GROIN PULL / INGUINAL HERNIA EXERCISE PROGRAM EVIDENCE BASED REHABILITATION
| MY SPORTS INJURY CLINIC IN MANCHESTER CITY
Inguinal hernia is a very common condition that affects many people around the world. This condition can be very painful and can affect a person’s ability to perform daily activities. Exercises to close an inguinal hernia alongside physical therapy counseling from our Manchester physiotherapists can help relieve symptoms and improve a person’s quality of life. The best treatment for inguinal sports hernia may depend on the severity of the injury, the patient’s overall health, and their goals for recovery.
An inguinal hernia is the protrusion of a part of the intestine or other abdominal organ through an opening in the abdominal wall into the groin. The abdomen is a part of the human body that is located between the thorax and the pelvis, it is also in charge of supporting and containing the important organs of the digestive system (intestine, stomach, liver, gallbladder) and genitourinary system (uterus, bladder, prostate).
What is an Inguinal Hernia?
Inguinal hernia is a pathology in which the intestine passes through the layers that surround it. This creates what is commonly called a “lump” in the groin or scrotum. This pathology can be from asymptomatic to fatal, having to be operated if necessary, in worst cases scenario and emergencies. Unlike other types of hernias, inguinal hernias usually occur bilaterally in men older than 60 years. Frequently with a history of hypertension or diabetes, who tend to exert themselves and lead sedentary lives.
Reports have claimed that abdominal wall hernias are quite frequent as they present an incidence of 1.7% in all ages and for those subjects aged over 45 the total number is 4%. In addition, there are studies confirming that inguinal hernias may reach up to 75% of abdominal wall hernias, being men the most affected with a lifetime risk of 27% and 3% in women. It is worth bearing in mind that repair of inguinal hernia is one of the most common operations in general surgery, with rates ranging from 10 per 100 000 of the population in the United Kingdom (John T Jenkins et la, 2008).
Inguinal hernia is pretty well-known as a source of pain in athletes, both elite and amateurs, this is why at My Sports Injury Clinic in Manchester City with our Manchester sports physios, chiropractors, and all trained health care provider staff we look after the well-being of our patients with a general and multidisciplinary approach and thus provide the best service to achieve a life without pain, so for further info contact us on https://mysportinjury.janeapp.co.uk/
Moreover, one out of ten patients who get to turn up at our sports injury clinic in Manchester claims having groin pain. In a more general view groin injuries account for 2% to 5% of all sports-related injuries. In this sense, it is fair to say that an early and precise diagnosis is paramount as well as is a proper treatment in order to keep these sports injuries away from becoming worse and chronic. (Vincent Morelli et la, 2001).
It should be noted that according to literature other pathologies which groin pain is presented are sports hernia, groin disruption, iliopsoas bursitis, stress fractures, avulsion fractures, nerve compression, and snapping hip syndrome. On the other hand, the sports which have the highest incidence rate of causing groin pain are soccer, football, and ice hockey due to repeated rapid sprints and stops while running and jumping.
Why does an inguinal hernia occur? Does the groin pull happen out of the sudden?
Inguinal hernias sometimes do not have a specific cause, but they can occur due to an increase in intra-abdominal pressure, the existence of a weak spot in the abdominal wall, straining to evacuate or urinate, as well as activities that require high effort. physical and lifting loads, pregnancy can also cause the appearance of an inguinal hernia, like chronic coughing and sneezing (Mohamad Hammoud et la, 2022).
The weakness of the abdominal wall is usually also a cause of inguinal hernia, especially in new-born babies, when the peritoneum does not close as it should. This weakness can also present in adulthood after abdominal injury or surgery.
Moreover, according to research the intestine can be partially exited due to intra-abdominal pressure as the weakest areas of the abdominal wall can present wear and bulging which can possibly break those abs walls. Another important factor in this pathology is the state of the deep abdominal muscles and their correct activation when performing movements.
The “bulge” that appears in an inguinal hernia is capable of changing depending on the position of the person. When standing, it can usually be seen better and when the person lies down, it can diminish or disappear. The most common symptom is the feeling of discomfort or pricking when overexerting.
Sports physiotherapy clinicians, sports massage therapists, and manual therapists are some of our experts in sports-related injuries that will help you to fix Inguinal Hernia pain in Manchester.
We help you go through this situation our sport injury specialists with great expertise, who will address, assess and determine what the most suitable treatment options are for your individual needs, this may vary between sports massage or more complex manual therapy techniques provided in our Manchester City centre location.
At My Sports Injury Clinic Manchester we strive for our patients to be in a healthy optimal state both mentality and physically so providing a series of proven conservative treatments that help alleviate, heal and keep your condition away from exacerbating, there are more structured physical therapy programs including, acupuncture in Manchester, Osteopathic techniques for correction purposes to the joints, Chinese massage & cupping therapy, deep tissue, thermotherapy and sports massages, dry needling, and postural correction rehabilitation amongst others.
How can Inguinal Hernia be diagnosed?
The diagnosis of inguinal hernia lies in verifying the existence of protrusion at the hernia level, especially when performing abdominal exertion maneuvers, coughing, etc. Therefore, most of the time, physical examination reveals the presence of the hernia. Ultrasonography and CT are useful for the detection of small hernias. In some cases, the hernias reach a large size, being apparent to the naked eye. The differential diagnosis should be made especially with varicocele and hydrocele (Amer Shakil et la, 2020).
What are the symptoms of an inguinal hernia?
The symptoms that occur in an inguinal hernia is the presence of a bulge over the pubic area, which is more visible during standing, when making an effort or coughing, and usually generates a burning sensation and pain in the area where this lump is located. This usually refers to the inguinal area, especially when performing trunk flexion movements, when lifting weight or coughing, there is also a feeling of heaviness, weakness and pressure on the groin area and sometimes pain and inflammation can refer around the groin area. Testicles (F J Pérez Lara et la, 2015).
It is important to bear in mind that when the protruded structure cannot be brought in, it can become trapped and strangulated, interrupting the blood flow to this tissue, and this situation can be fatal if it is not treated, so if symptoms such as fever occur, nausea, vomiting, sudden pain, inability to evacuate or eliminate gases and the lump becomes red, cyanotic or dark in colour, it is necessary to see a doctor urgently.
When overexertion is done, due to the pressure we generate in the abdomen, the intestine tends to come out of the abdomen more, but in turn the muscles tend to activate more, causing the part of the intestine that is protruding to be more compressed.
It’s usually a feeling that goes away after a while. If the compression is maintained over time, it is called a strangulated hernia and it interrupts the correct blood supply to part of the intestine. In this case, necrosis of the intestine can occur, which can be fatal for the person. When we come to this case, the only solution is surgery, since the patient’s life would be at stake. The most used surgical techniques for this case in recent years are Nyhus and Lamparoscopic.
How do exercises help close an Inguinal Hernia?
When the right exercises are practiced, the abdominal muscles and the abdominal wall can be strengthened. This helps to increase the pressure in the groin area and thus helps to close the hernia. The exercises also help increase blood flow to the area of the hernia, which helps reduce pain and swelling.
Types of exercises to close an Inguinal Hernia
Abdominal exercises such as crunches and stretching exercises are great to help close an inguinal hernia. These exercises tone the abdominal muscles, which helps stabilize the spine and reduce pressure in the groin area. Weight training is also recommended to strengthen the abdominal muscles. Some exercises, such as jumping jacks, leg lifts, squats, and push-ups, can also help increase the endurance of your abdominal muscles.
Tips for performing the exercises for Inguinal Hernia
It is important to remember that exercises to close an inguinal hernia must be performed with caution. It is critical that the patient warms up before performing the exercises to avoid injury. The movements must be smooth and controlled to avoid injury to the muscles. A warm-up should be done before each exercise session to avoid injury and muscle fatigue. Exercise should also be stopped if you feel pain or discomfort.
How to treat an Inguinal Hernia without surgery at Sports Injury Clinic in Manchester?
Treating an inguinal hernia without surgery can be helpful for people who want to avoid surgery. Some alternatives include: the use of an abdominal support, the adoption of a healthy lifestyle that includes a balanced diet, the performance of specific exercises to strengthen the abdominal area and avoid lifting weights. It is also important to avoid straining when having a bowel movement. While these alternatives won’t completely eliminate the hernia, they can relieve symptoms and improve your quality of life. It is important to emphasize that these measures should not delay a surgical intervention if the doctor considers it necessary.
In conclusion, exercises to close inguinal hernias are a great way to improve health and reduce the risk of complications. These exercises can be done with or on her own by a healthcare professional such as a certified manchester physiotherapist, as long as they are performed in a safe and responsible manner. This means doing exercises that are appropriate for your level of fitness and with the necessary care and advice to avoid injury. Finally, remember that it is important to consult with a health professional before beginning any exercise program to close inguinal hernias.
According to the results of a study research which pointed out that active exercises were a very essential and vital part of sports hernia and inguinal rehabilitation. An active rehabilitation program was highly helpful and effective for sports hernia management, adding up to diminished pain and a return to sports (Walid Ahmed Abouelnaga et la, 2019).
If surgery is needed there are some things you should take into account.
What is the treatment for Inguinal Hernia?
The definitive treatment of inguinal hernia is surgical and consists of the reintroduction of the abdominal contents and repair or reinforcement of the inguinal wall.
To carry out said repair or herniorrhaphy, there are several techniques that range from the use of the tissues themselves (muscles, fascias, etc.) to restore the integrity of the abdominal wall, to the use of prostheses or artificial meshes that play this role.
One of the latest advances in the surgical treatment of inguinal hernias consists in repairing them laparoscopically, especially indicated in those hernias that have been operated on previously and that have reappeared or in those that initially manifest on both sides.
What are the risks and benefits of surgery for an Inguinal Hernia?
One of the main reasons to undergo inguinal hernia surgery is to avoid the complications that can occur due to this problem, since they can be very dangerous. Amongst these complications we can find intestinal occlusion, intestinal subocclusion, and strangulated inguinal hernia, etc.
The main benefit of inguinal hernia surgery is the solution to the discomfort and pain caused by the problem. In addition to eliminating discomfort, another clear benefit is avoiding serious complications.
What is the plan to follow to treat Inguinal Hernia?
Before performing a surgical intervention, it is important to carry out an assessment and prepare the anatomical structures in order to improve and accelerate the postoperative period.
The objectives of the pre-operative of Inguinal Hernia physiotherapy treatment are to strengthen, improve mobility, get to the surgery in an optimal way, thus accelerating and improving the recovery processes.
So, physiotherapy treatment for inguinal and abdominal hernia consists of a well-structured plan carried out by our Manchester physios at our sports injury clinic, moreover, it is worth mentioning that inguinal and abdominal hernia is one of the pathologies that we treat the most. The treatment is based on a series of analytical stretching, combined with therapeutic exercises to recover muscle strength and electrostimulation to selectively tone the muscles involved.
When can I return to exercise after Inguinal Hernia Surgery?
During the first 3 or 4 weeks, it is advisable not to do any sudden exercise. It is proven that broadly patients might be able to walk as much as they can tolerate pain after the surgical procedure, slight discomfort is normal. Non-impact exercise such as swimming, biking, or elliptical training can be performed around 6 to 12 weeks after surgery. Planks for core strengthening can also be performed from 6 to 12 after surgery.
The inclusion of sports after Inguinal Hernia surgery must be progressive and mainly weights must be avoided until after 3 or 4 months, and before lifting weights physical therapy rehab has to be done.
How long does it to recover from surgery for an Inguinal Hernia?
When a person is going to have surgery, whether it’s for an inguinal hernia or anything else, the main thing they want to know is when they’ll be okay again. In the case of active people who practice sports regularly, what they are most interested in is knowing when they will be able to resume sports activity, in order to make this happen patients have to receive guidance through the rehab process by our physios in Manchester full of expertise.
You should be able to get back to work 2 weeks after surgery however this may vary on what your tasks are, if your job includes manual labour or lifting heavy weights you might need more time off to return to work, and this will only be possible after a strict rehabilitation plan post inguinal hernia surgery. Furthermore, amongst the factors that determine the necessary recovery time is the type of surgical approach used in the surgery and the technique, mainly for the care of the surgical wound, which is less in laparoscopy.
References
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Rolph R, Morgan C, Chapman G, Marsh S. Groin pain in athletes BMJ 2020; 368 :m559 doi:10.1136/bmj.m559
Morelli V, Smith V. Groin injuries in athletes. Am Fam Physician. 2001 Oct 15;64(8):1405-14. PMID: 11681783.
Shakil A, Aparicio K, Barta E, Munez K. Inguinal Hernias: Diagnosis and Management. Am Fam Physician. 2020 Oct 15;102(8):487-492. PMID: 33064426.
Hammoud M, Gerken J. Inguinal Hernia. [Updated 2022 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513332/
Pérez Lara FJ, Del Rey Moreno A, Oliva Muñoz H. Do we really know the symptoms of inguinal hernia? Hernia. 2015 Oct;19(5):703-12. doi: 10.1007/s10029-014-1319-4. Epub 2014 Nov 7. PMID: 25376363.
Abouelnaga WA, Aboelnour NH. Effectiveness of Active Rehabilitation Program on Sports Hernia: Randomized Control Trial. Ann Rehabil Med. 2019 Jun;43(3):305-313. doi: 10.5535/arm.2019.43.3.305. Epub 2019 Jun 28. PMID: 31311252; PMCID: PMC6637051.