Sportsman’s Groin and the Inguinal Ligament Release Procedure

Abstract

Groin pain is a very common condition affecting athletes and non-athletes. Despite its prevalence there is no universally accepted definition for this clinical entity and there is no single radiological or pathological finding which is reproducible and objective to explain the cause of pain. Many conditions giving rise to groin pain are grouped together under a label such as athletic pubalgia or sportsman’s groin. These terms are unhelpful as they are too vague and do not explain the exact pathology which is causing the symptoms. The diagnosis of groin pain should be based on anatomical and pathological findings so that terms such as adductor tendinopathy, osteitis pubis and inguinal ligament strain should be used. Some athletes have pain arising from the adductor tendon insertion but more commonly athletes have pain arising from the inguinal ligament attachment. They present with pain arising from the pubic tubercle and clinical examination confirms tenderness at this site. A new theory based on clinical, laparoscopic and pathological findings may indicate that a common cause of groin pain is disruption of the inguinal ligament attachment. A laparoscopic procedure to release the tension in the inguinal ligament has been proven to significantly improve the symptoms of groin pain in athletes and non-athletes alike.