A new study published in the April 2017 issue of the Orthopaedic Journal of Sports Medicine suggests that while the return to sport rate for NFL players after sports hernia surgery is high, those athletes who undergo surgery tend to have shorter careers and play less games per season.
“’Sports hernia,’ also known as athletic pubalgia or core muscle injury, is a highly complex problem in athletes,” Joshua D. Harris, M.D., a Houston Methodist orthopedic surgeon, told OTW. “Most players with a ‘sports hernia’ will describe groin pain, worse with acceleration and deceleration, start and stop, or rapid changes in speed or direction. These movements are absolute requirements for successful participation in the NFL.”
Harris said that “sports hernia” is not an actual hernia where a bulge or mass is observed in the groin. Instead different combinations of muscle, tendon, bone or nerve injury could be at the root of the athletic groin pain.
Using internet-based injury reports, Harris and colleagues identified NFL players who underwent “sports hernia” surgery between January 1996 and August 2015 and compared demographic and performance data from these players to a control group.
Of the 56 NFL players identified, 53 of them were able to return to play (95% return to sport rate) with no significant difference in performance score pre and post-surgery. However, players who had the surgery tended to play in the NFL for fewer seasons (3.8 versus 3.2 years) and fewer games in each season (14 versus 12 games) than players who did not have the surgery.
Harris noted however that “it must be recognized that players undergoing this surgery frequently have career-threatening pain or dysfunction that already has failed non-surgical measures that prompts the surgery in the first place.”
More research is in the works to improve treatment of “sports hernia.” Harris said that understanding the role of strength and flexibility training in groin and hip pain prevention is the focus of future studies, including those at Houston Methodist. Several ongoing investigations at Houston Methodist are also focusing on the impact of hip problems like hip impingement on the incidence of sports hernia in all types and levels of athletes.
I read the study. Some player positions were not included in the full analysis. The effect size, though significant, was small. They did not control for concomitant injuries when analyzing data on games/season or years played. Also, this study was limited to one sport. It was an adequately conducted study, but is very limited in its conclusions. The players who had the AP surgery usually returned to playing football, played a couple fewer games per season (though we do not know exactly why. It may have been a concomitant injury), and played for a slightly shorter career (less than six months). Alot of factors contribute to playing time, career length. It does not look like having this surgery considerably undermines the football playing careers of the majority of players.