Jerry Gilmore talks about Gilmore's Groin Disruption

Jerry Gilmore is a renowned London surgeon and a world expert on groin pain and its surgical repair. The Gilmore Groin and Hernia Clinic at 108 Harley Street is an impressive groin and hernia treatment centre with on site x-ray and ultrasound scanning facilities, which enables rapid assessment and diagnosis.

Jerry Gilmore's pioneering work on Gilmore's Groin, groin and hernia problems has helped to restore full fitness to many athletes, both professional and recreational. In 1995 this outstanding work was recognised nationally by the award of Fellowship of the Institute of Sports Medicine.

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Mr Gilmore, what was the process that led you to recognise the groin disruption syndrome that became known as Gilmore's Groin?

"The first patient referred to me was a midfield player from Tottenham Hotspur, the second patient was a midfield player from Aberdeen. Both had not played football in over three months because of pain in the inguinal region made worse by sprinting, twisting, turning and kicking.

"In view of the fact that no orthopaedic or other problem could be identified, I considered it likely that the problem lay in the inguinal canal, the site where men usually develop a hernia.

"On exploration neither had a hernia but both had evidence of trauma to the tissues. In view of the fact that the external oblique aponeurosis and the conjoined tendon was torn and there was an abnormal gap between the conjoined tendon and the inguinal ligament.

"I therefore carried out repair of these tissues. Following surgery both were back in training within four weeks and playing within six weeks."

What is the typical history and signs and symptoms of a patient with Gilmore’s Groin?

"Typical history is pain in the groin in the inguinal region. The symptoms are increased by running and especially sprinting. Also with twisting, turning and kicking.

"After sport, the patient is usually stiff and sore for a few hours or even a few days.

"The day after a game, the patient tends to get pain turning in bed or getting of a bed or a car. The patient may also notice pain with coughing, sneezing and sit-ups.

"There is a history of specific injury in only 30% of patients. Specific injuries include overstretching, abduction and eversion injuries. Symptoms usually indicate that it is a wear and tear injury.

"20% of patients also get an adductor tear which causes pain in the adductor insertion area in the upper inner aspect of the thigh. It is made worse especially by kicking, twisting and turning. "

Why is Gilmore's Groin much more common in men?

"Gilmore's Groin is common in men because of the anatomy of the inguinal canal. "

What are the pathological findings of a Gilmore's Groin at surgery?

"The pathology of Gilmore's Groin is:

• Torn external oblique aponeurosis
• Torn conjoined tendon
• Conjoined tendon torn from pubic tubercle.
• Dehiscence between conjoined tendon and inguinal ligament."

Would this tissue damage heal on its own if it was rested long enough?

"It is my experience that if the tissue damage is severe, it will not heal on its own no matter how long the rest. In some young patients with a short history, resting will alleviate the symptoms.

"In many however, the symptoms returned at the beginning of the next season having rested between seasons. In my experience surgery is the only way to fix the problem."

Some hernia repair surgery can be done using an endoscope, but Gilmore's Groin requires a three inch incision ' why is this?

"Gilmore's Groin repair is more successful when done through an open approach. The incision is usually 5-6cm. The endoscope approach uses a mesh to redistribute the stresses and strains in the groin where as the open approach used by myself repairs each element of the disruption."

How long does it usually take to return to sports following Gilmore's Groin repair surgery?

"We aim for return to sport following Gilmore's groin in four weeks for professional sportsmen and it is usually four to six weeks in all other cases. "

What is the success rate following Gilmore's Groin repair surgery?

"The success rate in professional soccer players has been shown to be 98%. ."

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