Sportsmen hernia: what do we know?

Area of Science:

• Sports Medicine
• Anatomy
• Biomechanics

Background:

• Athletes frequently experience prolonged inguinal pain, potentially jeopardizing their careers.
• Sportsmen hernia is a debated cause of chronic groin pain, lacking a clear definition.
• Anatomical review suggests the need to redefine this condition and its nomenclature.

Purpose of the Study:

• To anatomically and biomechanically analyze the causes of chronic groin pain in athletes.
• To propose a revised definition and name for the condition commonly referred to as sportsmen hernia.
• To highlight the role of muscular imbalances in the pubic region.

Main Methods:

• Analysis of anatomical forces acting on the anterior pelvis during athletic activities.
• Examination of muscle insertions and opposing forces at the pubic symphysis.
• Review of existing literature on groin pain and sportsmen hernia.

Main Results:

• Athletic maneuvers generate significant torque, placing high force on the anterior pelvis.
• Imbalanced forces between abdominal muscles (rectus abdominis, transversus abdominis) and adductor muscles (adductor longus) disrupt muscle-tendon insertions at the pubis.
• A weak posterior groin wall, exacerbated by these forces, may be the primary issue, potentially leading to tendon enthesitis and pubic symphysis arthropathy.

Conclusions:

• The condition is best understood as a muscular imbalance syndrome of the groin, involving abdominal and adductor muscles.
• Sportsmen hernia can be considered a component within this broader syndrome.
• A multidisciplinary approach is recommended due to insufficient diagnostic and treatment literature.