Gilmore's Groin: Not Just Any Groin Pain

Gilmore's Groin is a condition that puzzled many surgeons for years, until the revered Mr Jerry Gilmore, founder of The Gilmore Groin and Hernia Clinic at 108 Harley Street, London, discovered what it was and how to treat it. Since then, patients from around the globe have been treated at this prestigious and world-renowned clinic for groin issues. However, many are referred there whenever a groin issue arises without proper consideration as to whether it is Gilmore’s Groin or not. Gilmore’s Groin is a specific condition with clear symptoms. Esteemed consultant surgeon and surgical director of the Gilmore Groin and Hernia Clinic, Mr Simon Marsh, offers his expert knowledge on the conditions. In the first, of a series of articles, he clarifies what the condition is, who is likely to suffer from it, and how it differs from a hernia.  

What is Gilmore’s groin?

There's still an awful lot of confusion about what Gilmore's Groin is so I'm going to start with a little bit of history. In 1981, the late Jerry Gilmore, founder of the 108 Harley Street clinic, saw three first-division footballers who all had groin pain, leaving them unable to play. They had all been out of football for more than six months, had had multiple tests performed which resulted in numerous opinions, but no one could figure out what exactly was causing the pain. What Jerry did was listen very carefully to them as they explained their symptoms, when the pain was present, and what seemed to cause it. He examined them carefully and used his knowledge of anatomy (and a bit of lateral thinking)to work out what was likely to be causing the problem.. Upon operating he found what we call a musculotendinous disruption, a tear if you like, in the groin muscle. Thanks to his detailed knowledge of anatomy, he was able to repair the groin muscles and all three of these footballers returned to playing football, two of them internationally, within eight weeks. Jerry Gilmore had discovered why the footballers were unable to play and how to fix it.

Is Gilmore’s Groin a general term for groin pain?

His success became rapidly and as a result, we've probably seen about 9 thousand people at this clinic. What people seem to forget though, is that there are lots and lots of things that can give you pain in the groin. It can come from your hip, the disc at the front of the pelvis, the abductor muscles, or even from your back. Gilmore’s Groin is a specific syndrome that has a very well-defined set of symptoms and signs. If a patient is examined correctly, the tear in the groin muscles, which characterise Gilmore’s groin, can be felt. Nowadays MRI scans will also show muscle tears. In most cases of people complaining of groin pain, it is caused by something other than Gilmore’s Groin. Unfortunately, it has become a habit now, when anyone has groin pain and no one can work out its cause, they put it down to Gilmore’s Groin. They call it a called a “diagnosis of exclusion” But actually it just reflects poor clinical skill.

Who is likely to suffer from Gilmore’s groin?

It’s worth running through the typical person who gets Gilmore’s groin. It’s nearly always a sporting injury that tends to occur in young, fit men. In a third of cases, there is a definite episode. Typically, it’s a footballer who gets their leg taken out to the side while playing, pain occurs immediately, they can't play on and it often results in quite significant bruising. In the remaining two-thirds of instances, there is no definite episode, rather it seems to be a a result of wear-and-tear. The deterioration is gradual, eventually resulting in the groin “giving out”. There is a very typical pattern of pain experienced during exercise. Footballers will find they get pain if they twist and turn or if they kick long balls or dead balls, there may be pain after exercising and they can feel very stiff and sore for a few days. They may recover temporarily, but the pattern will get worse, and eventually, they will find that the pain comes on suddenly during a game and they will have to be taken off.

How is Gilmore’s groin diagnosed? Is it the same as a hernia?

When you examine someone who you suspect has Gilmore’s Groin, there’s a particular way of checking the groin muscles.. You have to put your finger up the back of the scrotum in men to find what is called the superficial inguinal ring.. This is where the tenderness is in a patient with Gilmore’s groin, and the superficial inguinal ring will be dilated (stretched). When the patient coughs, the muscles will bulge because they are torn and split, which you can feel with your fingers. There is a misunderstanding and many people refer to this condition as a sportsman’s hernia, however, this is incorrect terminology. A hernia is a lump that is caused by the contents of the tummy coming out through the muscles. Remember, Gilmore’s Groin is not a hernia, it is torn muscle. As previously mentioned, thanks to MRI scans, in 80% of cases you are able to see the changes that confirm there is a tear. This allows the specialist to make a definite diagnosis of this specific syndrome which can then be treated with an operation that has a very high success rate.

Often people are sent to the 108 Harley Street clinic when they are incorrectly diagnosed with Gilmore’s Groin. This is very disappointing for the patient. It is worth reiterating again that there is a vast array of reasons why someone might have groin pain. Gilmore’s Groin is a specific syndrome with a very specific set of signs, symptoms and MRI findings.