1. Sports Hernia
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2. What is a Sports Hernia
• A sports hernia is a very complex injury
that is extremely hard to diagnose
because of the many specific muscles,
tendons, ligaments, and tissues it can
involve.
• Sports hernias are used as an umbrella
term to characterize a groin injury caused
by the imbalance of strength between the
lower abdominal muscles, and the
muscle of the medial thigh (mostly
adductors).
• Naturally athletes develop stronger
adductor muscles, because the lower
body is trained more than their core.
• This imbalance in strength becomes a
problem because various muscles and
tissues of the abdomen and adductors
share sites of attachment in areas such
as the pubis.This creates a “tug of war”
type stress on the bones, muscles,
tendons, and ligaments of the groin area.
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3. Specific Examples and Anatomy
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 The inguinal ligament attaches at the anterior superior iliac spine and the pubic tubercle, and is a
site of origin and insertion for multiple muscles and tissues of the abdomen, and medial thigh.
 The rectus abdominis site of insertion lies on the inguinal ligament, while muscles of the
adductors attach at where at the pubic tubercle where it meets the inguinal ligament.
For a sports hernia to occur, the a section of the abdomen(usually the transversalis fascia,
external obliques or rectus abdominis) must suffer a strain tear, or thinning in the muscle tissue.
Once a part of the abdomen has been weakened the pelvic area cannot cope with the imbalance of
strength, causing injury to areas of the groin.
In many cases the inguinal ligament suffers most from the “tug of war” that ensues when playing
an explosive sport that requires twisting, kicking, or awkward contact.
on the left we see an injured rectus abdominis where it inserts at the inguinal ligament, and on the
right we see a weakened abdominal wall called the transversalis fascia( fascia of the abdominal
wall that runs underneath the obliques and along the inguinal ligament)

4. Conservative Treatment
 Non surgical treatment of a sports hernia is
most often used as a coping mechanism,
allowing the athlete to perform until they are
able to have surgery.
 Because sports hernias are hard to diagnose
many athletes treat it as a strained groin with
rest and physiotherapy. These techniques are
also used in the case of sports hernias,
however the physical therapy would focus on
strengthening the core, and controlling lateral
movements. In some cases rest, ice,
physiotherapy, tape, and compression shorts
will allow the athlete to play through the pain
continue postponing surgery.
 Without surgery the groin pain will almost
always become a chronic reoccurring issue.
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5. Surgery
 Sports hernias are now surgically treated in two main categories, laparoscopic surgery
(minimally invasive) and the traditional open surgery.
 Up until recently sports hernias were only operated on under the traditional open method, which
involve reattaching the rectus abdominis, conjoined tendon, and/or transversalis fascia to the
pubis and inguinal ligaments, along with polypropylene mesh that supports and reinforces the
injured area. After an open surgery the athlete must take 6 weeks to simply recover and
rehabilitate from the surgery. After these 6 weeks the athlete can expect to be back in play in a
minimum 3 months; pending symptoms the athlete may experience, and the success of
physiotherapy.
 Laparoscopic surgery is a fairly new technique used on sports hernias and has reduced the
recovery time of athletes who qualify for the surgery significantly.
 This surgery involves a number of small incisions in the inguinal area so that a surgical
camera(laparoscope or endoscope) can be inserted in order to pinpoint where exactly the
damaged area is. Surgical instruments are then used through the other incisions to reinforce
the injured area of the abdominal wall with polypropylene mesh and surgical tacks.

6. Additional procedures
 Adductor Tenotomy: a
surgical procedure where the
tendon that attaches the
adductor to the pubis is cut,
allowing it heal at a longer
length, relieving tension.
 Illioinguinal Neurectomy:
Process of cutting or
releasing the inguinal nerve
in order to relieve pain.
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8. Adrian Peterson
 “I just remember getting twisted up pretty bad in an awkward position.
My jersey never moves like that. I don't know if it was from a tackle or
from me pulling away from someone. I just remember thinking when I
saw my jersey like that, that I must've gotten twisted up pretty bad”
(Adrian Peterson)
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