RT Journal Article
SR Electronic
T1 Sports hernias: a systematic literature review
JF British Journal of Sports Medicine
JO Br J Sports Med
FD BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine
SP 954
OP 964
DO 10.1136/bjsm.2008.047373
VO 42
IS 12
A1 P Caudill
A1 J Nyland
A1 C Smith
A1 J Yerasimides
A1 J Lach
YR 2008
UL http://bjsm.bmj.com/content/42/12/954.abstract
AB This review summarises the existing knowledge about pathogenesis, differential diagnosis, conservative treatment, surgery and post-surgical rehabilitation of sports hernias. Sports hernias occur more often in men, usually during athletic activities that involve cutting, pivoting, kicking and sharp turns, such as those that occur during soccer, ice hockey or football. Sports hernias generally present an insidious onset, but with focused questioning a specific inciting incident may be identified. The likely causative factor is posterior inguinal wall weakening from excessive or high repetition shear forces applied through the pelvic attachments of poorly balanced hip adductor and abdominal muscle activation. There is currently no consensus as to what specifically constitutes this diagnosis. As it can be difficult to make a definitive diagnosis based on conventional physical examination, other methods, such as MRI and diagnostic ultrasonography are often used, primarily to exclude other conditions. Surgery seems to be more effective than conservative treatment, and laparoscopic techniques generally enable a quicker recovery time than open repair. However, in addition to better descriptions of surgical anatomy and procedures and conservative and post-surgical rehabilitation, well-designed research studies are needed, which include more detailed serial patient outcome measurements in addition to basing success solely on return to sports activity timing. Only with this information will we better understand sports hernia pathogenesis, verify superior surgical approaches, develop evidence-based screening and prevention strategies, and more effectively direct both conservative and post-surgical rehabilitation.