Nerve entrapment

Anatomy: Numerous nerves penetrate the abdominal wall and transmit nerve branches to the area on the stomach, groin and thigh. The nerve can be entrapped where it penetrates the abdominal wall.

Symptoms: Pain in the groin region. Discomfort and sensory disturbances can often be induced if the area where the nerve is entrapped is scratched/pushed.

Examination: In the medical examination the doctor attempt to produce the discomfort symptoms by scratching or pushing the area in which the nerve is entrapped. By administering a couple of millilitres of local anaesthetic in this area the symptoms should disappear if the diagnosis is correct (otherwise the diagnosis is wrong). There is no examination (X-ray, ultrasound, MRI, scintigraphy) that can detect the nerve entrapment. The real frequency of the diagnosis is debated amongst professionals.

Treatment: Since the condition is harmless and without risk even if you continue sports activity, continuing sport is recommended in the hope that the discomfort will pass on its own. Pausing and alternative training of the abdominal muscles can be attempted. If the discomfort is long-lasting with no sign of abatement, even during summer or winter breaks, you can consider surgically severing the nerve, provided that pain abates when local anaesthesia is administered (article-1) (article-2).

Rehabilitation: If the discomfort stems from the nerve, you should be able to resume sports activity immediately following the operation.
Also read rehabilitation, general.

Complications: Since it can be difficult to make a correct diagnosis in athletes with long-term groin pain (article), it should be supplemented with, amongst other things, ultrasound scanning and consideration of x-ray scintigraphy and possibly an MRI scan. It should be considered whether the diagnosis is correct, and amongst other things consider the following:

• Inflammation of the adductor muscle of the thigh
• Rupture of the adductor muscle of the thigh
• Inflammation of the pubic bone joint (osteitis pubis)
• Inflammation of the abdominal muscle fastening on the pubic bone
• Stress fracture
• Bursitis on the front of the hip joint (bursitis iliopectinea)
• Other bursitis
• Fluid accumulation in the hip joint
• Degenerative arthritis in the hip joint
• Rupture of the superficial hip flexor (ruptura musculus rectus femoris)
• Rupture of the deep hip flexor (ruptura musculus rectus femoris)
• Outer snapping hip
• Inner snapping hip
• Lumbago
• Piriformis syndrome