Inguinal Disruption: It’s Not a Hernia

The professional understanding of inguinal disruption (chronic and acute groin pain) has evolved dramatically over the past decade - including just deciding what to call it

Inguinal disruption predominantly affects male athletes involved in kicking sports and sports that require twisting while running. It’s found less often in athletes involved in sports such as swimming and cycling. However, it does also occur in non-athletes and females. It has been known as sportsman’s groin, sportsman’s hernia, incipient hernia, Gilmore’s groin, groin disruption, and athletic pubalgia, but the British Hernia Society’s recent consensus statement recommends inguinal disruption as the preferred nomenclature due to its accuracy.1

The term and definition is meant to differentiate this condition from a true hernia. The condition most often causes pain experienced where the rectus abdominis muscle and the adductor longus tendon originate on the pubic bone. Pain may radiate to the perineum and inner thigh. The pain can range from mild to disabling. The goal of treatment, of course, is to return individuals to full function and athletic activity as quickly as possible without compromising patient safety.

The good news is that most patients improve over six to eight weeks with conservative management, including activity modification, physiotherapy, and core/adductor strengthening exercises.2 Exercise therapy strengthens adductor and abdominal muscles to correct instability across the pelvic girdle. This improves pain and leads to a more rapid return to sports compared to passive approaches.3

Inguinal disruption may be experienced suddenly or gradually over time. Today’s nagging groin pain can progress into tomorrow’s serious problem. Please see us for an evaluation and to discuss alterations in your training techniques that can protect your health and safety long-term.

References:

Sheen A, Stephenson B, Lloyd D, et al. Treatment of the Sportsman’s Groin: British Hernia Society’s 2014 Position Statement on the Manchester Consensus Conference. Br J Sports Med. 2014; 48 (14): 1079-1087.
Rolph R, Morgan C, Chapman G, Marsh S. Groin Pain in Athletes. BMJ. 2020 Mar 4; 368.

Almeida MO, Silva BN, Andriolo RB, Atallah ÁN, Peccin MS. Conservative interventions for treating exercise‐related musculotendinous, ligamentous and osseous groin pain. Cochrane Database of Systematic Reviews. 2013 (6).