Sports Hernia Repair Specialist

Anthony Echo, MD -  - Plastic Surgeon

Anthony Echo, MD

Plastic Surgeon & Reconstructive Surgeon located in Houston, TX

Sports hernias often occur in athletes who participate in soccer, football, and ice hockey. Anthony Echo, MD, is currently the only surgeon in the United States trained to repair sports hernias using the Muschaweck technique. He traveled to Qatar to work with Dr. Muschaweck, a pioneer in sports hernia repairs. He combines her technique with his expertise in peripheral nerve surgery to perform sports hernia repairs that get you back in the game quickly. Schedule an appointment online or call one of the two offices in Houston Methodist Hospital or the Willowbrook neighborhood of Houston, Texas.

Sports Hernia Repair Q&A

What is a sports hernia?

A sports hernia is a misleading name because this condition isn’t a hernia, and it’s often, but not always, caused by sports. In the medical world, it’s called athletic pubalgia. You may also hear it called a core muscle injury, Gilmore’s groin, hockey groin, and sportsman’s groin.

No matter what name you use, a sports hernia affects one or both inguinal canals, which are the two short passageways that allow structures to pass from the abdomen to your external genitalia.

The floor of the inguinal canal consists of solid muscle and tendon. When the inguinal floor becomes thin and weak, you have a sports hernia, a problem that’s usually caused by an acute injury, overuse, or an imbalance between the thigh adductor and abdominal muscles.

You don’t have a true hernia because the inguinal floor remains intact, and abdominal contents don’t push through the weak area. Instead, the floor muscle bulges out when you engage in physical activities.

The bulging inguinal floor isn’t dangerous, but it pushes against a nerve in the canal and causes symptoms.

What symptoms develop if I have a sports hernia?

The most common symptom is groin pain, which appears in the area just above the crease created by your thigh and abdomen when sitting. This pain typically goes away when you rest and increases when you engage in intense or explosive athletic activities.

Your pain may vary in severity and range from sharp and stabbing to dull or achy. You may also feel the pain while running or when you do sit-ups or squats. In some cases, it only takes a sneeze or cough to trigger the pain.

How is a sports hernia diagnosed?

Dr. Echo has years of experience diagnosing sports hernias through physical examinations and diagnostic imaging. In most cases, he performs a dynamic ultrasound.

During a dynamic ultrasound, he asks you to do a small sit up or tighten your core muscles while obtaining ultrasound imaging. Dynamic ultrasounds are the top imaging technique for diagnosing a sports hernia because the inguinal bulging only occurs when you’re active.

Dr. Echo may also perform an MRI pelvis athletic pubalgia protocol. This is a specialized MRI study designed to carefully evaluate muscles in the inguinal region.

How do experts repair a sports hernia?

Most surgeons don’t recommend surgery because they can’t verify that you have a hernia. They often treat the problem with physical therapy, which may minimally improve strength in the groin area, but usually not enough to stand up to the pressure of competitive athletics.

Athletes who want to stay in the game and maintain top performance typically need surgery to strengthen the weak muscle.

To repair a sports hernia, Dr. Echo performs the Muschaweck technique. As a modified version of the Shouldice no-mesh repair technique, the Muschaweck procedure allows him to reconstruct and strengthen the inguinal floor without overtightening the muscle.

His exceptional training in nerve repair allows him to remove the nerve responsible for your groin pain while carefully preserving the nerves necessary for sexual function and sensation. As a result, you have less pain and a faster recovery.

When might I need an adductor fasciotomy?

Groin pain that occurs when you’re active can also be caused by chronic exertional compartment syndrome. This condition causes muscle pain and swelling in a specific group of muscles, such as the adductors. 

To relieve the problem, Dr. Echo performs an adductor fasciotomy. During this procedure, he cuts the fascia surrounding the muscle group to relieve pressure in the compartment and prevent damage from the compression of arteries and nerves.

When can I return to play after a sports hernia repair?

Following the Muschaweck minimal tension repair technique, you may be able to return to sports in two weeks. Everyone heals at a different pace, however, and Dr. Echo prefers to have patients follow a four-week rehabilitation protocol. By comparison, conventional surgery to repair the groin requires 6-12 weeks of rehabilitation.

To get relief from your sports hernia, call Anthony Echo, MD, or schedule an appointment online.