When you think of injuries that can occur while playing sports, you may think of tearing an ACL, breaking an arm, or spraining an ankle. One condition you might not even be aware of is a sports hernia (aka an athletic pubalgia), which can occur with overexertion in any sport. So how do you get a sports hernia, and how do you treat it when you get one?
While the term sounds scary, there are many exercises and stretches you can do to help you get back to performing the way you want. If your doctor thinks you can avoid surgery, physical therapy can be a great option to help you return to activity in a safe, observed environment. We work with many athletes at EW Motion Therapy to improve recovery, prevent future injury, and improve performance. Even if you do not choose physical therapy with us, the goal of this article is to provide some information on sports hernias so you can make the best decision for your health.
This article discusses some possible causes of sports hernias, how they affect functional movement, and how physical therapy can help. With this information, you can pursue the best treatment and return to your sport as soon as possible.
What causes sports hernias?
A sports hernia is technically not a hernia, so the medical community prefers to call it an athletic pubalgia. A hernia is a weakening in the abdominal wall allowing a body part or tissue to squeeze through. With a sports hernia, no body parts are squeezing through injured tissue - instead, it is a weakening or tearing of the muscles, ligaments, or tendons surrounding the abdomen and pelvis. We will continue to refer to the condition as a sports hernia for this article.
Sports hernias typically affect males more than females, and they are known to worsen over time. Many things can cause sports hernias, including improper lifting mechanics, poor breathing patterns, core weakness, and repetitive twisting or bending. It can be challenging to determine what caused your exact sports hernia, but you might be able to determine what movements involved in your sport are causing you pain. For example, suppose you are diagnosed with a sports hernia after having pain while lifting weights. In that case, you may need to consult a professional to improve your lifting mechanics.
How do sports hernias affect movement?
Because your core and abdomen are involved in many movements, there are multiple things in your day that a sports hernia might make more difficult. Any increase in intra-abdominal pressure can put more pressure on the torn or weakened muscles. Bending over, lifting, and twisting are movements that can increase intra-abdominal pressure. If you think about these in the context of a daily task, like getting out of bed in the morning, the sports hernia can make that process much more painful. You can also have pain while coughing, sneezing, and laughing.
How can physical therapy help?
A primary benefit of pursuing physical therapy for a sports hernia is that it is non-surgical. If your pain has worsened in the past 3-6 weeks, or if you notice a protrusion from the painful area, you should rule out that you need surgery by talking to your doctor first. But physical therapy can be a great treatment solution for mild to moderate sports hernias. If you come to physical therapy, your therapist will work with you on techniques to alleviate the intra-abdominal pressure causing you so much pain. They will teach you proper breathing techniques, how to activate deep core muscles, and how to ensure an appropriate form and body mechanics during exercise.
As part of your treatment, your therapist will assign home exercises for you to do. Here are a few examples of exercises our therapists have given for sports hernia patients. If you want to try any of these yourself, check with your doctor to make sure you can do them safely.
Supine Transversus Abdominus Bracing - Hands On Stomach: Begin lying on your back with your knees bent, feet resting on the floor, and your fingers resting on your stomach just above your hip bones. Tighten your abdominals, pulling your navel in toward your spine and up. You should feel your muscles contract under your fingers. Hold this position, then relax and repeat. Make sure to keep your back flat against the floor and do not hold your breath as you tighten your muscles.
Supine Dead Bug with Leg Extension: Begin lying on your back with your knees bent and feet flat on the floor. Tighten your abdominals, lift both legs to a 90-degree angle, and your arms up toward the ceiling. Slowly lower one arm overhead and straighten your opposite leg at the same time. Return to the starting position and repeat with your other arm and leg. Make sure to keep your abdominals tight and your back flat on the floor during the exercise.
Marching Bridge: Begin lying on your back with your arms laying straight to your sides, knees bent, and feet flat on the ground. Tighten your abdominals and slowly lift your hips off the floor into a bridge position. Lift one leg off the ground, keeping your knee bent. Lower it back down and repeat, alternating between each leg. Make sure to keep your back straight throughout the exercise and your arms flat on the floor.
How else can I recover?
Now you know more about sports hernias and how physical therapy can help. Along with various exercises and techniques, there are other ways you can help your body recover from a sports hernia, including proper nutrition, drinking more water, and using a cold compress to alleviate pain. Nutrition and hydration are not only helpful for healing but also for improving quality of life and giving yourself the best chance at successful outcomes.
Any sports injury is challenging to go through, both physically and mentally. Any athlete knows that time away from your sport can be full of lost opportunities simply because your body could not keep up with your ambition. We work with many athletes at EW Motion Therapy who want to perform better but need extra help getting their bodies in the best shape. That is why our physical therapists and personal trainers work alongside each other to develop the best treatment plan for you to improve performance and prevent future injury. If you are interested in physical therapy or personal training with us, fill out the Request an Appointment form on our website, and someone from our staff will contact you within 48 hours with your next steps.