04: Abdominal Wall & Groin Pain in a Male Runner — Sports Hernia or Something Else?

Dr. Sara Raiser (Running Medicine Physician), Kelsey Pontius (Sports Dietitian), and Dr. Kate Mihevc Edwards (Physical Therapist) bring their interdisciplinary lens to a tricky injury that often occurs in male young athletes: abdominal wall and groin pain. In this episode, the team unpacks the case of a 17-year-old male high school track athlete presenting with lower abdominal and groin pain that radiates into the adductors and limits his stride. The pain is nagging, sometimes sharp, but mostly tight and aching. Is it a sports hernia? Or something else entirely? Dr. Raiser explains the red flags that must be ruled out,  from inguinal and femoral hernias to femoral stress injuries and hip pathology and why standard imaging often fails to provide answers. Dr. Mihevc Edwards dives into biomechanics, thoracic mobility, breathing mechanics, and gait analysis, showing how interconnected tissues and referral patterns often blur the clinical picture. Pontius highlights the nutrition and mental health side: how underfueling, over-cross-training, and performance pressure can amplify both pain and recovery challenges in young athletes.Together, the team breaks down how an interdisciplinary approach combining medical care, physical therapy, nutrition, and communication with coaches can not only solve cases like this but also protect the identity and confidence of athletes who define themselves through sport. This episode is for athletes, parents, coaches, and clinicians who want to better understand abdominal wall and groin pain in runners and why “sports hernia” may be just one part of the bigger picture.Timestamps0:00 – Welcome & sponsor intro3:30 – Case intro: 17-year-old high school runner with abdominal wall/groin pain8:15 – Differential diagnosis: hernia, sports hernia, hip pathology, stress fracture14:00 – Why imaging often comes back “normal” & how to set expectations19:30 – Physical therapy perspective: thoracic spine, breathing, trunk control25:40 – Nutrition, fueling, and the risk of under-eating in injured adolescent athletes32:10 – Mental health & the identity struggle of the sidelined teen runner38:30 – The role of coaches and parents in the recovery plan45:15 – Lever system & safe return-to-run training tools50:00 – Final interdisciplinary takeawaysThank you to our sponsor, Lever Movement. Use code Casemiles for 20% offBecome a supporter of this podcast: https://www.spreaker.com/podcast/interdisciplinary-case-miles--6623567/support.If you enjoyed this episode, don’t forget to follow and subscribe so you never miss a case.Have a question or a case you'd like us to explore on the show? We’d love to hear from you. Reach out anytime at [email protected].