What is Gilmore’s Groin?

Gilmore’s Groin – so named as it was first recognised by 108 Harley Street’s own founder, the late Mr Jerry Gilmore – is also known as a sportsman’s hernia. It is a painful condition that affects the groin area, commonly experienced by athletes and active individuals. Unlike a traditional hernia, there is no visible bulge, making it difficult to diagnose without specialist knowledge. The condition involves a tear or injury to the muscles or tendons of the lower abdomen, particularly where they attach to the pubic bone. The Gilmore’s Groin and Hernia Clinic has since been led by Mr Simon Marsh, our Surgical Director. Over the years, Mr Simon Marsh has made adaptations to the repair of the Gilmore Groin, which we now call ‘Marsh Modification’ of the Gilmore Technique.

Symptoms of Gilmore’s Groin

There is a specific set of symptoms people get before and after exercise that is typical of Gilmore’s groin. Footballers, for example, will get pain when they push off to sprint, when they change direction suddenly, or when they’re kicking longballs or dead balls. A rugby player may experience a similar pain particularly if they are the goal kicker. 

Typically, Gilmore’s groin symptoms would present the next day after playing sports. Classically, the person is stiff and sore, and in some cases, they have difficulties walking for a day or two. They may experience pain if they’re getting up from a low position, like getting out of bed, or a low sports car perhaps. Pain might also occur when they cough or sneeze because the abdominal muscles stretch as a result. 

Just as there’s a very specific pattern of symptoms both during and after exercise, there’s a very specific site where the pain occurs. The location is very specific, over the area called the superficial inguinal ring which is just above the crease in the thigh, the lower part of the tummy. 

The symptoms of Gilmore’s Groin typically include:

• Sharp or aching pain in the groin area, which may worsen with physical activity.
• Pain that may radiate to the inner thigh or lower abdomen.
• Discomfort when coughing, sneezing, or performing sudden movements.
• Gradual worsening of pain over time, especially during sports or exercise.

Causes and Risk Factors

Gilmore’s Groin is often caused by repetitive stress or trauma to the groin area. The most common risk factors include:

• High-intensity sports or activities involving twisting, turning, or sudden directional changes (e.g., football, rugby, hockey).
• Weakness or imbalance in the muscles of the lower abdomen or pelvis.
• Poor warm-up or stretching routines before physical activity.
• Inadequate core stability or improper technique in sports.

Diagnosis and Testing

Accurate diagnosis of Gilmore’s Groin is crucial for effective treatment. At the Gilmore Groin and Hernia Clinic London, diagnosis begins with a thorough clinical examination. Diagnostic imaging techniques such as ultrasound and MRI scans are employed to identify any tears or damage to the muscles and tendons.

Treatment Options

At the Gilmore Groin and Hernia Clinic London, our team is led by world-renowned consultant Mr. Simon Marsh, who has extensive experience in diagnosing and treating Gilmore’s Groin. Our approach is patient-centered, focusing on the individual’s specific circumstances before opting for any surgery. 

Treatment Approach and Philosophy

Treatment for Gilmore’s Groin at our clinic may involve a combination of non-surgical and surgical interventions. Gilmore’s groin can sometimes heal without surgery through conservative treatment, such as physiotherapy and rehabilitation. However, the likelihood of it healing on its own depends on the severity of the condition and the patient’s lifestyle. For professional athletes, surgery may be necessary sooner due to the demands of their careers. If the condition involves significant pain, a dilated superficial inguinal ring, or impacts daily activities, surgery is often recommended.

• Non-Surgical Treatments: These include rest, physiotherapy, core strengthening exercises, and anti-inflammatory medications to manage pain and promote healing.
• Surgical Treatments: In cases where non-surgical methods are ineffective, surgical repair of the damaged muscles or tendons may be necessary. The procedure typically involves a small incision and minimal downtime, allowing most patients to return to their activities within a few weeks.

Detailing The Treatment

When conservative treatments fail, surgical intervention may be required for Gilmore’s groin. This surgery requires an in-depth understanding of the complex anatomy of the inguinal region, including the precise locations of muscles, tendons, and nerves, as originally detailed by the late Jerry Gilmore when he first identified the condition. The approach focuses on the anterior abdominal wall, where Gilmore’s groin syndrome primarily affects the three muscle layers: the external oblique, internal oblique, and transversus abdominis.

During surgery, these muscle layers are repaired anatomically, with torn muscles and tendons meticulously sutured back to their original positions using dissolvable stitches that naturally degrade over two to three months. This ensures the restoration of normal anatomical function without the complications associated with foreign materials.

In 2010, Jerry Gilmore and I refined the surgical technique by adding an inguinal ligament tenolysis. This procedure involves releasing the inguinal ligament, which attaches to the pubic tubercle and can become tight, causing inflammation or secondary osteitis pubis. By releasing this ligament, we reduce tension and prevent further complications. Following the tenolysis, the muscles are repaired anatomically to restore their normal function.

While some surgeons use a mesh for treatment, this method does not address the underlying muscle and tendon tears. Mesh placement over the anterior abdominal wall merely stiffens the area without repairing the injured structures. Consequently, many patients continue to experience pain post-surgery because the root cause remains unaddressed. Unlike these mesh-based approaches, Jerry’s method focuses on anatomical suture repair, which directly targets and repairs the torn tissues, ensuring proper healing and functional recovery.

Preventing Gilmore’s Groin

Exercises and Stretches to Prevent Injury

Preventing Gilmore’s Groin involves strengthening the core muscles and maintaining flexibility in the groin and pelvic area. Recommended exercises include:

• Planks and side planks to build core stability.
• Hip flexor stretches to improve flexibility.
• Resistance band exercises to strengthen the muscles of the lower abdomen and pelvis.

Importance of Proper Warm-up and Cool-down

A proper warm-up routine, including dynamic stretching and light aerobic activity, is essential to prepare the muscles for physical exertion. Cooling down with static stretching can help maintain flexibility and reduce muscle soreness.

Footwear and Equipment Considerations

Wearing appropriate footwear and using well-fitted equipment can minimise the risk of injury. Proper support and cushioning in shoes are vital, particularly for athletes involved in high-impact sports.

Gilmore’s Groin and Sports

Impact on Athletic Performance

Gilmore’s Groin can significantly impact athletic performance by causing pain and limiting movement. Without proper treatment, it may lead to prolonged absences from sports or activity, affecting an athlete’s career.

Return to Play Guidelines

Following treatment, patients are advised to gradually return to physical activity. Our clinic provides tailored rehabilitation programs that focus on regaining strength, flexibility, and endurance while minimising the risk of re-injury.

Patient Testimonials and Success Stories

Many patients at the Gilmore Groin and Hernia Clinic London have successfully recovered from Gilmore’s Groin with our comprehensive treatment plans. Testimonials from professional athletes and individuals who have returned to their sports or daily activities highlight the clinic’s commitment to exceptional care.

• “I had the pleasure of having my inguinal and umbilical hernia repairs performed by Dr. Simon Marsh and his exceptional team. From the initial consultation to post-operative care, the experience was second to none. Dr. Marsh’s expertise and compassionate demeanor put me at ease, and his team ensured a smooth, stress-free process. The procedure went flawlessly, and my recovery has been remarkably quick. I can’t thank Dr. Marsh and his team enough for their outstanding care. Highly recommend!”
  
• “So far this practice has been world class.  I feel very comfortable in choosing them for my hernia care, and am very optimistic for finishing treatment going forward.”

As pioneers in Gilmore’s Groin diagnosis and treatment, we welcome you to enquire with us for any help related to Gilmore’s Groin or hernias. Our decades of experience and dedication to patient-focused, holistic care are here for you, so please reach out for a consultation or appointment – we look forward to welcoming you!