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By Categories: Hernia Types

Other causes of Groin Pain

Sportsman’s groin, Gilmore’s groin, Sportsman’s hernia, Footballer’s hernia, Pubalgia, Inguinal canal disruption, Sports Hernia, Conjoint tendon disruption.

Several names are given to the condition found in sportsmen and women characterised by groin pain. Symptoms may start during exercise but there is rarely a history of sudden pain. Following exercise, the early stages are characterised by pain and stiffness. The stiffness gradually improves but the symptoms fail to improve despite rest.

The condition was first described by Jerry Gilmore, London in 1980.

Pain is exacerbated by running, jumping, change of direction, coughing and sneezing. It is usually possible in the early stages to continue exercising.

No lump is palpable in the groin, but on close clinical examination, there is often a dilated superficial ring on the affected side.

Ultrasound is helpful. On straining there is a protrusion of the posterior wall of the inguinal canal. The pain in the groin and pelvis can be referred from a number of problems, including injuries to the lumbar spine, the hip joint, the sacroiliac joint, the abdomen, and the genito-urinary system.

Osteitis Pubis

Refers to inflammation of the joint of the symphysis pubis (pubic bone). The inflammation leads to both acute and chronic pain.
It is most prevalent amongst athletes, runners, and footballers and may represent an overuse injury. Symptoms can be so severe that it is not possible to continue exercising.
Osteitis pubis is diagnosed on an Xray. MRI scanning can be very helpful in assessing the severity of the inflammation.
Until recently no treatment was available. Physiotherapy however has developed rehabilitation strategies in the past few years which are proving very effective. Rest and anti-inflammatory agents are recommended. Considerable success has been noted using prolotherapy (glucose and local anaesthetic injection) for those patients who failed to improve with conservative management.

Abdominal strain

An abdominal muscle strain is an injury to one of the muscles of the abdominal wall. This usually occurs in response to excessive stretching. Rectus abdominis and the oblique muscles can all be affected.

As with groin strains, the symptoms are sudden onset of pain, muscle spasms and bruising.
Injuries are usually managed conservatively with rest, ice and analgesia.

You would be advised to see a Physiotherapist who can help you with your recovery.

Groin strain

A groin strain is a common injury for the sportsman, of all abilities. The term usually refers to a injury to one of the adductor muscles or tendons, either in the muscle itself or at its attachment to the pelvis. There are 5 adductor muscles, Adductor magnus, Adductor longus and Adductor brevis, Gracilis and Pectineus. These adductor muscles are found on the upper inner thigh. Their action is to adduct the legs,ie squeeze the legs together.

These injuries usually occur during sprinting, running and kicking.

Groin strains are graded 1-3 depending upon their severity.
GRADE 1 Minor tear <10% of fibres torn
GRADE 2 Intermediate tear <90% of muscle fibres torn
GRADE 3 Major tear 90 – 100% of muscle fibres torn

Injuries are usually managed conservatively with rest, ice and analgesia.

You would be advised to see a Physiotherapist who can help you with your recovery.

Sacroiliac joint dysfunction / Sacroiliitis

The sacroiliac joints are situated at the bottom end of the spine where the sacrum joins to the pelvis. The joints act as shock absorbers for the body whilst standing, walking and sitting.

The SIJ commonly suffers from ‘disorders’, especially from running. These disorders are best described as jamming or restriction to the movement of the joint. As the two SIJs make up two of the three joints of the circular pelvis one of them not working has an impact on the whole circle. Sometimes an unrecognised/untreated issue in the SIJ leads to repeated stress across the pubic symphysis at the front of the pelvis, producing pain and possibly leading to Ostitis Pubis in some cases.

Inflammation of the sacroiliac joint gives rise to sacroiliitis, which is a common cause of unilateral low back pain, with pain extending from the low back into the buttock or thigh.
The pain can extend into the hip and groin, thereby confusing this condition with causes for groin pain.

You would be advised to see a Physiotherapist who can help you with your recovery.

Hip joint

The hip joint can produce pain in younger athletes as well as the more widely recognised Osteoarthritic changes seen in the older community. Hip pain is often felt deep in the front of the groin and can be confused with hernia-type pain. An assessment with an experienced physio in this field will differentiate the problems.

Adductor Tendinopathy

The adductor tendons are a group of muscles which attach to the bottom of the pelvis. Onto the very Pubic bone associated with Ostitis Pubis. This tendon can become damaged and torn, often repeatedly during sports like football. This can lead to a chronic condition which gives pain in the lower groin.

You would be advised to see a Physiotherapist who can help you with your recovery.

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NGH surgeon gets MBE for amazing work in Africa2024-01-30T11:10:47+00:00

What is a Hernia?2023-03-31T12:53:03+00:00

A hernia is the protrusion of a structure through the wall of the cavity containing it. In the context of this website, a hernia is simply the protrusion of the bowel through a hole or weakness in the muscle layer of the wall of the abdomen.

There are many different types of hernia, named according to the site of the weakness of the abdominal wall. All hernias may gradually increase in size over time. They can be asymptomatic but may cause symptoms of aching or pain. A lump may or may not be palpable. One of the key concerns is the risk of a hernia becoming obstructed or strangulated. The first signs of this are a sudden increase in pain and tenderness of the hernia. The swelling may increase in size and it may not be possible to reduce the hernia, that is to push the swelling back in.

What happens if I don’t have it repaired?2023-03-31T12:52:27+00:00

Hernias do tend to get bigger over time. As they get larger they can become more difficult to repair.  There is a risk that the contents of a hernia may become trapped, called strangulation of the hernia. This is a painful condition which requires urgent surgical attention.

What about exercise after hernia surgery?2023-03-31T12:52:00+00:00

You should resume exercise as soon as possible after surgery.  Please look at the rehab programs for further information. Just start with some gentle walking and you will progress quickly.

Is it a Hernia if it only hurts when I run fast?2023-03-31T12:51:31+00:00

Possibly. A Sportsman’s hernia has a wide variety of presentations, from pain whilst sitting up in bed and coughing, to only being symptomatic when you are running hard. Even then it may not be painful but just give you a sense of instability and lack of power.

Is a Sportsman’s hernia the same as a Gilmore’s groin?2023-03-31T12:51:06+00:00

Yes. The condition known as a Sportsman’s Hernia has many different names. It was first described by Jerry Gilmore in 1980, following the successful treatment of 3 professional footballers with groin symptoms.
Other names for the condition include: Sportsman’s groin, Sportsman’s Abdominal Wall Syndrome, Gilmore’s Groin

How soon can I drive and return to work?2023-03-31T12:50:28+00:00

You should not drive for 48 hrs after any general anaesthetic. After hernia surgery, you are advised to have some time off work to recover.  I normally advise you to plan to return to work 7 -10 days after surgery. If your job involves manual work with heavy lifting, this time may need to be extended to as long as 4 weeks. If your job is desk-based then you may be able to return slightly earlier, but this will depend upon the speed of your recovery.

Could I have a hernia, even if I can’t feel a lump?2023-03-31T12:46:53+00:00

A hernia is most commonly identified as a lump, which gets bigger on coughing and disappears when lying flat. However, this is not the case for some individuals, especially in the sportsman. Sometimes the lump can be challenging to feel on oneself, occasionally the diagnosis is only made after further tests such as ultrasound.

A true sports hernia can be nothing more than a feeling of weakness around the lower trunk. It could be a pain when trying to walk or maybe just running. The presentation is variable, which is why it makes it tough to diagnose if you do not see them very often.

Do all hernias require surgery?2023-03-31T12:47:35+00:00

Surgery is usually advised. Occasionally patients are not fit enough to undergo surgery. If the risk of surgery is considered excessive then it may be suggested that a truss is worn which tries to control the hernia with pressure.

Do I have to have a general anaesthetic?2023-03-31T12:48:33+00:00

No, you do not necessarily need to have a general anaesthetic.  For an inguinal hernia, an open repair can be performed in most instances under local anaesthetic, if you prefer. The laparoscopic technique does require a general anaesthetic.

How do I know if I have a hernia?2023-03-31T12:49:03+00:00

Men and women, young and old, can all have a hernia. Often the first thing you notice is discomfort in the area of the groin, especially when lifting or straining. You might feel a lump in the groin which gets bigger if you cough and can disappear if you lie down.

How do I know if it is a Hernia?2023-03-31T12:49:57+00:00

Sometimes the first symptom is a lump in the groin, other times it is pain or discomfort. Hernias do not account for all groin and abdominal symptoms, and certainly not all of these require surgery.  Many injuries around the groin and abdomen can be treated with physiotherapy alone.

It is always important to rule out other causes of groin pain, including lower back and hip problems. This is the point where an assessment by a Physiotherapist with experience in Hernias and all the associated issues is essential. If there is a true hernia then you will be referred to Rob Hicks for a surgical opinion. If it is not a hernia the actual condition can be addressed with Physiotherapy.

However, if it is a true ‘Hernia’ or ‘Sports Hernia’ then it will not usually resolve without surgery. At The Hernia Clinic, we can offer the most current and appropriate surgical techniques to correct the defect, which is followed up by an integrated rehabilitation package. This will include biomechanical assessment and a graded rehabilitation program.

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