The Gilmore’s Groin (Groin Disruption) syndrome was first recognised in 1980, following the successful treatment of three professional footballers who had been unable to play for many months because of undiagnosed injuries of the groin. Although some people refer to it as a Sportmen’s Hernia there is no true hernia present. Groin disruption (Gilmore’s Groin) is a severe musculo-tendinous injury of the groin, which can be successfully treated by the surgical restoration of normal anatomy.
The condition has also become known amongst other things as sports hernia, sportsman’s groin, footballers groin, footballers hernia and athletic pubalgia.
The pathology of groin disruption found at operation is varied, however, the main features include:
- Torn external oblique aponeurosis
- Torn conjoined tendon
- Conjoined tendon torn from pubic tubercle
- Dehiscence between conjoined tendon and inguinal ligament
Groin disruption is a clinical diagnosis based on history and examination. Inverting the scrotum and placing the examining little finger in each superficial inguinal ring in turn gives the diagnosis.
If the diagnosis is clear then further investigations may not be required. Both MRI and high frequency ultrasound scanning may be helpful in some patients with conflicting symptoms and physical signs.
The Surgical Treatment of Gilmore’s Groin consists of restoring normal anatomy with a six-layered structural repair of the inguinal region. Adductor tenotomy is indicated in patients with persistent and troublesome adductor tears, which do not respond to conservative treatment.
The original Gilmore technique has been modified with the aim of reducing the recovery time, whilst maintaining the strengths of the full anatomical repair. The formal repair is now known as the Marsh Modification of the Gilmore Technique.
There is an established rehabilitation programme for Gilmore’s Groin, which may be recommended as an alternative to surgery. There is also a Post-Operative Rehabilitation Programme available for both Gilmore’s Groin and Hernia surgery.
When doing the exercises it is important to activate the “core stability” muscles. These muscles consist of the stabilising abdominal muscles and some of the lower back muscles. The hospital physiotherapist will show you how to do this and the Practice Nurses are available for advice if you have any concerns. The rehabilitation is divided into four stages which can be completed at an individual’s own rate.
- While exercising, and afterwards, some discomfort will be experienced at the repair and adductor insertion site.
- Provided you adhere to the programme and avoid sudden sharp movements, you will suffer no harm.
- Stiffness and discomfort occur the day after vigorous exercises. For this reason, some form of exercise is advised 7 days a week.
- Swelling at the operation site takes 8 to 12 weeks to clear completely.
- Professional sportsmen may be playing again at 4 weeks, amateurs may take 6-8 weeks.