Orthopaedic Conditons & Treatments

Sports Hernia Repair, Treatment & Surgery

The treatment and surgery that may be best for your sports hernia repair is determined based on important factors including your age, past and present health, the extent and exact location of the hernia and your history with other medications and treatments. A sports hernia is a complete or partial tear to the oblique abdominal muscles and is one of the least understood sports injuries because it differs so much from traditional hernias.

Sports Hernia Diagnosis

A sports hernia can cause significant pain, and while painkillers may dull the pain temporarily, it can continue to come back once medication has worn off. If you are having pain in your abdomen that is recurring, it is important to seek medical treatment. To help diagnose your condition, your doctor will ask you questions related to your activities and perform a physical exam on the affected area. To better diagnose this injury, your doctor will use one of the following techniques:

  • X-Ray (Radiograph) – This test is used more as a preventative test to determine that no other injury is present. It does not show ligaments, and therefore cannot be used to diagnose a sports hernia in particular. It is performed by sending radiation through the affected area. The radiation is then absorbed by the bone, which allows it to create a black-and-white image of the skeletal structure.
  • Magnetic Resonance Imaging (MRI) – This test is increasingly being used to help diagnose sports hernias. Because many doctors have relied solely on a physical exam in the past and have missed this unique injury, now more and more are using an MRI image to help determine the diagnosis. During this test, you are placed in a vessel with electromagnetic radio waves. These waves generate a resonance which is then transferred to an image.

Nonsurgical Treatment for Sports Hernia Repair
In some instances, sports hernia repairs can be done without the need for surgical intervention. This is done by using physiotherapy and rest to allow the body to heal naturally. Anti-inflammatory medications are also frequently used during the healing process to reduce symptoms. Still, it is important that even though symptoms may not be present because of the use of painkillers, you do not continue to exercise and follow the doctor’s guidelines to help the injury heal faster. In many cases, the injury still comes back after a certain period of time and surgery is necessary.

Surgery for Sports Hernia Repair

In most cases, sports hernia repairs require surgery. The aim of sports hernia surgeries is to sew the injury back together so that the nerve endings are not being pulled and ligaments can strengthen without pain. The majority of sports hernia repairs are performed surgically, using one of the following techniques:

  • Open Surgery – Depending on the location of the injury, a long incision may be necessary to reach the affected area. This is the traditional approach to this type of surgery and is still performed in many cases today because it allows the surgeon to sew the ligaments back together without the need for mesh or other additives that may cause complications down the road.
  • Laparoscopic Surgery – In some cases, a smaller incision may be adequate for repairing the injury. This is determined by the doctor based on the extent of the hernia. This approach uses an endoscope. A small incision is created and a camera is placed inside so the doctor can see the area he or she is working with. Then, the doctor uses mesh to help repair the hernia.
  • Adductor Tenotomy – When a hernia is severe, it may spread to the groin and adductor muscles. When this happens, a secondary surgery may be required. Because of reduced blood flow to these muscles following the hernia, it may be difficult for them to fully repair. In this situation, the secondary surgery sews the adductor muscles back together, increasing blood flow and allowing the tendons to heal faster.

Sports Hernia Repair Research
A significant portion of the sports hernia repair research surrounds various approaches to surgically fixing the injury. Because so many people who suffer from this injury are athletes, and many rely on their physical abilities to earn their paychecks, making it back onto the field, track or other environment in a timely manner, with an injury that will not resurface, is crucial to their professional lives.

One surgical procedure that has been studied has been the laparoscopic approach. This approach, as described earlier, uses a smaller incision and a camera to view the injury. The smaller incision reduces the amount of tissue exposed and the amount of damage to the surrounding ligaments and muscles, as can be found in some open surgeries. A mesh is then applied to the bone to help reattach the tissue and ligaments that were damaged in the injury.

While this approach initially sounded ideal, the mesh that was used to attach to the ligaments and joints has since been found to cause the hernia to return. Because of this, surgeons who previously leaned toward the laparoscopic approach are returning to the traditional open surgery.

As research on treatment is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.            

Rehabilitation Services
The Rehabilitation Network of the North Shore-LIJ Health System is dedicated to providing you and your family with result-oriented, comprehensive rehabilitation services. Our goal is to help you and your loved ones find relief from pain and get moving again after an accident, illness, injury or surgery. We’re your partner in a safe, healthy, more rapid recovery.

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Trauma Services in New York performs Sports Hernia Repair surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.