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February 5, 2020

Groin Pain Syndrome Known as Sports Hernia: A Review

Author Affiliations
  • 1Division of General and Trauma Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
  • 2Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
  • 3Surgical Service Line, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
JAMA Surg. Published online February 5, 2020. doi:10.1001/jamasurg.2019.5863

Importance  Groin pain in active individuals and athletes without clinical evidence of hernia or hip pathologic findings is challenging for health care clinicians and aggravating for those experiencing pain. Frequently called sports hernia or athletic pubalgia, many surgeons continue to refute the diagnosis because there is a lack of consensus and clear comprehension of the basic pathophysiologic features of this groin pain syndrome.

Observations  Understanding the anatomic and pathophysiologic findings of groin pain syndrome is necessary to appropriately treat this problem. In general, the level of evidence of the literature is of relatively low quality. Exercise-based therapy can be an effective first-line therapy in individuals who develop groin pain syndrome. Surgical therapies are typically reserved for those who experience nonoperative management failure. The common features of the varied surgical procedures include the resultant changes in the vectors of pull on the pubic bone or joint, the defects in the inguinal canal, and the inguinal sensory nerve compression or bowstringing.

Conclusions and Relevance  The diagnosis of nonhip, nonhernia, chronic groin pain is common. Understanding the diagnosis and treatment options may facilitate recovery and allow return to an active lifestyle and sport.

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