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Sports Hernia Diagnosis

What Is A Sports Hernia?

A sports hernia is tearing of the transversalis fascia of the lower abdominal or groin region. A common misconception is that a sports hernia is the same as a traditional hernia. The mechanism of injury is rapid twisting and change of direction within sports, such as football, basketball, soccer and hockey.

The term “sports hernia” is becoming mainstream with more professional athletes being diagnosed. The following are just to name a few:

Torii Hunter
Tom Brady
Ryan Getzlaf
Julio Jones
Jeremy Shockey
If you follow any of these professional athletes, they all seem to have the same thing in common: Lingering groin pain. If you play fantasy sports, this is a major headache since it seems so minor, but it can land a player on Injury Reserve on a moments notice. In real life, it is a very frustrating condition to say the least. It is hard to pin point, goes away with rest and comes back after activity, but is hardly painful enough to make you want to stop. It lingers and is always on your mind. And if you’re looking for my step-by-step sports hernia rehab video course here it is.

One the best definitions of Sport hernias is the following by Harmon:
The phenomena of chronic activity–related groin pain that it is unresponsive to conservative therapy and significantly improves with surgical repair.”

This is truly how sports hernias behave in a clinical setting. It is not uncommon for a sports hernia to be unrecognized for months and even years. Unlike your typical sports injury, most sports medicine offices have only seen a handful of cases. It’s just not on most doctors’ radar. The purpose of this article is not only to bring awareness about sports hernias, but also to educate.

Will you find quick fixes in this article for sports hernia rehab?
Nope. There is no quick fix for this condition, and if someone is trying to sell you one, they are blowing smoke up your you-know-what.

Is there a way to decrease the pain related to sports hernias?
Yes. Proper rehab and avoidance of activity for a certain period of time will assist greatly, but this will not always stop it from coming back. Pain is the first thing to go and last thing to come. Do not be fooled when you become pain-free by resting it. Pain is only one measure of improvement in your rehab. Strength, change of direction, balance and power (just to name a few) are important, since you obviously desire to play your sport again. If you wanted to be a couch potato, you would be feeling better in no time. Watching Sports Center doesn’t require any movement.

Why is this article so long?
There is a lot of information on sports hernias available to you on the web. However, much of the information is spread out all over the internet and hard for athletes to digest due to complicated terminology. This article lays out the foundational terminology you will need to understand what options you have with your injury. We will go over anatomy, biomechanics, rehab, surgery, and even the fun facts. The information I am using is from the last ten years of medical research, up until 2016. We will be making updates overtime when something new is found as well. So link to this page and share with friends. This is the best source for information on sports hernias you will find.

Common Names (or Aliases?) for Sports Hernias
Sportsman’s Hernia
Athletic Pubalgia
Gilmore’s Groin
How Do You Know If You Have A Sports Hernia?
Typical athlete characteristics:
Male, age mid-20s
Common sports: soccer, hockey, tennis, football, field hockey
Motions involved: cutting, pivoting, kicking and sharp turns
Gradual onset

How A Sports Hernia Develops
Chronic groin pain typically happens over time, which is why with sports hernias, we do not hear many stories of feeling a “pop” or a specific moment of injury. It is the result of “overuse” mechanics stemming from a combination of inadequate strength and endurance, lack of dynamic control, movement pattern abnormalities, and discoordination of motion in the groin area.

There is a lot going on in the groin area. There are many muscles, tendons, and fascia pulling in different directions. These contracting structures need to coordinate together for any athletic motion. This perspective is also known as the injury prevention model.

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This 24 years old man amputated his left hand’s thumb, index, middle and ring fingers with a power saw in 2015. Pre-operative photographies are presented. The video shows the results 7 months after replantation. You can see another videos in my site: https://drliaghatclinic.com, https://instagram.com/liaghatclinic, https://t.me/liaghatclinic

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Leopold's Maneuvers are difficult to perform on obese women and women who have hydramnios. The palpation can sometimes be uncomfortable for the woman if care is not taken to ensure she is relaxed and adequately positioned. To aid in this, the health care provider should first ensure that the woman has recently emptied her bladder. If she has not, she may need to have a straight urinary catheter inserted to empy it if she is unable to micturate herself. The woman should lie on her back with her shoulders raised slightly on a pillow and her knees drawn up a little. Her abdomen should be uncovered, and most women appreciate it if the individual performing the maneuver warms their hands prior to palpation. First maneuver: Fundal Grip While facing the woman, palpate the woman's upper abdomen with both hands. A professional can often determine the size, consistency, shape, and mobility of the form that is felt. The fetal head is hard, firm, round, and moves independently of the trunk while the buttocks feel softer, are symmetric, and the shoulders and limbs have small bony processes; unlike the head, they move with the trunk. Second maneuver After the upper abdomen has been palpated and the form that is found is identified, the individual performing the maneuver attempts to determine the location of the fetal back. Still facing the woman, the health care provider palpates the abdomen with gentle but also deep pressure using the palm of the hands. First the right hand remains steady on one side of the abdomen while the left hand explores the right side of the woman's uterus. This is then repeated using the opposite side and hands. The fetal back will feel firm and smooth while fetal extremities (arms, legs, etc.) should feel like small irregularities and protrusions. The fetal back, once determined, should connect with the form found in the upper abdomen and also a mass in the maternal inlet, lower abdomen. Third maneuver: Pawlick's Grip In the third maneuver the health care provider attempts to determine what fetal part is lying above the inlet, or lower abdomen.[2] The individual performing the maneuver first grasps the lower portion of the abdomen just above the symphysis pubis with the thumb and fingers of the right hand. This maneuver should yield the opposite information and validate the findings of the first maneuver. If the woman enters labor, this is the part which will most likely come first in a vaginal birth. If it is the head and is not actively engaged in the birthing process, it may be gently pushed back and forth. The Pawlick's Grip, although still used by some obstetricians, is not recommended as it is more uncomfortable for the woman. Instead, a two-handed approach is favored by placing the fingers of both hands laterally on either side of the presenting part. Fourth maneuver The last maneuver requires that the health care provider face the woman's feet, as he or she will attempt to locate the fetus' brow. The fingers of both hands are moved gently down the sides of the uterus toward the pubis. The side where there is resistance to the descent of the fingers toward the pubis is greatest is where the brow is located. If the head of the fetus is well-flexed, it should be on the opposite side from the fetal back. If the fetal head is extended though, the occiput is instead felt and is located on the same side as the back. Cautions Leopold's maneuvers are intended to be performed by health care professionals, as they have received the training and instruction in how to perform them. That said, as long as care taken not to roughly or excessively disturb the fetus, there is no real reason it cannot be performed at home as an informational exercise. It is important to note that all findings are not truly diagnostic, and as such ultrasound is required to conclusively determine the fetal position.

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Rhabdomyolysis is a condition in which damaged skeletal muscle (Ancient Greek: rhabdomyo-) tissue breaks down rapidly (Greek –lysis). This damage may be caused by physical (e.g. crush injury), chemical, or biological factors. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidney and may lead to kidney dysfunction. The severity of the symptoms (which may include muscle pains, vomiting and confusion) depends on the extent of the muscle damage, and whether kidney failure develops. The mainstay of treatment is generous intravenous fluids, but could include dialysis or hemofiltration.

Rhabdomyolysis and its complications are significant problems for those injured in disasters such as earthquakes and bombing. Relief efforts in areas struck by earthquakes often include medical teams with skills and equipment for treatment of survivors with rhabdomyolysis. The disease and its mechanisms were first fully elucidated during the Blitz of London in 1941.

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