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About Dr. Grischkan
Get more information about Dr. Grischkan's background with hernia surgery.

We're located in Beachwood near I-271 southeast of Cleveland, Ohio. View our map.


Sports Hernia Surgery, Treatment and Diagnosis

A sports hernia is a painful condition in the groin that, unlike a groin strain, does not get better. This chronic pain is typically caused by an underlying tear of the oblique muscle, tendon or ligament often near the insertion of the pubic bone. In many patients the pain is localized either near or over the pubic bone - giving rise to "athletic pubalgia," the other common name for sports hernia. The term "sports hernia" is actually a misnomer as there is no hernia associated with this kind of pathology.

The term "sports hernia" was first coined in the 1960's for Spanish soccer players who developed groin pain with no evidence for inguinal hernias. Since that time, Gilmore described the underlying pathology and many physicians began to refer to the sports hernia as "Gilmore's Groin."

Current research has implicated the imbalance between the strong flexors of the upper leg and the weaker abdominal core muscles. This results in shearing forces that can cause soft tissue tearing at the insertion points of these muscles into the pelvic frame. Hence the focus on the obliques and adductor muscles as they attach to the pubic bone. While initially, the diagnosis was limited to professional athletes, studies have shown that even the weekend recreational athletes are at risk to develop sports hernias.

The diagnosis of a sports hernia is typically a diagnosis of exclusion. That means that many other causes of groin pain must be ruled out, and most importantly, no inguinal hernia is detected. In general, the diagnosis is reinforced by a history of three months of relative rest with no improvement in symptoms when resuming sports. Unfortunately, radiologic tests such as CT scans, MRI or ultrasound offer very little in diagnosing sports hernias and most centers don't bother with them.

While initial treatments focus on a conservative approach with physical therapy, rest and anti-inflammatory medications, the results have been disappointing. Thus, the only modality to offer any meaningful success is surgical reconstruction. The aim of surgical intervention is to strengthen the inguinal canal, similar to an inguinal hernia repair, in order for the groin to resist the pull of the leg flexors. This is accomplished with a mesh to achieve far greater strength than tissue repairs can provide. Additionally, the nerve along the floor of the groin is excised during surgery as it can be the source of pain due to the inflammatory changes that accompany the sports hernia injuries. Our success rate using the modified Shouldice method for sports hernia surgery is among the highest in the country.

Typical recovery will take about 4 to 8 weeks with therapy starting at 3 weeks to rehabilitate the groin muscles. Based upon our extensive experience with all types of elite athletes, most sports hernia surgery patients are able to return to full unrestricted activities with no pain following completion of the rehabilitation.

Call 216-591-1422 to learn more or contact us to request a brochure.