Intended for healthcare professionals

Practice 10-Minute Consultation

Groin pain in athletes

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m559 (Published 04 March 2020) Cite this as: BMJ 2020;368:m559
  1. Rachel Rolph, general surgery registrar1,
  2. Catrin Morgan, core surgical trainee1,
  3. Gareth Chapman, general practitioner2,
  4. Simon Marsh, consultant general surgeon3 4
  1. 1Guys and St Thomas NHS Foundation Trust, London, UK
  2. 2Ball Tree Surgery, West Sussex, UK
  3. 3Colchester Hospitals University Foundation NHS Trust, Colchester, UK
  4. 4The Gilmore Groin and Hernia Clinic, London, UK
  1. Correspondence to R Rolph r.rolph{at}nhs.net

What you need to know

  • Inguinal disruption is an overuse injury associated with sports or activities that involve twisting, sprinting, and kicking movements

  • Consider inguinal disruption in athletes presenting with groin pain and tenderness on palpation over the inguinal ligament or pubic tubercle and no hernia

  • Most patients improve over six to eight weeks with conservative management, including activity modification, physiotherapy, and core/adductor strengthening exercises

A 33 year old man who plays sport regularly complains of pain in the right groin over two months. It is worse on the day after exercise, especially on turning to get out of bed.

Groin pain accounts for one in 10 patient visits to a sports injury clinic.12 Inguinal or groin disruption (Gilmore’s groin) is a common cause in athletes. It is caused by tears in the conjoint tendon, the oblique muscles, and the inguinal ligament, which result from overuse. Inguinal disruption is also incorrectly referred to as a “sportsman’s hernia,” a misleading term as there is no hernia. Young men are commonly affected (median age 26-28 years),23 although about 5% of cases are seen in women. The condition is sometimes misdiagnosed in primary care, particularly among amateur athletes, when it is not suspected.4

What you should cover

Understanding the anatomy of the groin (fig 1 …

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