Sports Hernias: Operate on me today? Or should I wait?
Probably the most important aspect to understand about sports hernias is that it is not truly a ‘hernia’. A hernia by definition is a hole in the muscle through which fat and/or intestines push through. However, in a sports hernia, there is a tear in the muscle, but no fat or intestine pushing through. The damaged muscle is what causes the pain and other symptoms. Second, there are NO consensus statements about exactly what a sports hernia is, what causes it, and how to repair it! Any hernia surgeon that claims to know everything about sports hernias isn’t being honest with him or herself, and likely their patients. I frequently see patients with chronic groin pain, many of which are referred from Sports Medicine Physicians in Southern California and beyond. Sometimes that groin pain is NOT a sports hernia. The most common diagnosis’ that I make outside of a sports hernia is a muscle strain, or an adductor (thigh) injury. For patients that present with a week, or a month of pain, I always recommend rest and anti-inflammatories for 2-4 weeks. Most of those patients don’t return to us, presumably because they feel better; or because they didn’t like our recommendations and went and had (possibly) unnecessary surgery elsewhere. I’m writing this post because I had a mother bring her 16 year old son in for a consultation. The son was a fantastic football player but had been suffering from a sore groin for 2-4 weeks. He had continued to play summer sports and hadn’t rested for more than a few days. He hadn’t taken any Advil, Aleve, Motrin, etc. The patient’s father (not at the consultation) had researched sports hernias and they had driven in to see me at our center. I gave them the typical recommendations and discussed that 99% of the time, this would turn out to be a simple groin strain or pull. After a long consultation, I seemingly convinced the mother that rest would be the best treatment, not rushing to surgery. They left but 10 minutes later the mother came back into our office and asked for me. She said she had called her husband and told him my recommendations. He continued to push back telling his wife that his son needed surgery so that he could recover in time for the Fall football season. I told her that in my opinion, and most other hernia surgeons opinion, letting anyone operate on their 16 year old son who had groin pain for 2-4 weeks, would be a huge mistake. I told her that I’m sure that they could find someone to do the surgery, but that it wouldn’t be appropriate, and it wouldn’t be a surgeon I would recommend. The patients who truly do have a sports hernia have had pain for more than a year, often 2-3 years. At this point we may intervene with surgery.
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