• Dr.med. Ulrike Muschaweck

    UM hernia specialist

Sportsman’s groin – a common sports injury

A sportsman’s groin (former name: “sports hernia”) is a special form of a typical groin injury, that occurs especially among athletes, resulting of an extreme strain in the groin region, for example sudden movements such as kicking, tackle kicking, etc. The sportsmen`s groin itself is not an inguinal hernia yet, which means, that there is no hernia sack, containing intestine.

What is a sportsman’s groin?

A sportsman’s groin is a circumscribed protrusion (bulge) of the transverse fascia in the area of the posterior wall of the groin canal. It results out of a weakness of the transverse fascia. During the tightening of the abdominal wall (while coughing, sneezing, etc.), the “bulge” is compressing the genital branch of the genito-femoral nerve. The phenomenon occurs predominantly among top athletes, who suffer from a lesion in the abdominal region caused by overstrain. This leads to sudden, sometimes even gradually beginning, party heavy pain.

The pain, caused by an irritation of the nerves, is a typical compression pain and provokes pulling and stinging pains, radiating into the thighs, the external side of the scrotum and partly even towards the iliac spine. At the same time, the pain can spread to the pubic bone. The cause for this is, that the rectus abdominis muscle is laterally distorted and therefore an increased tension effects the pubic bone. This symptom is also known as „Osteitis pubis“.

The yellow line is the nerve which provokes the pain (genital branch).
The protrusion is the so-called bulge.

The black arrow shows the distorted rectus abdominis ( Rectus abdominis muscle),  Cause of the osteitis pubis.

 

Reviews of Dr. Ulrike Muschaweck, specialist for the treatment of hernias

“Absolute professional! Would choose her again at any time!

I have consulted Dr. Muschaweck for the second time (once on the left and once on the right side) and can only recommend her. Very competent consultation and care, both before and after the operation. I don’t have any pain at all and would definitely choose Dr. Muschaweck again. Additionally, I felt that I was in good hands, because she and her team are very likeable and trustable. Thanks again for the excellent operations!”

“Very professional

beginning from the first consultation up to the operation itself. There is no comparison to the otherwise common hospital services. The personal care before and after the operation is just great and the whole intervention was painless. Even after the operation, I didn’t need the two packages of painkillers – there were no sufferings, not even minor ones. If I needed to have such an operation again (for example on the other side), I would definitely consult Dr. Muschaweck again.”

How is a sportsman’s groin diagnosed?

A clear diagnosis is only possible in means of a comprehensive examination by an experienced physician, in case of minor defects sometimes only a specialist can find them. The final diagnosis can be made through a static and dynamic ultrasound examination. An MRI examination is not necessary, in particular because this examination is made while the patient is lying down and therefore minor defects will not be seen.

Especially for top athletes a quick diagnosis is mandatory as well as a quickest possible treatment, so as not to lose time. If the diagnosis is clear and only mild pain occurs, the operation can be postponed up to six weeks and a physiotherapeutic treatment is tried. However, the risk of chronic groin pain remains and then an operation is mandatory.

Physical stress is allowed after the operation, after 2 days jogging, after 5 or 6 days sprinting and after 8 or 10 days football training is allowed. Lifting loads is also not a problem after the surgery.

How is the sportsman’s groin treated?

A sportsman’s groin is not an inguinal hernia, therefore an individual treatment is needed. Unfortunately, the sportsman’s groin is treated worldwide like a normal inguinal hernia.

In 2002, Dr. Muschaweck developed a special technique for the treatment of a sportsman’s groin, which is now accepted worldwide. The principle of this procedure is to avoid the enlargement of the defect of the groin canal.  Instead of that, the defect in the fascia transversalis is repaired with a special surgical suturing technique. A mesh never is needed, which is of great importance for top athletes. Additionally, intact, healthy fascias will not be opened and this diminishes the pain after the surgery. Also, the strain on the rectus abdominis muscle at the pubic bone is reduced.

The special surgery technique is called “Minimal-Repair-technique” or “Muschaweck-Repair “and was presented during the 100th anniversary of Real Madrid in Madrid.

This procedure is conducted under local anesthesia in combination with sedation. Two days after the surgery, the patient can start with physical workout. After 14 days, normal physical stress is possible.

Dr. Muschaweck gives lectures on this topic worldwide, for example in the Camp Nou in Barcelona as well as in the football stadium of Bilbao. In June 2018, a congress with an audience of 3.500 people took place in Camp Nou.

This post is also available in: German

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