Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Hernia Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
In short
Two different problems share one name in the changing room, and that causes a lot of confusion.
A true inguinal hernia means something has come through the wall of the belly. There is a lump. A sports hernia means pain from a strained tendon and a weak groin wall, with nothing coming through and no lump at all.
The treatments are not the same, so the label matters.
In players with long-standing groin pain, the adductor tendon is the commonest single cause. The pubic joint and the hip account for much of the rest.
Only a minority have a true hernia. That is worth knowing before anyone reaches for an operation.
You will be examined standing, and asked to cough. A hernia shows itself then. Nothing else in this list does.
Then the tender points are mapped. The inner thigh points at the adductor. The bone itself points at the pubic joint. Deep pain on twisting points at the hip.
Sorting athletic groin pain
| Cause | How it usually behaves | First treatment |
|---|---|---|
| Adductor tendon strain | Tender on the inner thigh, worse on squeezing the legs together | Graded rehabilitation |
| Osteitis pubis | Tender right on the pubic bone, sore after running | Rest, then rehabilitation |
| Hip impingement or labral tear | Deep groin pain on twisting and deep bending | Hip assessment and physiotherapy |
| Inguinal-related groin pain | Tender, weak posterior wall. No lump | Rehabilitation first, surgery for a few |
| True inguinal hernia | A lump on standing or coughing that goes back on lying down | Repair |
Bring any scan and your physiotherapy notes. Most athletic groin pain is settled without an operation.
An MRI scan is the useful one here. It shows the tendon, the pubic bone and the hip, which is where most of the answers lie.
Ultrasound, done standing and straining, is good at showing a hernia and poor at everything else on this list. So the scan is chosen by what is being asked, not by habit.
For everything except a true hernia, structured rehabilitation comes first. The evidence for it is good and most players get back to sport without an operation.
Surgery is considered for a genuine hernia, and for a small group with inguinal-related groin pain who have done the rehabilitation properly and are still stuck.
No. There is no lump and nothing has come through the abdominal wall. It describes pain from a strained tendon and a weakened groin wall, which is a different problem.
A hernia gives a lump that appears on standing or coughing and settles on lying down. Pain with no lump at all is usually something else, and it is examined standing to be sure.
Usually not. Graded rehabilitation settles most cases. Surgery is kept for players who have completed a proper programme and still cannot play.
Yes, and it happens often enough to matter. Finding a small hernia does not mean it is the cause of the pain, so both are assessed before anything is planned.
MRI, in most cases. It shows the adductor tendon, the pubic joint and the hip together. Ultrasound done standing and straining is added when a hernia is suspected.
The main page on this site is robotic hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Shah's Gastro, Cancer & Robotic Surgery Centre
Apollo Hospital, Bhat, Gandhinagar
Gota OPD, Ahmedabad
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