Sports Hernia or Gimore’s Groin

A sports hernia or Gimore’s groin (known medically as athletic pupalgia or inguinal disruption syndrome) is a soft tissue injury in the groin area.

Despite its name it is not actually a true hernia although some theories as to its cause do suggest it could be a slight weakness in the groin. There are many names given to this problem that you may have encountered. Unlike a true hernia, you do not usually have a visible bulge in the groin.

The most likely cause is due to abnormal load bearing in the groin area leading to inflammation and injury to the tendons that insert at this point. The pain and pressure experienced is generally felt in the groin area although it can radiate to the top of the thigh and be felt in the hip. Usually it is one side that is affected but sometimes both groins can be painful.

Sports hernias are usually triggered by repetitive injuries or the result of explosive motions  such as kicking, twisting, acceleration and deceleration. This is why we see it most commonly in footballers, rugby players and runners although it can happen in any activity.

The tendons that attach our oblique muscles in the lower abdomen and our adductor or thigh muscles to our pelvis are most at risk of being damaged.

Pain usually comes on during a game or activity and often necessitates the early retirement from the game as the pain becomes too much to bear. Some people then experience a lower grade pain together with stiffness for 2 to 3 days following the activity. This is often accompanied by increased pain whilst getting in and out of a car and also turning in bed at night. Patients also report pain on coughing or sneezing.

Generally, if you stop your sport, the problem will more than likely go away but that clearly is not an option for many people who want to continue with their sport or activity. Therefore there are a number of treatments available to you that Mr Stellakis will discuss. They range from simple physiotherapy to full reparative surgery. Occasionally injections of local anaesthetic and steroids are deployed.

Frequently Asked Questions

Mr Michael Stellakis will identify a sports hernia by asking how the injury occurred and performing a physical examination to rule out a true hernia. The diagnosis is essentially a clinical one based on taking a history and examining the patient. If a sports hernia is suspected, he may order diagnostic tests such as an X-ray, ultrasound or MRI scan to assess any damage to tendons and to see if the tell-tale signs of a sports hernia are present.

An MRI is the most effective test for identifying tears and inflammation in the tendons. It is also important to exclude other injurious problems that can also cause groin pain in the sports person and this is particularly important if considering surgical options.

Treatment will depend on your age and general health, the severity of the injury and will also take into account the level of physical activity you wish to return to.

Non-surgical treatment such as abstinence from the sport,  anti-inflammatory medication and physiotherapy can nearly always  improve mild to moderate injury. The problem comes when returning to the trigger activity. Unfortunately up to 80% of sportsman will relapse.

The evidence shows however that surgery will give you the best chance of returning to your sport full time. There are different operations that are performed but these are tailored to the patient and the symptoms. The surgery is not major and with Mr Stellakis is nearly always keyhole which has a higher success rate, less complications along with a quicker recovery. Surgery in the right circumstances leads to an improvement in 90% of sportsman to the extent that thy can return to their sport.

Recovery from surgery takes between one to two weeks on average. It is important to have some physiotherapy during this recovery process. Generally people can start returning their sport at about 6 weeks but often the physiotherapist will give more accurate advice at the time.

All surgery carries a degree of risk. This particular operation is very similar to a TEP laparoscopic hernia repair and the risks are identical. Please see under that section and download the information sheet.