Athletic Pubalgia (Sports Hernia)
Any nerve in the body can be easily injured after blunt trauma and subsequently cause chronic pain. This occurs in two stages. In the acute stage, that is the stage shortly after the blunt trauma or the injury pain in the area of the nerve innervation can be due to the acute inflammation. In the second and later stage scar tissue forms around the nerve. This scar tissue may compress the nerve and act as a compression neuropathy for years. If the trauma is severe scar tissue can even form within the substance of the nerve itself. That entity is called neuroma in continuity. If left untreated these conditions lead to many years of chronic, pain and also loss of muscle strength, muscle atrophy and weakness and loss of sensation. The quality of the pain syndromes can be varied. It may be constant or it can be relapsing and remitting.
Most doctors and patients can fail to recognize these dynamics and fail to make the correct diagnosis.
A classic example is an entity called “athletic pubalgia”. This entity can be also referred to as “sports hernia” or “sportsman’s hernia”. It occurs following trauma to the ilio-inguinal nerve and genito-femoral nerve. It causes abdominal and groin pain. It is caused by blunt injury to these nerves. This type of blunt injury is more likely to occur in athletes performing contact sports. In my practice I have seen it in football players, rugby players, hokey players and fighters. There may be other or additional causes of athletic public such as tears of muscle attachments of the anterior abdominal wall muscles to the pubic bones. But I feel the major causesative entity of abdominal and groin pain in athletes is caused by injury to the nerves.
Another similar entity in near anatomic vicinity is blunt injury to the lateral femoral cutaneous nerve. Injury to that nerve causes numbness over the anterolateral thigh and buttock. Furthermore hip pain, aching and knee aching can also occur.
The therapy is simple and entails surgical exploration; identification of the area of scar tissue and trauma, neurolysis, clearing the nerve free of the scar and reconstructing the nerve of a neuroma has formed (neuroma-in-continuity).
Following nerve decompression of the scar or the entrapment nerve function takes months to return completely. In general the sooner the problem is addressed the higher the chances of complete recovery and symptom resolution.
I perform operations as an outpatient procedure. Recovery is expeditious.