Understanding Sports Hernias

Core muscle injuries can occur from any repetitive movement engaging the core. There are a few different types of core muscle injuries:

• Oblique muscle strains: Tears in the internal or external oblique abdominal muscles 
• Adductor muscle strains: Tears in the groin/inner thigh adductor muscles
• Core muscle tears: Ruptures of the rectus abdominis or pyramidalis muscles 

Core muscle injuries can range in severity, from Grade 1, mild muscle strains, to Grade 3, complete muscle tears that may require surgical repair. Treatment options depend on severity but often start conservatively with rest, ice, compression, elevation, anti-inflammatory medications, and physical therapy focused on core and hip strengthening. For complete muscle tears or chronic pain, surgery may be necessary to suture the torn tissues. This is often done laparoscopically for a quicker recovery. Timelines for returning to your normal activities range from a few weeks for mild strains to several months for more severe repairs that require surgery. Strict adherence to rehab and rest protocols helps minimize reinjury risk.

Our physicians use a combination of modalities to diagnose core muscle injuries, including a detailed history, physical examination, and imaging like MRI, ultrasound, or CT scan. We will ask questions about the onset and nature of the pain and what movements or actions exacerbate the symptoms. Physical exams help identify any structural abnormalities indicative of muscle tears. Resistive adduction maneuvers, where the patient pushes inward against resistance to recreate their pain, help confirm strained adductors. Imaging is also often used to rule out bone fractures or alternative pathology. MRI can identify strained muscles or torn rectus abdominus/adductors but is not always conclusive, sometimes leading to exploratory laparoscopy for a definitive diagnosis. 

Identifying the location and degree of the core muscle injury guides appropriate treatment, which can range from conservative rehab to surgical repair.

Early assessment of symptoms can help guide appropriate treatment to minimize long-term issues. An accurate diagnosis will check for possible femoral or inguinal hernias as well, which have overlapping symptoms. There is a range of surgical and non-surgical treatment options for core muscle injuries, depending on the degree of muscle tearing. Mild Grade 1 sprains may heal with just 6-8 weeks of conservative treatment while severe complete muscle ruptures often require operative fixation to allow return to normal activity. 

Non-Surgical:

• Rest/restricted activity to allow torn tissue to heal
• Ice packs and NSAIDs to reduce pain and inflammation
• Physical therapy focused on core strengthening and hip stability
• Gentle stretching and massages for muscular tightness/spasms
• Use of groin straps or braces to provide compression/support

Surgical:

• Reinforcement of strained/weakened areas with absorbable mesh
• Bone anchoring to repair muscles that have been torn off the bone
• Tenotomy/release procedures to relieve tension/disconnect torn ends
• Post-surgical structured rehabilitation program focusing on range of motion and gradual strength building

Before Treatment

If you suspect you have a core muscle injury, the first step is to consult with a healthcare professional, typically a sports medicine specialist or surgeon specializing in hernia repair. Your doctor will conduct a thorough physical examination and may order imaging tests such as an MRI or ultrasound to confirm the diagnosis. During this phase, it is crucial to communicate any symptoms or concerns you have to ensure an accurate diagnosis and appropriate treatment plan.

During Treatment

The treatment approach for a core muscle injury can vary depending on the severity of the injury and the individual's lifestyle and activity level. Non-surgical options may include rest, physical therapy, and targeted exercises to strengthen the surrounding muscles and improve core stability. If conservative measures fail to provide relief or if the hernia is causing significant pain and functional limitations, surgical intervention may be recommended. Core muscle injury surgery typically involves repairing the torn tissues and reinforcing the weakened area with sutures or absorbable mesh to stabilize the abdominal wall. Your surgeon will discuss the specifics of the procedure, including anesthesia options, expected recovery time, and potential risks and complications, to help you make an informed decision.

After Treatment

Recovery from core muscle injury, whether surgical or non-surgical, requires patience and dedication throughout the rehabilitation process. Following surgery, it is recommended to rest for six weeks. You may experience some discomfort, swelling, and limited mobility during this time. Your healthcare team will provide detailed instructions on post-operative care, including wound care, pain management strategies, and gradual return to activity guidelines. A six-week physical therapy program will play a crucial role in restoring strength, flexibility, and function to the affected area, helping to prevent recurrence and optimize long-term outcomes. It is essential to follow your doctor's recommendations closely and communicate any concerns or setbacks during this time to ensure the best possible recovery.

Surgical treatment for core muscle injury carries certain risks and potential side effects, just as with any surgical procedure. It is essential to discuss these potential risks and side effects with your healthcare provider before undergoing surgery for a core muscle injury. Your surgeon will provide personalized guidance based on your individual health status, medical history, and the specifics of your condition. Possible risks include:

• Infection at the surgical site
• Excessive bleeding
• Nerve injury resulting in permanent nerve damage
• Chronic pain in the groin area
• Hernia recurrence
• Scar tissue formation 
• Blood clots
• Adverse reactions to anesthesia, including allergic reactions and respiratory issues

The Institute for Advanced Reconstruction participates in a wide range of insurance plans, including those listed below. However, each physician has their own accepted insurance and hospital affiliations. Before scheduling an appointment, please contact your insurance carrier to confirm that your provider is in-network.
If we are not an in-network provider, our friendly insurance specialists will help you find the most coverage available for your treatment. 

• Horizon Blue Cross Blue Shield of New Jersey
• Medicare
• Railroad Medicare
• Aetna
• Cigna
• United Healthcare
• Oxford (Freedom, Liberty)
• MagnaCare

Candidates for core muscle injury surgery typically include individuals who have persistent groin pain. If you are experiencing chronic groin pain or suspect you may have a core muscle injury, seeking evaluation by a specialist at The Institute for Advanced Reconstruction is recommended. Our team of experts can provide comprehensive evaluation and treatment options tailored to your specific needs, helping you get back to the activities you love with confidence. Schedule a consultation today to begin your journey toward relief and recovery.