Groin Strain...or Something More?

If you have ever participated in sports such as soccer, hockey, or sprinting, chances are you have experienced a "groin strain" of some kind. This normally occurs when the muscles of the groin have exceeded their limits in both flexibility and strength during activity.

If the injury persists longer than a minor strain, it may be athletic pubalgia or a "sports hernia." This is a condition where the adductor muscles of the hip or the abdominal muscles are involved. The muscle and tendon junction will suffer minor tears, or experience a complete rupture if the force is great enough. If the muscular system is still intact, there may be a problem with the abdominal wall which leads to an inguinal hernia or a small tear of the internal oblique muscle.

The inguinal canal is an area adjacent to the hip that is formed by muscle, tendons and ligaments to allow proper movement of muscle and protection to arteries, veins, and nerves. With activities previously mentioned, the inguinal canal may weaken, causing pain and instability to the structures of the canal. When the muscle weakens, bulging of soft tissue through the area will occur, leading to an inguinal hernia.

With an injury such as this, conservative treatment includes rest, stretching, strengthening, and medication. If the symptoms do not clear, a more invasive treatment may be needed. In this situation, surgery may be required. Surgical treatment may be done with either a conventional (open) incision procedure or a laparoscopic (closed) repair.

The conventional or open procedure requires the surgeon to make a large incision into the muscles of the groin where the repair takes place. This procedure will require the interruption of abdominal muscle and will have a recovery time of approximately four to six weeks with a good rehabilitation program.

With a laparoscopic or closed hernia repair, several small incisions are required. Small surgical tools are passed through the incision to perform the repair. With this less invasive approach, the patient will recover much quicker and with less pain. The recovery time for this procedure is significantly less, returning the individual to normal activities in approximately one week.

Currently on staff at Columbia St. Mary's Hospitals is Dr. Richard Cattey, who is one of only a handful of surgeons worldwide, performing the sports hernia repair. Dr. Cattey has been voted "One of the Top Surgeons in Milwaukee" and "Top Doc's in Milwaukee" by Milwaukee Magazine. In 1996-1997, Dr. Cattey was also named to "The Best Doctors in America - Midwest Region." For more information on Dr. Cattey or "sports hernias," please contact the Milwaukee Institute of Minimally Invasive Surgery at (414) 961-4343 or (800) 377-2673.



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