Very often, we have patients who present with abdominal tenderness which likely is a sports hernia. A sports hernia is a weakness in the soft tissue and muscle area around their pubic symphysis and their lower abdomen. This is important because these muscles are their core muscles, and the core muscles are part of your pelvic floor as well. So if you have a weakness there, you will have a weakness in your pelvic floor and thus causing the pelvic pain. Having a sports hernia can now result into pelvic pain because of their weakness in their abdominal muscles and their core. Then patients may present with pain in their groin, they may present with pain going down their leg, pain in their hip. Pelvic pain does radiate, and it does not just stay in one location, so it can mimic other things like lower back pain.
Patients with sports hernias can attribute this from being very active. Oftentimes, they are athletes or have active lifestyles. We’re evaluating their lumbar spine, we’re evaluating their hips, we’re evaluating their abdomen and checking to see if they could have a potential hernia. When patients have sports hernias, we also have to treat the underlying pelvic floor dysfunction that they may have.
Typically, we do that with pelvic floor physical therapists, possibly some Valium suppositories, maybe a nerve medication for any neurogenic inflammation, if they need, we may do hydrodissection nerve blocks and trigger point injections to their pelvic floor. And at the same time, we’re hopefully working with a hernia surgeon to evaluate if there is a need for repair of the sports hernia. When patients present with pelvic pain, we’re trying to understand where their pelvic pain is coming from and why they have it. Until we figure out what’s causing the issue, the pain won’t resolve.