Friday, June 29, 2007

A better definition of a "sports hernia"

It is not a true hernia. It is when the posterior inguinal wall has been overstretched due to movements such as in athletics, and is thus causing pressure against a nerve. There is no visible inguinal hernia but instead there is swelling of that stretched the posterior wall tissue. This swelling can be felt with an experienced finger, and an ultrasound can help confirm the diagnosis.
The transversalis fascia (the encasing around the transverse abdominus muscle) becomes dilated at the weakest point in the inguinal wall (called Hesslebach's Triangle), causing the weaker tissue to widen. At that point, when the sufferer tenses his/her abdominal muscles such as while working out, the swelling increases and more pressure is placed on the sensitive nerve that passes behind the posterior inguinal wall.
The nerve that is irritated is the genital branch of the genitofemoral nerve.
As the Hesslebach's triangle tissues widen, it yeilds an increase in pressure on the rectus abdominus muscle and the rectus then retracts away from the pubic bone. That is what can cause the pain along the pubic bone that is commonly seen in athletes with this injury. When this happens it is called pubalgia.

At least that is what I can come up with through all my reading. I hope it helps others to better understand what is going on with their groin pains. I know it helped me tremendously to understand the etiology; that way I can better explain it to a doctor that is willing to listen to patients...

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Anonymous said...

So did you resolve it without surgery? If so, what did you do?