Travel PT professionals can prevent and treat sports hernias

A sports hernia does not fit the traditional definition of a "hernia," as those on travel physical therapy assignments know. While a common hernia involves an organ or soft tissue that protrudes outside its normal cavity, there is no bulging in a sports hernia. This injury occurs in the form of tears and the weakening in the deep layers of the abdominal wall. 

As its name suggests, sports hernias mainly affect athletes who play soccer, hockey, football and rugby. These activities require a sudden change of direction, placing extreme stress on the lower abdominal area that may cause a strain or tear of the soft tissue.

The tricky part about a sports hernia, also called an athletic pubalgia, is that the symptoms are similar to that of a groin pull, strained abdominal muscle or other lower trunk injuries. Thus, the condition can be hard to accurately diagnose. About 5 percent of all sports injuries involve groin pain, and 40 to 85 percent of chronic groin pain in athletes may be caused by a sports hernia, according to Core Performance. The condition is more common in males, but it can happen to anyone. 

Preventive exercises

This painful, soft tissue injury can put the brakes on an exercise routine, so here are some exercises to strengthen the muscles around the hip and abdominal area to help avoid it:

Hand walks: To do this exercise, bend over at the waist and place hands into a pushup position, with your back arched. Keeping your knees straight, walk your toes toward your hands. When you feel the stretch in your hamstrings, walk hands back out and repeat.  

Glute bridge – one leg: Start by laying on your back on the floor. Facing up, bend your right knee to a 90-degree angle with your heel on the ground while holding your left leg to the chest. Fire your right glute to bridge hips so your weight is supported only by the right heel and shoulders. Hold for a few seconds and return to start position. Repeat.

Inverted hamstring stretch: This exercise begins by standing on one leg with arms raised perpendicular to the ground. Bend forward at the waist so your torso is parallel with the floor. Remember to keep the back flat. While doing this, kick the raised heel to the ceiling. When you feel the stretch, return to starting position, step back with your other foot and repeat. 

Treatment

As a travel physical therapy professional, you can provide individualized treatment to target the key problems. Before turning to surgery, most patients with a sports hernia are advised to do exercises that strengthen the hip area and increase flexibility.

Though each treatment should be tailored to the patient's specific needs, a common physical therapy treatment may include:

Icing and compression: At the early stages of injury or when pain levels are high, applying ice to the area can help reduce swelling and lower pain. 

Stretching: You can help your patient perform hip and low back exercises to gently stretch and strengthen his or her muscles. 

Muscle retraining: After a tear, it is important to help rebuild the abdominal and hip muscles. This is the essential part of the treatment. Watch out for muscles that may not be "firing" or contracting due to pain and inhibition. 

Strengthening: Once the patient no longer experiences pain, start hip strengthening and non-aggravating core strengthening. 

Manual therapy: Conduct hands-on stretching, soft-tissue mobilization and joint mobilization based on your evaluation of the patient. 

Return to sports drills: When the patient reaches the point where he can progress without pain, add movements specific to his treatment program. For example, returning to running or light sports drill may help prepare the body for the full participation of the the sport.