DEAR DR. DONOHUE: My son, a baseball player, complained about pain in his upper left leg for a couple of weeks. I had him take some time off from baseball, and the pain got better. However, when he started playing again, it came back, and I got worried. I had my wife take him to a doctor, who diagnosed him as having a sports hernia. I’m not sure what that is. Will you explain? I asked the boy if he had a groin bulge and he said no. I thought all hernias made a bulge. His only treatment is rest. Is that all that can be done? – R.T.

ANSWER:
A sports hernia is a special kind of hernia. There is no visible bulge as there is with the other, more common kinds of hernia. It makes itself known by groin pain. “Groin” is a word open to all sorts of definitions. It’s the crease that the upper thigh makes when it joins the lower abdomen. It’s the site for the common hernias, and it’s the site for sports hernias.

Repetitive use of the lower abdominal muscles and the upper thigh muscles disrupts groin structures, inflames muscles and disturbs tendons. The place where most damage occurs with a sports hernia is the backmost wall of the canal through which the spermatic cord passes into the testicle. Sports that demand lots of high-speed twisting and turning are the ones that are implicated as causes for most sports hernias. Hockey, soccer and football are the usual examples, but it can happen in any sport, including baseball.

Rest is the treatment, and it takes weeks for the pain to leave. Your son can try ice packs on the painful region, three times a day for 15 minutes each time. Anti-inflammatory medicines like ibuprofen are helpful. When the pain goes, he should begin a rehab program of stretching and strengthening muscles in that area.

If the pain doesn’t leave, then surgical correction is an option. Almost every year, I read about a professional athlete who has had surgery for a sports hernia.

DEAR DR. DONOHUE: I have two boys in high school, and both are into sports. I suspect many boys are using steroids. I have warned my sons not to take them. Do schools routinely test for drug use? My sons’ school doesn’t. I think it should. – M.L.

ANSWER:
The word “steroid” causes much confusion. Cortisone and its many related compounds are steroids, but they aren’t the kind you mean. You’re referring to male hormone steroids, also called anabolic steroids. They build muscles.

The example of professional athletes enhancing their performance through the use of male hormone steroids is bound to influence younger athletes. I’m sure there is a market among high-school athletes for these substances. The University of Michigan recently polled a large number of high-school athletes for male hormone steroid use and found that 1.7 percent of sophomores and 2.3 percent of senior athletes admitted to using these steroids. Those figures are underestimates, since this is a written response without any drug testing.

Programs for testing high-school students are in place in some states. New Jersey and Texas have two such programs. The cost of testing probably makes it an impossibility for many schools, but I agree with you. Testing programs should be in place.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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