Hernias occur when part of the internal tissue (fat, muscle, intestines etc) bulge through a weakness in the overlying abdominal wall. The herniating tissues are at risk of complications such as strangulation (pinching) which can cause intestinal blockages and may cut off the blood supply which requires immediate treatment.
There are 3 common forms of hernia:
Inguinal hernia
This is a protrusion of the contents of the abdomen (belly) through the inguinal canal. It usually appears as a swelling in the groin area. Eighty percent of all hernias are inguinal, men are 25 times more likely to suffer an inguinal hernia and 5% of the population will suffer an inguinal hernia.
Inguinal hernias can either be direct or indirect. Direct hernias happen when part of the abdomen herniates through a weak point in the abdominal wall and into the inguinal canal. Indirect hernias occur when part of the abdomen bulges through the deep inguinal ring (this is less common and occurs due to a birth defect.
Symptoms include:
- Pain in the groin when you exercise
- Pain on increases in abdominal pressure such as when coughing or sneezing.
- A bulge in the groin area which often disappears when you lay down
If an inguinal hernia is not treated further contents of the abdomen (such as the intestines) can protrude into the hernia causing it to grow. The intestines can become pinched, causing blockages and ischema (a lack of blood to the area) which can cause fatal consequences.
Femoral hernia
Ten percent of hernias are femoral hernias and will look like a swelling in the upper thigh with symptoms similar to those stated above. Femoral hernias occur just below Inguinal hernias, at a weak point called the femoral canal. Femoral hernias are more common in women, especially older and frail women
Symptoms include:
- A lump in the groin area (slightly below that of an Inguinal hernia, although it is nearly impossible to tell)
- Pain when you exercise but not as frequently on coughing and sneezing
The incidence of strangulation of herniated structures is high with femoral hernias and so they require surgical repair as soon as possible
Abdominal hernias
Epigastric: This type of hernia is most common in men aged 20-30. It is a protrusion of usually fatty tissue along the midline of the abdomen between the naval and lower ribs. They are usually painless and rarely contain intestinal material
Umbilical: This type of hernia occurs most often in babies as a protrusion at the belly button caused by a delayed closing of the abdominal wall which usually closes before birth. If small this will usually close within the first 2 years, if not surgery may be required. Even following surgery or closing of the abdominal wall the child may still be susceptible to future hernias due to a weakness in the abdominal wall.
What can the athlete do about it?
- You should see a Doctor immediately if you suspect a hernia
- It will not get better through rest
What can a doctor do about it?
- Operate - If the abdominal wall is ruptured it will not get better by resting and surgery will be needed
- Operations should be performed at the earliest convenience
- Hernias with complications such as strangulation may require emergency surgery
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