DEFINITION
A sports hernia is a painful musculotendinous injury to the medial inguinal floor caused by and exacerbated by vigorous sport or physical exertion. It is not a true hernia because there is no “herniation” or protrusion of a visceral sac (5). However, its repair is very similar to that of an inguinal hernia, and the term has become ingrained. Because the term “athletic pubalgia syndrome” is nearly identical in meaning, the terms are used interchangeably here. However, a surgical procedure intended to correct the abdominal wall injury is called a sports hernia repair.
With athletic pubalgia syndrome, there is disequilibrium between the upward and oblique pull of the abdominal muscles on the pubis against the downward and lateral pull of the adductors on the inferior pubis. This imbalance of forces can lead to injuries of the lower central abdominal muscles and the upper aponeurotic common insertion of the adductor muscles. Although it is occasionally the result of an acute injury, it is more likely the result of repetitive eccentric overload to the abdominal wall stabilizers of the pelvis. It has been postulated that inadequate blood supply or simply failure to heal these repetitive attritional type injuries results in the condition.