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J Am Acad Orthop Surg, Vol 15, No 8, August 2007, 507-514.
© 2007 the American Academy of Orthopaedic Surgeons
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Sports Hernia: Diagnosis and Therapeutic Approach

Adam J. Farber, MD and John H. Wilckens, MD

Dr. Farber is Chief Resident, Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD. Dr. Wilckens is Chairman, Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, and Assistant Professor, Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Farber and Dr. Wilckens.

Reprint requests: Dr. Wilckens, c/o Elaine P. Henze, BJ, ELS, Medical Editor, Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue #A672, Baltimore, MD 21224.

Groin pain is a common entity in athletes involved in soccer, ice hockey, Australian Rules football, skiing, running, and hurdling. An increasingly recognized cause of groin pain in these athletes is a sports hernia, an occult hernia caused by weakness or tear of the posterior inguinal wall, without a clinically recognizable hernia, that leads to a condition of chronic groin pain. The patient typically presents with an insidious onset of activity-related, unilateral, deep groin pain that abates with rest. Although the physical examination reveals no detectable inguinal hernia, a tender, dilated superficial inguinal ring and tenderness of the posterior wall of the inguinal canal are found. The role of imaging studies in this condition is unclear; most imaging studies will be normal. Unlike most other types of groin pain, sports hernias rarely improve with nonsurgical measures; thus, open or laparoscopic herniorrhaphy should be considered.






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