Sports bar - Information and specialists

Athlete's groin is a term used to describe acute or chronic groin pain in athletes. There are various possible causes of pain in the groin area. A precise diagnosis is important so that the patient receives specific treatment. Untreated groin pain places a heavy burden on athletes and can lead to the end of their sporting career.

Below you will find further information and specialists.

What is a sports groin

Athlete's hernia is a complex of complaints that has many names among doctors. Synonyms include "soft groin" or "pubic inguinal pain syndrome" (PIPS). It mainly affects top athletes. It is caused by heavy strain on the groin due to repeated abrupt movements. These complaints occur in footballers and tennis players, for example.

Groin pain is a common problem among athletes and can have serious consequences for professional athletes. @ Jo Panuwat D / AdobeStock

Over time, the intense strain causes the posterior wall of the groin canal to weaken. However, an athlete's hernia is not a hernia! It is not a hernia (opening or tear) in which abdominal organs can protrude.

An athlete's hernia is a protrusion of the posterior wall of the inguinal canal. This can also occur with high intra-abdominal pressure, for example when coughing or straining. The protrusion of the inguinal fascia presses on neighboring nerve cords. This causes pain.

Other causes are a spermatic cord lipoma in men and a Nuck's cyst in women. The spermatic cord lipoma in particular is more common in young athletes. The causes have not yet been precisely clarified, but mechanical stimulation during fast movements may also be a trigger.

A lipoma is a benign fatty tissue tumor in the inguinal canal. It can increase in size and thus displace other areas in the vicinity. This causes pain in the direction of the abdomen or testicles.

If structures near the groin are diseased, they can also cause pain in the groin. For example:

• Hip and hip joints
• Pubic bone
• Spine
• Surrounding muscle groups (back and abdominal muscles, adductors)
• Nerve cords
• Lymph nodes
• Intra-abdominal organs

Symptoms of an athlete's groin

Even if the causes of groin pain are varied, a sportsman's groin is usually accompanied by a typical symptom pattern:

• Drawing or burning pain in the groin, abdominal or back area, as well as in the scrotum and thighs: Doctors refer to this as nerve compression pain, which is caused by pressure on the nerve pathways. This pain can radiate from the groin to different areas.
• Pain in the pubic area: With a soft groin, the inguinal canal is widened (due to overstretching). This enables the displacement of tendinous structures that anchor the abdominal muscles to the bone. The result is an altered strain on the pubic bone, which can also lead to pain.

The pain often disappears when resting or during a rest period. However, it usually returns during sporting activity.

Diagnosis of a sportsman's groin

If you suffer from symptoms that look like an athlete's hernia, you should consult an experienced specialist for a diagnosis. In the case of competitive athletes, this is usually the supervising sports physician.

The diagnosis is made in several steps:

1. Anamnesis interview: The doctor will first conduct a comprehensive anamnesis interview (doctor-patient interview) with you. During this interview, you will tell him how intense your sporting activities are and where and how severe the pain is. Your medical history will also be examined during this consultation.
2. Physical examination: During the physical examination, the doctor will palpate the groin area in order to diagnose a hernia if necessary.
3. Dynamic ultrasound examination (sonography): A dynamic ultrasound examination (sonography) provides a clear diagnosis. The altered tissue structures can be easily visualized with this procedure. This, in conjunction with typical symptoms, allows a diagnosis to be made.
4. Further examinations: If the diagnosis is still not clear, further examinations such as X-rays or magnetic resonance imaging (MRI) are used.

Treatment of an athlete's hernia - therapy and prognosis

Various options are available for the treatment of sports hernia. Your specialist will recommend the most suitable procedure for you. The doctor will take the following points into consideration when deciding on treatment:

• Cause of the groin pain
• Type of pain (acute, chronic, pain character and severity)
• Importance for the athlete (e.g. quick return to professional sport)

If acute groin pain remains untreated, chronic illnesses can develop. High-performance athletes in particular should act quickly if they suspect an athlete's groin in order to prevent an exacerbation. Also to reduce the risk of a hernia.

• Conservative therapy

If the pain is minor, you can start with conservative therapy: you need to take it easy for a while to avoid renewed irritation. You can then carry out targeted stability and strengthening exercises with the help of physiotherapy.

• Surgical intervention

If the symptoms do not improve - despite a period of rest and physiotherapy - then surgery is advisable. Various techniques are possible. The type of surgical technique depends on the nature of the pain and the tissue affected:

• Nerve compression: In this case, pain relief can be achieved by making an incision through the nerve or by removing the damaged nerve area.
• Displacement of the muscular support apparatus: Surgical transection with refixation is a treatment option here.
• Spermatic cord lipoma: This must be surgically removed either laparo-endoscopically (keyhole surgery) or through a small incision.

All procedures are primarily aimed at achieving freedom from pain. Doctors usually combine these methods with surgical reinforcement of the posterior wall of the inguinal canal. This stabilizes the soft groin with a plastic mesh (prosthesis). In young athletes without a pronounced inguinal hernia, biodegradable plastic meshes are also used. These are very stable, but are completely broken down by the body after 15-18 months and replaced by the body's own connective tissue.

The surgical techniques for the sports hernia are minimally invasive. Patients are given a local anesthetic and can resume light training two days after the procedure. The success rate for the treatment of an athlete's hernia is high. Around 80 percent of those affected can resume their sporting activities pain-free and fully functional two weeks after the procedure.

Where to find specialists

If you are suffering from pain that indicates a sports hernia or a hernia, contact your family doctor. He or she will refer you to the appropriate specialist. These are often experienced orthopaedists, hernia surgeons or specialized sports physicians, sports surgeons or sports orthopaedists.

You can find specialists in group practices, medical centers or at your local hospital, for example. You can also obtain information or recommendations from the relevant specialist association.

Conclusion: Get back on track quickly with the right therapy

An athlete's hernia can become a major burden and jeopardize your sporting career. If you experience pain, you should therefore not hesitate and undergo a sports medical examination immediately. If you seek treatment in good time, you can prevent chronic groin pain. If conservative therapy does not help, an operation is advisable. This is minimally invasive. Two weeks later you can resume your sport without pain.