By: Andrew Boyarsky
M.D., FACS
“Athlete Hernia” is a syndrome of unexplained groin pain most commonly seen in elite athletes. This pain usually develops without any real known or identifiable cause. It rarely starts with a definite injury. It is extremely important to recognize that so-called “weekend warriors” can develop this syndrome.
However, it is wrong to make this diagnosis in this group of “athletes” without an extensive discussion and evaluation by the surgeon, referring physician and physical therapist. Without the involvement of all these professionals, proper diagnosis is difficult and disappointment for these patients can ensue as they often want a simple explanation for their pain. More often than not, another problem will be identified as the cause of the pain and an operation can be avoided.
Due to the fact that there are really no definite signs seen on physical examination even by an experienced General Surgeon, the diagnosis is often one of exclusion. There are a variety of injuries in this area that can mimic this condition and they must be ruled out before the patient is eligible for an operation.
Possible injuries and conditions in the pelvic bones, hips, thighs and the muscles and tendons of this area must be evaluated by an Orthopedic Surgeon or a qualified Sports Medicine physician prior to being evaluated for “Athlete Hernia.” If all these other possibilities are deemed normal, and if after a well-organized six week course of physical therapy is completed, the pain in the groin immediately returns, then the diagnosis is in question.
The diagnosis of “Athlete Hernia” is made in the office with a proper history, noting subtle differences in the affected side as opposed to the normal side, a series of normal radiologic studies of the area and an abnormal dynamic ultrasound, performed in the office. When these rather strict criteria are met, an open groin exploration is then performed. This is accomplished with local anesthesia, a rather limited incision and a repair that utilizes otherwise healthy tissue without the use of any mesh or foreign materials other than sutures.
When properly diagnosed and treated, most individuals can be back to full activity within six weeks. Younger patients tend to recover quicker and at times have been back to their sport within four weeks. When an operation is performed with the strict criteria met, there is a 95-98 percent success rate. If you have unexplained groin pain, make an appointment with your healthcare provider today.
Board certified General Surgeon Andrew Boyarsky, M.D., FACS, is on staff at Hackensack Meridian Health Raritan Bay Medical Center. The accomplished surgeon has been in practice for more than 30 years and has been listed on several “Top Doctors” lists, is a longtime surgical educator and achieved recognition as Professor of Surgery, Emeritus at Rutgers University Robert Wood Johnson Medical School. Dr. Boyarsky is responsible for the surgical treatment and management of patients with a broad array of diseases, including but not limited to conditions affecting the gall bladder, abdomen and breasts, skin and soft tissue, hernia and the endocrine system. His office is located at Raritan Bay-Old Bridge, 2 Hospital Plaza in Suite 340. To make an appointment, call 732-360-3520.
