The presentation is of pain just local to the lower tummy or groin and inner thigh and can be apparent when doing a session or when running quickly. There can be associated with nervy symptoms like burning or pins and needles into the thigh and genitals.
Often it only becomes painful after a period of time running or when working really hard. The symptoms usually stop pretty soon after you stop and there is seemingly little to show for it.
In runners, the symptoms can present themselves as a feeling of a loss of stability while at pace, a loss of power when running, or a recurrent back issue. These are the hardest to diagnose because there is often nothing painful in the lower abs.
We have seen many hernias in runners over the years with just a recurrent sacroiliac joint dysfunction or a feeling of tightness and weakness in the hamstring, adductor and occasionally the quadriceps. When assessed there is sometimes little to find in the leg and the problem just rumbles on. However, on further examination, if there is a hernia, treatment of this can resolve the thigh, core or sacroiliac joint problem.
A hernia is a weakness in the lower abdominal wall which allows the lower intestines to push into the hollow and press and stretch a couple of nerves that pass through it. This is why the pain can be referred as these nerves supply the inner thigh and genitals.
Stressing the nerves also shuts down the core muscles leading to the instability feelings and the pelvis or lower back problems. It is more common in males as this hollow is bigger to allow passage of vessels to the genitals. Typically, therefore, the hernias that are missed are in women where the symptoms are more subtle.
Hernias need proper diagnosis and if present the surest way to fix them is surgery followed by detailed rehabilitation. It is something we are particularly specialised in.
There are other types of hernia such as Femoral Hernia, Umbilical/Paraumbilical Hernia, Incisional Hernia, Spigelian Hernia as well as other types of groin pain such as muscle and tendon strain, hip joint pain and Ostitis Pubis.