“Hello, I am a professional football player. I play in Asia. For the past four months, I have been dealing with a groin injury that radiates to the lower abdomen. Overall, I don’t know what caused the pain or what could be the underlying cause. I only know that it’s a significant problem for me to enter into duels at 100%, as well as sprinting. I have much less aggressiveness, and I believe that the injury is the reason for it all. Here, they are not in favor of me getting an ultrasound, as they believe that nothing will be seen. I also do exercises for groin warm-up before every training session. I take painkillers before every match, and then I generally feel better for the next two days, and then it starts all over again. I’m interested in what the smartest thing to do is. I’m from Serbia, and I’m considering going to have groin surgery if necessary. Because here, I would never allow them to do it. I would be grateful for any advice.”
The exact cause of chronic groin pain is not always possible to determine with 100% certainty. Therefore, collaboration between an orthopedist, a physiotherapist, and an abdominal surgeon is crucial. In football players, classical inguinal hernia is very rarely seen, meaning there is extreme laxity of the abdominal wall and protrusion of abdominal wall contents. Pain can be caused by weakness of the same wall, which then causes pain during intense exertion. In such cases (most common in football), weakness cannot be proven by physical examination, ultrasound, or magnetic resonance imaging. On the contrary, such a diagnosis is made after examination and diagnosis by an orthopedist and after appropriate physiotherapy. If there is no improvement after 3 months of persistent physiotherapy and focused exercise, and if hip MRI does not indicate other biomechanical disorders or inflammatory processes in the tendons, it is time to visit an abdominal surgeon. If other conditions are met, he will proceed with preoperative preparation and assess which surgical approach is best in the specific case, with the aim of stabilizing and reinforcing the abdominal wall. The two most common approaches are classical tissue suturing and mesh implantation, each with its advantages and disadvantages.
