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A sports hernia is a painful musculotendinous injury to the medial inguinal floor.
It is the result of repetitive eccentric overload to the abdominal wall stabilizers of the pelvis.
It is common in sports that require sudden changes of direction or intense twisting movements.
Despite the term "hernia" in the title, it is not a true hernia as there is no "herniation" of abdominal contents
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Figure description: The upward and oblique pull of the abdominal muscles on the pubis fights against the downward and lateral pull of the adductors on the inferior pubis. This imbalance of forces can lead to injury.
PE: Evaluation of other GU/GYN/other intra-abdominal pathology comes first.
Clinician may note tenderness of the pubic ramus and medial inguinal floor.
Pain is more severe with resisted hip adduction and with resisted sit-up.
Combining these maneuvers (resisted situp while adducting hips) recreates the pathophysiology described above and is a good exam maneuver.
References
Sports hernia: the experience of Baylor University Medical Center at Dallas
Proc (Bayl Univ Med Cent). 2011 Apr; 24(2): 89 91