title: 'Treatment of the sportsman's groin': British Hernia Society's 2014 position statement based on the Manchester Consensus Conference.
abstract: BACKGROUND
  The aim was to produce a multidisciplinary consensus to determine the current position on the nomenclature, definition, diagnosis, imaging modalities and management of Sportsman's groin (SG).
  
  
  METHODS
  Experts in the diagnosis and management of SG were invited to participate in a consensus conference held by the British Hernia Society in Manchester, U.K. on 11-12 October 2012. Experts included a physiotherapist, a musculoskeletal radiologist and surgeons with a proven track record of expertise in this field. Presentations detailing scientific as well as outcome data from their own experiences were given. Records were made of the presentations with specific areas debated openly.
  
  
  RESULTS
  The term 'inguinal disruption' (ID) was agreed as the preferred nomenclature with the term 'Sportsman's hernia' or 'groin' rejected, as no true hernia exists. There was an overwhelming agreement of opinion that there was abnormal tension in the groin, particularly around the inguinal ligament attachment. Other common findings included the possibility of external oblique disruption with consequent small tears noted as well as some oedema of the tissues. A multidisciplinary approach with tailored physiotherapy as the initial treatment was recommended with any surgery involving releasing the tension in the inguinal canal by various techniques and reinforcing it with a mesh or suture repair. A national registry should be developed for all athletes undergoing surgery.
  
  
  CONCLUSIONS
  ID is a common condition where no true hernia exists. It should be managed through a multidisciplinary approach to ensure consistent standards and outcomes are achieved.
authors.affiliation: Department of Surgery, Central Manchester Foundation Trust, Manchester Royal Infirmary, Manchester, UK.
authors.forename: Aali J
authors.initials: AJ
authors.lastname: Sheen
authors.affiliation: Department of Surgery, Royal Gwent Hospital, Newport, UK.
authors.forename: B M
authors.initials: BM
authors.lastname: Stephenson
authors.affiliation: Department of Surgery, Leicester General Hospital, Leicester, UK.
authors.forename: D M
authors.initials: DM
authors.lastname: Lloyd
authors.affiliation: Department of Musculoskeletal Radiology, Leeds Teaching Hospitals, Chapel Allerton Hospital, Leeds, UK.
authors.forename: P
authors.initials: P
authors.lastname: Robinson
authors.affiliation: Department of Sports Medicine, Blackburn Rovers STC, Blackburn, UK.
authors.forename: D
authors.initials: D
authors.lastname: Fevre
authors.affiliation: Department of Surgery, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland.
authors.forename: H
authors.initials: H
authors.lastname: Paajanen
authors.affiliation: Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK.
authors.forename: A
authors.initials: A
authors.lastname: de Beaux
authors.affiliation: Department of Surgery, Derriford Hospital, Plymouth, UK.
authors.forename: A
authors.initials: A
authors.lastname: Kingsnorth
authors.affiliation: Department of Surgery, Gilmore Groin and Hernia Clinic, London, UK.
authors.forename: O J
authors.initials: OJ
authors.lastname: Gilmore
authors.affiliation: Department of Surgery, Royal Bournemouth Hospital, Bournemouth, UK.
authors.forename: D
authors.initials: D
authors.lastname: Bennett
authors.affiliation: Department of Surgery, Central Manchester Foundation Trust, Manchester Royal Infirmary, Manchester, UK.
authors.forename: I
authors.initials: I
authors.lastname: Maclennan
authors.affiliation: Department of Surgery, Western Infirmary, Glasgow, UK.
authors.forename: P
authors.initials: P
authors.lastname: O'Dwyer
authors.affiliation: Department of Surgery, Derriford Hospital, Plymouth, UK.
authors.forename: D
authors.initials: D
authors.lastname: Sanders
authors.affiliation: Department of Surgery, London Hernia Centre, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Kurzer
mesh_terms: D015746:Abdominal Pain / Q000209:etiology* / Q000534:rehabilitation / Q000601:surgery; D059350:Chronic Pain; D032921:Consensus; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005081:Exercise Therapy / Q000379:methods; D006119:Groin; D006552:Hernia, Inguinal / Q000175:diagnosis; D006801:Humans; D007264:Inguinal Canal; D008279:Magnetic Resonance Imaging; D010348:Patient Care Team; D059388:Pelvic Girdle Pain / Q000150:complications / Q000000981:diagnostic imaging; D026741:Physical Therapy Modalities; D015641:Radiography, Interventional; D013178:Sports Medicine; D009626:Terminology as Topic; D014463:Ultrasonography
keywords: Groin injuries