provide a dynamic way to engage the core and build strength through resistance. These exercises are particularly useful in sports hernia rehabilitation, promoting stability and enhancing muscle coordination.
- Using resistance bands: Resistance bands offer a versatile way to strengthen muscles and improve flexibility without putting excessive strain on the body. They can be used in various exercises to target specific areas affected by a sports hernia, making them a valuable tool in physical therapy.
Early Rehab Exercises for Sports Hernia
During the early stages of rehabilitation, the following exercises for sports hernia physical therapy are recommended to improve core strength and stability:
- Stability Ball Dead Bugs: This exercise targets the core while engaging the body’s stabilizing muscles. This movement helps improve balance and coordination, making it an effective addition to any workout routine.
- Supine Transversus Abdominus Bracing – Hands On Stomach: Supine Transversus Abdominus Bracing involves engaging the core muscles while lying on your back. This technique can be enhanced by placing your hands on your stomach to feel the contraction and support proper alignment.
- Supine Dead Bug with Leg Extension: The Supine Dead Bug with Leg Extension is an effective core exercise that targets the abdominal muscles while promoting stability. Engaging the upper and lower body enhances coordination and strengthens the core without straining the back.
- Marching Bridge: The marching bridge exercise effectively strengthens the core and stabilizes the pelvic region, which can help alleviate discomfort associated with a sports hernia. This exercise promotes better muscular balance and function by engaging the glutes and hips while maintaining proper alignment.
Exercise Progressions
As the athlete progresses in their recovery, more advanced exercises can be introduced to strengthen the core further and improve stability:
- Side Plank with Rotation: The Side Plank with Rotation is an effective exercise that targets the core, shoulders, and obliques. Incorporating rotation enhances stability and helps improve overall mobility and strength.
- Half Kneeling Med Ball Diagonals: The Half-Kneeling Med Ball Diagonals exercise enhances core stability and strengthens the obliques. This dynamic movement involves lifting a medicine ball diagonally across the body while in a half-kneeling position.
- Transverse Lunge: The transverse lunge is an effective lower-body exercise that targets the glutes, quads, and hamstrings while improving balance and stability. To perform it, step laterally with one leg, bending both knees to lower your body, and then return to the starting position.
- Lateral Step Down: The Lateral Step Down is an exercise that targets the lower body, particularly the quadriceps and glutes. It involves stepping sideways off a platform while maintaining balance and control as you lower your body.
Can I Prevent a Sports Hernia?
While it may not always be possible to prevent a sports hernia, maintaining strong core muscles, improving flexibility, and using proper techniques during sports activities can help reduce the risk of injury.
How Long Does It Take to Recover from a Sports Hernia?
The recovery time for a sports hernia can vary depending on the severity of the injury and the type of treatment received. Athletes who follow a physical therapy program may see decreased pain and improved function within 4 to 6 weeks. Studies show that the percent decrease in VAS (pain score) was 80.25% in the active rehabilitation group, compared to 41.93% in the conventional treatment group.
When Should I See My Healthcare Provider?
If you experience persistent groin pain that worsens with physical activity or does not improve with rest, you must consult a healthcare provider to determine whether a sports hernia is the cause.
Conclusion
Sports hernias can be a debilitating injury for athletes, but with proper diagnosis and treatment, including physical therapy, it is possible to regain full performance. Physical therapy offers a range of exercises and strategies to strengthen the core, improve stability, and facilitate recovery. For anyone suffering from a sports hernia, early intervention and a structured rehabilitation plan are key to getting back to the activities you love.
FAQs
How Long Does It Take to Recover from a Sports Hernia with Physical Therapy?
Recovery can take 4 to 6 weeks, depending on the severity of the injury and the patient’s adherence to physical therapy exercises.
Can Physical Therapy Alone Treat a Sports Hernia, or Is Surgery Necessary?
In many cases, physical therapy can effectively treat a sports hernia without surgery. However, if conservative treatments fail, surgery may be necessary.
What Activities Should I Avoid While Recovering from a Sports Hernia?
During recovery, avoiding twisting, cutting, and high-intensity movements that could aggravate the injury is important.
