- Athletic pubalgia
Athletic pubalgia, also called the sportman's hernia or sports hernia, Gilmore's groin or groin disruption, is a medical condition of the
groin affecting athletes.Ahumada LA, Ashruf S, Espinosa-de-los-Monteros A, Long JN, de la Torre JI, Garth WP, Vasconez LO. "Athletic pubalgia: definition and surgical treatment". "Ann Plast Surg" 2005;55(4):393-6. PMID 16186706]Jerry Gilmore recognized thesyndrome in 1980 and developed a surgical repair technique. It is a syndrome characterized by chronic groin pain in athletes and a dilated superficial ring of theinguinal canal .Soccer andIce Hockey players are affected most frequently, and both recreational and professional athletes may be affected. Ahernia cannot be found onphysical examination ormedical imaging , and is not revealed during surgery. The term hernia thus is a misnomer,Joesting DR. "Diagnosis and treatment of sportsman's hernia". "Curr Sports Med Rep" 2002;1(2):121-4. PMID 12831721] but has persisted, as surgical reconstructions similar to those performed for inguinal hernias are often effective for "sports hernias" as well.Symptoms include pain during sports movements, particularly hip extension, and twisting and turning. This pain usually radiates to the adductor muscle region and even the testicles, although it is often difficult for the patient to pin-point the exact location.
Following sporting activity the person with athletic pubalgia will be stiff and sore. The day after a football match, getting out of bed or a car will be difficult. Any exertion that increases intra-abdominal pressure, such as coughing, sneezing, or sporting activity can cause pain. In the early stages, the person may be able to continue playing their sport, but the problem usually gets progressively worse.
As pain in the groin and pelvis can be referred from a number of problems, including injuries to the lumbar spine, the hip joint, the sacro-iliac joint, the abdomen, and the genito-urinary system, diagnosis of athletic pubalgia requires skillful differentiation and pubic examination in certain cases where there is intense groin pain.
The diagnosis of Gilmore's groin is based on the patient's history and clinical signs. The most notable clinical sign is dilation of the superficial inguinal ring on the affected side, which can be palpated by the examining doctor when the scrotum is inverted with the little finger. Typically, there is specific pain on coughing and sneezing, as well as sitting up and squeezing the legs together.
The exact lesion may differ, but common pathologic findings at operation are:" [http://www.108harleystreet.co.uk/Pages/gilmore-groin-hernia-clinic.htm The Gilmore Groin & Hernia Clinic] ". Retrieved November 24, 2006.]
* torn external oblique aponeurosis
* tear in theconjoint tendon
* conjoint tendon torn frompubic tubercle
* dehiscence between conjoined tendon andinguinal ligament
* tear in the fascia transversalis
* abnormal insertion of therectus abdominis muscle
* tear of theabdominal internal oblique muscle from the pubic tubercle
* entrapment of theilioinguinal nerve orgenitofemoral nerve eMedicine|sports|162] Several of these lesions may occur simultaneously. Also, many athletes have concomitant weakness or tearing of theadductor muscles of the hip .The exact incidence of these entities is unknown: some believe it is the most common cause of chronic groin pain in athletes, while others argue that it is only rare.Fredberg U, Kissmeyer-Nielsen P. "The sportsman's hernia--fact or fiction?" "Scand J Med Sci Sports" 1996;6(4):201-4. PMID 8896091] Conservative therapies (gentle
stretching and a short period of restGPNotebook|53477314] ) may temporarily alleviate the pain, but definitive treatment consists of surgical repair followed by a structured rehabilitation.Notable cases
Well-known sufferers include:
*Kentucky Wildcats guardJodie Meeks
*Denver Nuggets guardChucky Atkins
* Patriotsquarterback Tom Brady " [http://www.boston.com/sports/football/patriots/articles/2006/01/31/bradys_groin_may_be_hurt/ Brady's groin may be hurt] ". "The Boston Globe ",January 31 2006 . Retrieved December 3, 2006.]
*San Jose Sharks forwardsJonathan Cheechoo andDevin Setoguchi
* Englandcricketer Ashley Giles " [http://sport.independent.co.uk/cricket/article1523075.ece Angus Fraser: England play with fire over fitness for Ashes tour] ". "The Independent ",13 September 2006 . Retrieved December 3, 2006.]
*Philadelphia Eagles quarterbackDonovan McNabb J Cluett. " [http://orthopedics.about.com/od/famousinjuries/p/dovovanmcnabb.htm Donovan McNabb - Sports Hernia] ". Retrieved December 3, 2006.]
* Outfielders Chris andShelley Duncan [http://www.stltoday.com/stltoday/sports/stories.nsf/cardinals/story/25754128FF55D8B98625735D000537B6?OpenDocument AP - Chris Duncan undergoes surgery for sports hernia] Retrieved September 22, 2007]
*Los Angeles Galaxy soccer playerBenjamin Benditson " [http://web.mlsnet.com/news/mls_events_news.jsp?ymd=20051110&content_id=47956&vkey=mlscup2005&fext=.jsp Los Angeles Galaxy mini bios] ". November 10, 2005. Retrieved December 3, 2006.]
*Houston Dynamo soccer playerJoseph Ngwenya
*Kilmarnock F.C. midfielderDanny Invincibile " [http://www.dailyrecord.co.uk/opinion/columnists/sport/billybrown/ Players will put on a United front to get back winning] ". "Daily Record",17 January 2007 . Retrieved January 19, 2007.]
*Toronto Maple Leafs forwardKyle Wellwood Sportsline. [http://www.sportsline.com/nhl/players/playerpage/273567 42 Kyle Wellwood, C] . Retrieved March 7, 2007.]
*Philadelphia Flyers forwardDaniel Brière SBR Forum. [http://forum.sbrforum.com/hockey-handicapping/4497-sabres-center-have-surgery-sports-hernia.html Sabres' center to have surgery for sports hernia] . Retrieved March 7, 2007.]
*New York Islanders centerShawn Bates Yahoo! Sports. [http://sports.yahoo.com/nhl/news?slug=rotowire-hawnatesoneforegular&prov=rotowire&type=fantasy Shawn Bates: Done for Regular Season] . Retrieved March 7, 2007.]
*Detroit Red Wings forwardDarren McCarty NetScape Sports. [http://sports.netscape.com/story/2007/01/31/kobasew-and-mccarty-out-of-action Kobasew and McCarty out of action] . Retrieved March 7, 2007.]
*New England Revolution forwardPat Noonan Yahoo! Sports. [http://sports.yahoo.com/mls/news?slug=ap-revolution-noonansurgery&prov=ap&type=lgns Revolution's Noonan to have surgery for sports hernia] . Retrieved March 21, 2007.]
*Nashville Predators wingerJean-Pierre Dumont Sports Illustrated. [http://sportsillustrated.cnn.com/2005/hockey/nhl/12/02/dumont/?section=si_hockey Sabres' Dumont out with hernia] . Retrieved March 21, 2007.]
*Dallas Stars defensemanSergei Zubov
*Anaheim Ducks goaltenderJean-Sébastien Giguère and forwardSamuel Påhlsson
*Chicago Blackhawks forward Jason Williams " [http://blackhawks.nhl.com/team/app/?service=page&page=NewsPage&articleid=350454"] Retrieved January 18, 2008.]
*Detroit Red Wings forwardTomas Holmström Detroit Free Press. [http://www.freep.com/apps/pbcs.dll/article?AID=/20080611/BLOG09/80611044/1053/SPORTS05 Holmstrom has surgery for sports hernia] . Retrieved June 12, 2008.]
*Colorado Avalanche forwardJoe Sakic
* Texas Rangers second basemanIan Kinsler Associated Press. [http://sports.espn.go.com/mlb/news/story?id=3541721 Sports hernia forces Rangers' Kinsler to DL, could end his season] . Retrieved August 19, 2008.]
*New Orleans Saints tight endJeremy Shockey
* Lemoyne College Dolphins center back Davide DiPaola
* Philadelphia Eagles Wide ReceiverKevin Curtis Footnotes
External links
* [http://www.108harleystreet.co.uk Gilmore Groin and Hernia Clinic]
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