Posterior Inguinal Wall Weakness ‘Sports hernia’:
Pathology:
It is thought that dilation of the external inguinal ring may be caused by a number of different pathologies, including :
Subjective History:
Usually an insidious onset of pain
May present as an acute injury followed by chronic pain
Pain will usually will occur near the end or after activity
As the condition progresses, the pain will worsen and start to occur earlier in the activity
The pain is usually located in the posterior inguinal floor inside the external ring.
The patient may describe radiation of pain into the testicle, adductors or laterally in the upper thigh
Pain usually aggravated by sudden movement, sneezing, coughing, sexual activity or valsalva manoeuvre.
Symptoms will tend to ease with prolonged rest from sporting activity , but will usually return once high intensity activity is resumed.
Objective Examination:
Maximal tenderness is usually felt over the pubic tubercle
The most helpful diagnostic sign is dilation and or discomfort to palpation of the external inguinal ring after invagination of the scrotum
There is some evidence that ultrasound examination and MRI may be able to detect hernias
References
Image from OpenI – Licensed by CC
Treatment :
Controversial pathology . More likely a chronic groin injury (tendinopathy)
Surgery not offered on the NHS
Please refer to adductor tendinopathy for management
References
Image from OpenI – Licensed by CC