The athlete's groin is classified according to the affected structures and the underlying cause:

1. According to affected structures:

- Muscular athlete's groin: Injury or overload of the adductor muscles.

- Tendon-related athlete's groin: Irritation or inflammation of the tendon attachments of the abdominal or thigh muscles.

- Ligamentous athlete's groin: Overload of the inguinal ligaments.

2. According to cause:

- Acute athlete's groin: Sudden complaints due to an injury or trauma.

- Chronic athlete's groin: Long-term pain due to repeated stress or instability.

The causes of a sports hernia are diverse and can be divided into mechanical, muscular, and structural factors:

• Mechanical stress:
  • Repeated, explosive movements such as quick changes of direction, stops, and starts that heavily strain the groin area.
  • Sports like soccer, ice hockey, athletics, or tennis that require intense stress on the groin area.
• Muscular imbalances:
  • Weakness of the abdominal muscles or adductors in relation to the opposing muscles.
• Structural factors:
  • Misalignments or instabilities in the pelvic or hip region.
• Lack of recovery:
  • Lack of recovery phases between intense training sessions.

The symptoms of a sports hernia are typically exercise-dependent and include:

• Local pain: Pain in the groin area that worsens with movement, especially during rotational movements or abrupt changes in direction.
• Radiating discomfort: Pain that radiates into the thigh, hip, or lower abdominal region.
• Movement restrictions: Limited mobility or stiffness in the hip region.
• Tenderness: Pain when touching the affected area.
• Loss of strength: Reduced performance in sports activities, especially when stressing the groin or hip region.

The diagnosis of athlete's groin is made through a combination of medical history, clinical examination, and imaging techniques:

- Medical history:

- Collection of information about the sport, load pattern, and duration of symptoms.

- Physical examination:

- Palpation of the groin area for tenderness.

- Functional tests such as the adductor test or hip extension test to provoke pain.

- Imaging:

- Ultrasound: Visualization of soft tissue changes such as inflammation or small tears.

- MRI: For detailed assessment of muscle, tendon, and ligament injuries.

- X-ray: To rule out bony changes or stress fractures.

Conservative Therapy

The treatment of sports hernia usually begins with conservative measures:

• Immobilization and load reduction:
  • Avoidance of painful activities to relieve the affected structures.
• Physiotherapy:
  • Exercises to strengthen the abdominal and pelvic muscles.
  • Stretching exercises to improve mobility and relieve the affected region.
• Pain therapy:
  • NSAIDs: To relieve pain and inflammation.
  • Local cold therapy for acute complaints and heat applications for chronic complaints.
• Manual therapy:
  • Mobilization techniques to improve pelvic stability.
• Alternative methods:
  • Shock wave therapy to promote the healing of soft tissue structures.

Surgical Therapy

In case of persistent complaints or unsuccessful conservative treatment, surgery may be necessary:

• Reconstruction of soft tissues: Repair or reinforcement of damaged structures in the groin area.
• Minimally invasive procedures: Arthroscopic interventions to treat accompanying hip problems, such as labral lesions.
• Post-treatment: Use of physiotherapy to restore function and load-bearing capacity.

To prevent sports hernia and reduce the risk of recurrence, the following measures are suitable:

1. Targeted training: Strengthening of the abdominal, pelvic, and adductor muscles to improve stability.
2. Regeneration: Sufficient recovery periods between training sessions.
3. Ergonomic movements: Avoidance of incorrect loading through correct technique in the respective sport.
4. Flexibility training: Regular stretching exercises to maintain mobility.
5. Early detection: Early medical clarification and adjustment of training at the first signs of discomfort.