Sufferers get a fairly characteristic set of symptoms including pain with running, twisting, turning and kicking. After playing sport they are stiff and sore and this is often much worse the next day.
Rising from a low position (for example getting out of bed, or in and out of a car) and coughing and sneezing make the pain worse. Only a third of patients can remember a specific injury, usually involving overstretching.
The diagnosis depends on taking an accurate history and performing a thorough examination. In order to feel the muscles at the back of the groin it is necessary to push a finger up into the scrotum, something which is always uncomfortable, but in the presence of a groin tear it is possible to feel the dilated archway in the outer layer of muscle along with the tears.
It is also possible to feel the loose inner layer that is exposed because the middle layer has been pulled up and away. It may be an understatement to say that examination on the affected side is more uncomfortable than on the normal side!
Successful treatment depends on accurate realignment of the groin muscles in each layer. The whole length of the groin muscles needs to be exposed to allow a proper repair to be carried out in all the layers. This means that an incision of about 7.5cm (3 inches) is made. This allows full exposure of all the muscle layers along the length of the disruption. Following surgery there is a rehabilitation programme that must be followed over the next 4 to 6 weeks.
Surgery is required in sportsmen who are unable to play their sport, or in cases that have not responded to physiotherapy. Gilmore’s Groin is most commonly seen in footballers, but is also seen in rugby (union and league), athletics, racquets sports, cricket and hockey as well as those undertaking general fitness training for other sports. Correct assessment, diagnosis and treatment means that the vast majority can return to their normal activity between 4 and 8 weeks after their operation.
Between 1980 and 2005 over 6000 cases were referred and 3600 operations performed. The operation is successful in 97% of professional soccer players and 85 English league clubs have referred players whilst many have come from other parts of the UK and abroad. In this period 364 international sportsmen and women were successfully treated.
So, what is a sportsman’s hernia? It’s a groin disruption, not a hernia!!