Sports hernia / Gilmore's groin: When groin pain strikes ...

Chronic, activity-related groin pain is a common problem and can have serious consequences, especially for professional athletes. The anatomical and functional complexity of the groin, as well as the frequent radiation of pain from other regions, often make establishing a diagnosis a challenge.

By taking a careful history, identifying the character of the pain and involving clinical, ultrasound and radiological examinations, it is usually possible to differentiate the symptoms. Given the high number of different possible causes of chronic groin pain in athletes, a multi-disciplinary approach is especially important.
It is crucial to clearly differentiate between the underlying pathology and the cause of the symptoms in order to avoid unnecessary surgery, prevent long-term damage and to provide the patient with targeted therapy.

Gilmore's groin is not a classical "hernia". Instead, Gilmore's groin is a generalised weakness in the medial section of the posterior wall of the inguinal canal. This gives rise to localised swelling of the transversal fascia into the inguinal canal. During tension of the abdominal muscles and abrupt movements, this can lead to the pain typical of Gilmore's groin, since it is caused by compression with nerve irritation. This weakness of the posterior wall of the inguinal hernia also leads to a change in the tension of the rectus abdominis muscle at its attachment to the pubic bone. This explains the localised pain and consequently the development of bone oedema in the area of the pubic bone (pubalgia athletica, osteitis pubis).

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