Advertisement

Current Sports Medicine Reports

, Volume 6, Issue 6, pp 354–361 | Cite as

Evaluation of groin pain in athletes

  • Kimberly G. HarmonEmail author
Article

Abstract

The evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, multiple pathologies often coexist, different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have had symptoms significantly limit their activity, have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. Often times the diagnosis given depends on the physician’s specialty. This article focuses on the groin structures and looks at three specific entities—“sports hernia,” public bone edema, and entrapment neuropathies—as potential causes of chronic groin pain. Potential diagnostic and treatment strategies are also discussed.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Netter FH: The Digestive System Part I. In The CIBA Collection of Medical Illustrations. New York: RR Donnelley & Sons Co.; 1975.Google Scholar
  2. 2.
    Swan KG Jr, Wolcott M: The athletic hernia: a systematic review. Clin Orthop Relat Res 2007, 455:78–87.PubMedCrossRefGoogle Scholar
  3. 3.
    Hackney R: The sports hernia: a cause of chronic groin pain. Br J Sports Med 1993, 27:58–62.PubMedCrossRefGoogle Scholar
  4. 4.
    Gilmore J: Groin pain in the soccer athlete: fact, fiction, and treatment. Clin Sports Med 1998, 17:787–793.PubMedCrossRefGoogle Scholar
  5. 5.
    Meyers WC, Foley DP, Garrett WE, et al.: Management of severe lower abdominal or inguinal pain in high-performance athletes. PAIN (Performing Athletes with Abdominal or Inguinal Neuromuscular Pain Study Group). Am J Sports Med 2000, 28:2–8.PubMedGoogle Scholar
  6. 6.
    Banks AJ, Malimson PD: Wrong diagnosis in athletes. Br J Sports Med 1982, 16:101.PubMedGoogle Scholar
  7. 7.
    Renstrom P, Peterson L: Groin injuries in athletes. Br J Sports Med 1980, 14:30–36.PubMedGoogle Scholar
  8. 8.
    Smedberg SG, Broome AE, Gullmo A, Roos H: Herniography in athletes with groin pain. Am J Surg 1985, 149:378–382.PubMedCrossRefGoogle Scholar
  9. 9.
    Ekberg O, Persson NH, Abrahamsson PA, et al.: Long-standing groin pain in athletes: a multidisciplinary approach. Sports Med 1988, 6:56–61.PubMedCrossRefGoogle Scholar
  10. 10.
    Taylor DC, Meyers WC, Moylan JA, et al.: Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia. Am J Sports Med 1991, 19:239–242.PubMedCrossRefGoogle Scholar
  11. 11.
    Polglase AL, Frydman G, Farmer K: Inguinal surgery for debilitating chronic groin pain in athletes. Med J Aust 1991, 155:674–677.PubMedGoogle Scholar
  12. 12.
    Simonet W, Saylor H, Sim L: Abdominal wall muscle tears in hockey players. Int J Sports Med 1995, 16:126–128.PubMedCrossRefGoogle Scholar
  13. 13.
    Irshad K, Feldman LS, Lavoie C, et al.: Operative management of “hockey groin syndrome”: 12 years of experience in National Hockey League players. Surgery 2001, 130:759–766.PubMedCrossRefGoogle Scholar
  14. 14.
    Kumar A, Doran J, Batt ME, et al.: Results of inguinal canal repair in athletes with sports hernia. J R Coll Surg Edinb 2002, 47:561–565.PubMedGoogle Scholar
  15. 15.
    Van Der Donckt K, Steenbrugge F, Van Den Abbeele K, et al.: Bassini’s hernial repair and adductor longus tenotomy in the treatment of chronic groin pain in athletes. Acta Orthop Belg 2003, 69:35–41.Google Scholar
  16. 16.
    Biedert RM, Warnke K, Meyer S: Symphysis syndrome in athletes. Clin J Sport Med 2003, 13:278–284.PubMedCrossRefGoogle Scholar
  17. 17.
    Kluin J, den Hoen PT, van Linschoten R, et al.: Endoscopic evaluation and treatment of groin pain in the athlete. Am J Sports Med 2004, 32:944–949.PubMedCrossRefGoogle Scholar
  18. 18.
    Paajanen H, Syvahucko I, Airo I: Totally extraperitoneal endoscopic treatment of sportsman’s hernia. Surg Laparosc Endosc Percutan Tech 2004, 14:215–218.PubMedCrossRefGoogle Scholar
  19. 19.
    Genitsaris M, Goulimaris I, Sikas N: Laparoscopic repair of groin pain in athletes. Am J Sports Med 2004, 32:1238–1242.PubMedCrossRefGoogle Scholar
  20. 20.
    van Veen RN, de Baat P, Heijboer MP, et al.: Successful endoscopic treatment of chronic groin pain in athletes. Surg Endosc 2007, 21:189–193.PubMedCrossRefGoogle Scholar
  21. 21.
    Steele P, Annear P, Grove JR: Surgery for posterior inguinal wall deficiency in athletes. J Sci Med Sport 2004, 7:422–423.CrossRefGoogle Scholar
  22. 22.
    Malycha P, Lovell G: Inguinal surgery in athletes with chronic groin pain: the “sportsman’s” hernia. Aust N Z J Surg 1992, 62:123–125.PubMedCrossRefGoogle Scholar
  23. 23.
    Susmallian S, Ezri T, Elis M, et al.: Laparoscopic repair of “sportsman’s hernia” in soccer players as treatment of chronic inguinal pain. Med Sci Monit 2004, 10:CR52–CR54.PubMedGoogle Scholar
  24. 24.
    Ingoldby C: Laparoscopic and conventional repair of groin disruption in sportsmen. Br J Surg 1997, 84:213–215.PubMedCrossRefGoogle Scholar
  25. 25.
    Srinivasan A, Schuricht A: Long-term follow-up of laparoscopic preperitoneal hernia repair in professional athletes. J Laparoendosc Adv Surg Tech A 2002, 12:101–106.PubMedCrossRefGoogle Scholar
  26. 26.
    Brannigan AE, Kerin MJ, McEntee GP: Gilmore’s groin repair in athletes. J Orthop Sports Phys Ther 2000, 30:329–332.PubMedGoogle Scholar
  27. 27.
    Ziprin P, Williams P, Foster ME: External oblique aponeurosis nerve entrapment as a cause of groin pain in the athlete. Br J Surg 1999, 86:566–568.PubMedCrossRefGoogle Scholar
  28. 28.
    Azurin DJ, Go LS, Schuricht A, et al.: Endoscopic preperitoneal herniorrhaphy in professional athletes with groin pain. J Laparoendosc Adv Surg Tech A 1997, 7:7–12.PubMedGoogle Scholar
  29. 29.
    Meyers WC, Lanfranco A, Castellanos A: Surgical management of chronic lower abdominal and groin pain in high-performance athletes. Curr Sports Med Rep 2002, 1:301–305.PubMedGoogle Scholar
  30. 30.
    Lovell G: The diagnosis of chronic groin pain in athletes: a review of 189 cases. Aust J Sci Med Sport 1995, 27:76–79.PubMedGoogle Scholar
  31. 31.
    Cunningham PM, Brennan D, O’Connell M, et al.: Patterns of bone and soft-tissue injury at the symphysis pubis in soccer players: observations at MRI. AJR Am J Roentgenol 2007, 188:W291–W296.PubMedCrossRefGoogle Scholar
  32. 32.
    Slavotinek JP, Verrall CM, Fon GT, Sage MR: Groin pain in footballers: the association between preseason clinical and public bone magnetic resonance imaging findings and athlete outcome. Am J Sports Med 2005, 33:894–899.PubMedCrossRefGoogle Scholar
  33. 33.
    Verrall GM, Slavotinek JP, Barnes PG: The effect of sports specific training on reducing the incidence of hamstring injuries in professional Australian Rules football players. Br J Sports Med 2005, 39:363–368.PubMedCrossRefGoogle Scholar
  34. 34.
    Verrall GM, Slavotinek JP, Fon GT: Incidence of pubic bone marrow oedema in Australian rules football players: relation to groin pain. Br J Sports Med 2001, 35:28–33.PubMedCrossRefGoogle Scholar
  35. 35.
    Albers SL, Spritzer CE, Garrett WE Jr, Meyers WC: MR findings in athletes with pubalgia. Skeletal Radiol 2001, 30:270–277.PubMedCrossRefGoogle Scholar
  36. 36.
    Fricker PA, Taunton JE, Ammann W: Osteitis pubis in athletes. Infection, inflammation or injury? Sports Med 1991, 12:266–279.PubMedGoogle Scholar
  37. 37.
    Johnson R: Osteitis pubis. Curr Sports Med Rep 2003, 2:98–102.PubMedGoogle Scholar
  38. 38.
    Lynch SA, Renstrom PA: Groin injuries in sport: treatment strategies. Sports Med 1999, 28:137–144.PubMedCrossRefGoogle Scholar
  39. 39.
    Macintyre J, Johnson C, Schroeder EL: Groin pain in athletes. Curr Sports Med Rep 2006, 5:293–299.PubMedGoogle Scholar
  40. 40.
    Morelli V, Smith V: Groin injuries in athletes. Am Fam Physician 2001, 64:1405–1414.PubMedGoogle Scholar
  41. 41.
    Lovell G, Galloway H, Hopkins W, Harvey A: Osteitis pubis and assessment of bone marrow edema at the public symphysis with MRI in an elite junior male soccer squad. Clin J Sport Med 2006, 16:117–122.PubMedCrossRefGoogle Scholar
  42. 42.
    Starling JR, Harms BA: Diagnosis and treatment of genitofemoral and ilioinguinal neuralgia. World J Surg 1989, 13:586–591.PubMedCrossRefGoogle Scholar
  43. 43.
    Kim DH, Murovic JA, Tiel RL, Kline DG: Surgical management of 33 ilioinguinal and iliohypogastric neuralgias at Louisiana State University Health Sciences Center. Neurosurgery 2005, 56:1013–1020.PubMedCrossRefGoogle Scholar
  44. 44.
    McCrory P, Bell S: Nerve entrapment syndromes as a cause of pain in the hip, groin and buttock. Sports Med 1999, 27:261–274.PubMedCrossRefGoogle Scholar
  45. 45.
    Akita K, Niga S, Yamato Y, et al.: Anatomic basis of chronic groin pain with special reference to sports hernia. Surg Radiol Anat 1999, 21:1–5.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2007

Authors and Affiliations

  1. 1.Department of Family Medicine, Department of Orthopaedics and Sports MedicineUniversity of WashingtonSeattleUSA

Personalised recommendations