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New Jersey Sports Medicine
Sports Hernia
               'Sports Hernia' or 'Athletic Pubalgia'

The term 'Sports Hernia' refers to chronic groin pain in an athlete, the 'groin
pull' that will not heal despite rest and therapy.  The term 'Sports Hernia' is a
misnomer as a true hernia is not present, such as in an inguinal hernia, a
condition in which the contents of the abdominal cavity, intestine or fat, may
protrude through a hole or weakness in the abdominal wall.

The term 'Athletic Pubalgia' is another term used to refer to chronic tendon
groin pain in the athlete, which may be due to tears and tendonopathy of the
musculotendonous structures that insert on the pelvis, the adductor tendon
and the rectus abdominus tendon.  The term 'Inguinal Disruption' has also
been used interchangeably to more accurately describe the condition.

While MRI is known to be a superior imaging tool in sports medicine, the
'sports hernia' or tear / tendonopathy of the adductor tendon, rectus
abdominus, or conjoined tendon can be often missed on routine pelvis and
hip MRIs.

MSK Ultrasound at New Jersey Sports Medicine is a superior in office tool,
less expensive, and rapid for diagnosing 'sports hernia'.














MSK Ultrasound at New Jersey Sports Medicine also allows rapid diagnosis
of injuries that may be cause of groin pain such as labral tears, hip
osteoarthritis, and/or hip effusions.
























Often times, an athlete with a 'sports hernia' may also have other hip joint
pathologies and sources for pain.  

Ultrasound guided injections of PRP (platelet rich plasma) can be performed
at New Jersey Sports Medicine for both diagnostic test and therapeutic
treatment.  Most orthopedic hip injections are offered under C-Arm X-ray
radiation guidance performed in a hospital or surgery center costly and
expensive setting.  Dr. Silberman can perform the injection under ultrasound
guidance at New Jersey Sports Medicine, rapidly and inexpensively.  
Injections can be performed with lidocaine for diagnostic blocks, PRP or
platelet rich plasma, dextrose for prolotherapy, or bone marrow aspiration
for stem cells.

In more than 20 years of injecting tendons, Dr. Silberman has not once seen
a case of an injection of PRP causing calcium to develop as some sports
hernia surgeons have claimed.  While in the same time period, Dr. Silberman
has seen surgery for sports hernia cause painful calcific tendonitis, with
referals to Dr. Silberman to treat with injections.  Often the calcium deposit
in the tendon is a result of the injury or insult to the tendon itself.











There are very few surgeons who claim to treat sports hernias and most of
them do not accept insurance, making the non guaranteed treatment very
costly.   PRP (platelet rich plasma injections) and Prolotherapy have been
reported in the literature to have successfully treated sports hernias.  At New
Jersey Sports Medicine and Performance Center, Dr. Silberman has seen the
same results in treating sports hernias.  Along with specialized therapy
exercises which can be taught and hands on physical, massage, or
chiropractic therapy, irreversible surgery should be the last resort for the
treatment of sports hernias.


Prolotherapy for sports hernia in elite soccer and rugby athletes:
https://www.ncbi.nlm.nih.gov/pubmed/15827920

PRP for sports hernia in a professional hockey player:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711326/
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