by Peter Perakis, M.D., Acute Care Surgeon, Beaumont Hospital, Troy
The World Series has ended, the MLB season is over and Detroit Tigers fans are still getting over a tough loss to the Boston Red Sox in the ALCS. While there were many factors that contributed to the series loss, one of the spotlights was on the injury of MVP third-baseman Miguel Cabrera.
Even though Cabrera was playing through his injury for the past few months, as soon as the Tigers’ season ended, surgery to repair muscles in his groin was scheduled.
How common are groin tears?
Groin pain is a common complaint and may result from a variety of causes, including osteitis pubis, fractures, arthritis, bursitis, hernias, muscular pain, tendonitis, tearing or avulsion of a tendon or ligament, urologic conditions, connective tissue diseases and nerve pain. The anatomy of the region is fairly complex, so a team approach to groin injuries is optimal and may require coordinated input from a sports physician, general surgeon, urologist, neurologist, orthopedic surgeon, gynecologist, radiologist and physical medicine and rehab specialist.
What causes groin tears?
A groin tear can be triggered by quick movements, twisting, turning, sprinting, bending forward, kicking and performing sit-ups all of which are common movements in sports such as baseball, soccer, hockey and football. Avoiding overuse of the thigh and lower abdominal muscles may prevent weakness or tear.
What treatment options are there for groin tears?
General principles in repairing a groin disruption entails a restoration of normal anatomy, with each layer being repaired, using permanent suture, possibly mesh. At operation, you may find a torn external oblique, conjoined tendon, inguinal ligament or dilated superficial inguinal ring. These types of injuries may not be true hernias, but rather a weakness in or injury to the pelvic floor caused by the weak flexion of the abdomen and the strong abduction of the hip. As up to 40% of patients with sports hernias also have torn abductor muscles, they may need this repaired as well. Minor abductor strains may be treated with medical therapy, although significant abductor tears, (especially in combination with other findings consistent with sports hernias) should be treated with abductor tenotomy or release at the time of surgery.
What is the recovery like from groin tear surgery?
The big question Tigers fans will be asking is when will Cabrera be back to MVP-caliber again? Rehabilitation is an important component of the management of these sports hernias. Patients will be expected to be walking on the first post-operative day, with a progressive increase in activity. In some professional athletes, return to competition has been 4 weeks. According to ESPN.com, Cabrera will rehabilitation for the next six to eight weeks.