Inguinal Hernia and Groin Pain

Hernia and groin problems are common sports injuries, particularly in soccer where the pelvic region is subject to large torsional (twisting) loads. An Inguinal Hernia refers to a protrusion of the abdominal contents through a weakness in the connective tissue of the Inguinal canal in the groin.

Groin pain is caused by soft tissue disruption that affects an area of the groin near the genitalia also called as the ‘inguinal region’. Such a tissue disruption is usually called as a sports hernia and the medical term for it is an ‘inguinal disruption’. There is discomfort in the region where the abdomen ends and the legs begin.

Inguinal Hernia surgery has been revolutionized over the past ten years. The world’s top hernia surgeons now perform hernia surgery under local anaesthetic. Depending on the individual circumstances of the patient, considering their age, occupation, general health and the size and degree of the Inguinal Hernia, the surgical technique is chosen which is ‘tailored’ to the patient’s situation. Rehab following Inguinal Hernia surgery is very rapid and exercises can begin the day after the hernia repair.

Following sporting activity, someone with an Inguinal Hernia will be stiff and sore. Typically, the day after a football match for example, getting out of bed or a car will be uncomfortable. Any exertion that increases intra-abdominal pressure, such as coughing, sneezing or sporting activity can cause pain. In the early stages, the person may be able to continue playing their sport but the problem usually gets progressively worse.

Pain in the groin and pelvis can be referred from a number of problems, including injuries to the lower back, the hip joint, the Sacro-Iliac joint, the abdomen and the genito-urinary system. Therefore, diagnosis of an Inguinal Hernia requires skilful differentiation.

Because it requires an expert to diagnose an Inguinal Hernia it is not unusual for many weeks or months to pass before the correct diagnosis is made. In those people who have typical Inguinal Hernia symptoms, an expert can confirm the diagnosis with physical tests and an Ultrasound scan.

Treatment- Conservative treatment with a Chartered Physiotherapist involves stabilizing and strengthening the muscles of the pelvic region, but this rarely cures the problem.

The surgical treatment of Inguinal Hernias has been revolutionized over the past ten years. The world’s top hernia surgeons now perform hernia surgery under local anesthetic. Depending on the individual circumstances of the patient, considering their age, occupation, general health and the size and degree of the Inguinal Hernia, the surgical technique is chosen which is ‘tailored’ to the patient’s situation.

The Minimal Repair is a mesh free technique which is used for patients who have a big defect in the fascia of the Inguinal canal, while the muscle layers are still intact. Physical immobility is not required and the patient can begin physical work a few days after surgery.

The advantages of a local anesthetic are that the patient is able to get up on their feet straight after the operation and there is no need for an overnight stay in hospital. Patients can usually eat immediately after surgery, as they don’t experience the side effects of a general anesthetic like nausea and vomiting, headaches and urinary retention.

Because these side effects are eliminated and the surgical repair is so unobtrusive, the rehabilitation process can begin immediately. Patients are encouraged to return to everyday activities and work the day after surgery. The patient can resume gentle exercise such as jogging or cycling. Elite athletes can begin sprinting after three or four days. Within five or six days there are no physical restrictions.

Prevention – Core Strength and Core Stability exercises can improve muscle function across the trunk and pelvis. Core strength exercises on a mat and using a Swiss Ball or Resistance Bands are ideal, because the improved muscular strength and stability can help to counteract the large forces that are applied to the lower abdomen and pelvis. This can reduce the risk of developing a hernia.