Inguinal Hernia

Inguinal hernias are a common cause of groin pain which affects mostly men, with over a quarter of all men having an inguinal hernia at some point in their life as opposed to 4% of all women. Inguinal hernias seem to occur more often in men due to the small opening that allows the testes to descend into the scrotum and which also forms a pathway (inguinal canal) for the spermatic cord (vessels, nerves, vas deferens). A hernia will often be the result of either one big event, or lots of smaller events where abdominal pressure exceeds the tolerance of the small opening resulting in either a tear or a chronic stretching of this space. This widening of the inguinal canal allows a passage for abdominal contents to migrate through, descending into the groin and causing a number of symptoms.

Inguinal hernia signs and symptoms are commonly:

• A visible and/or palpable bulge around the pubic bone (mound just above the penis) which can be worsened with coughing, sneezing or carrying heavy objects
• Pain or discomfort in your groin which can be exacerbated by coughing, sneezing, lifting or anything that increases abdominal pressure
• A feeling of burning or aching in the groin or around the bulge
• A heaviness or a pressure in the area of the bulge
• Pain extending into the testicle on the affected side

Diagnosis of an inguinal hernia requires a thorough subjective and physical assessment followed by an ultrasound in order to confirm the presence, size and contents of the hernia. Management of these types of hernias depends on the degree of herniation, your level of pain and how much it is restricting your day to day lifestyle. Generally, if the size of the hernia is not too large and the symptoms and lifestyle restriction aren’t significant then it can be conservatively managed using some activity modification to reduce symptoms. Importantly though, once the hernia has progressed to a point where it becomes symptomatic, it will not ‘heal itself’ and the chances are that it will continue to get bigger over time. The only way to ‘fix’ the hernia is via surgical management.

Surgery usually requires an overnight stay and very light activity for 1-2 weeks at which point you can slowly re-introduce activity using symptoms as a guide. The time until full healing is around 3-months post-surgery, at which point you should be returning to all activities if you haven’t already done so. This process from 2-weeks to 3-months post-surgery can be very different for every individual. Some people will have less intense activity to return to which should mean a quicker return to normal, where those people who need to return to quite intense activity may need a longer, slower rehabilitation. If you need guidance on returning to activity after having an inguinal surgery, or if you need an assessment of your groin pain, come into the clinic to see one of our experienced BeFit Physiotherapists.

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