Sportsman's Hernia

Also known as: Hockey hernia, or athletic pubalgia

Sportsman's hernia involves a weakening or tearing of the transversalis fasia, conjoined tendon, or internal oblique fibers, creating an inside-out hernia within the dorsal wall of the inguinal canal (Paajanen et al 2004; Genitsaris et al 2004). It is associated with twisting, turning, or directional change at speed while the patient forced the hip into abduction, adduction, or extension (Sizer 2006). This results in shearing forces to the pubic symphysis and overloads the previous mentioned structures.

Clinical Presentation and Diagnosis

  • Pain in the lower abdominal, inguinal, and groin regions that is exacerbated by Valsalva or exertion (Meyers et al 2000)
  • Resisted double hip adduction will be painful (Sizer 2006)
  • Resisted hip tests may be weak and oblique abdominal tests will be painful and possibly weak when the hip is positioned in extension (Hemingway et al 2003)
  • X-rays reveal may reveal oseitis pubis
  • Diagnostic ultrasound is good for detection
  • Adductor palpation will be negative

Treatment

  • These patient do not fare well with conservative management
  • Surgical laparoscopic repair of the defect has been reported
    • Susmallian et al (2004) reported a 97.1% return to sport after this surgery
  • Open mesh repair appears superior to laproscopic repair (Holzheimer 2005)
Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-ShareAlike 3.0 License