If you play ice hockey, tennis, or soccer, you may be at risk for the most commonly misdiagnosed groin pain—a sports hernia.

“Caused by repetitive twisting and turning at high speeds, sports hernias are frequently confused with common muscle strain,” says Michael Sampson, D.O., who practices in Blacksburg, VA. According to Dr. Sampson, muscle strain is caused when a muscle is stretched beyond its limit, which tears the muscle fibers. Tearing of the muscle fibers usually occurs where the muscle meets the tough, connective tissue of the tendon. Muscle strains are often treated by heat or ice therapy.

A sports hernia often results from overuse of groin muscles, which causes stress on the groin area. A common symptom of a sports hernia is pain that remains for a number of weeks or months. Other symptoms may include pain that increases with sudden movements, acceleration, twisting and turning, cutting, and kicking. Pain can also be provoked by coughing and sneezing, explains Dr. Sampson.

“The primary symptom of a sports hernia is groin pain that may branch out along the hip to the groin area,” says Dr. Sampson.

One method of diagnosing this type of hernia involves asking the patient to perform certain activities, such as sit-ups, to see whether the movement increases the pain. If the pain intensifies, the possibility of a sports hernia increases.

Dr. Sampson says that treatment of a sports hernia often includes rest, using an ice pack on the area for 20 to 30 minutes three to four times a day and taking anti-inflammatory medications. If pain persists, surgery is often the next step in treatment. During surgery, the lower abdominal muscles and connective tissues are released and reattached. Some hip muscles are also loosened during this process as well.

Although men statistically get sports hernias more often than women, Dr. Sampson recommends that all athletes, regardless of their sport, practice exercises targeted at prevention of the condition. Individuals at risk should include exercises that increase flexibility and strengthen the muscles in and around the pelvic area in their daily exercise routine.