How to Test For Ilioinguinal Neuralgia | Pelvic Health for Men

By: Becky Paulson, PT, DPT

Hi Pelvic Healers! Dr. Becky Paulson here (@beckypaulsondpt). Recently, I had two patients present with groin pain—particularly, testicular pain.⁣⁣
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Presenting symptoms included redness, swelling & discomfort in the scrotum, as well as pain with deep hip flexion.⁣⁣ Interestingly, both these patients had a left, lower quadrant surgery (but for different reasons). Hmm...⁣⁣
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What I discovered is that both of these patients had an irritation of the ilioinguinal nerve—a condition referred to as Ilioinguinal Neuralgia. A common cause of this issue is having a surgical scar across the inguinal/lower abdominal region, for instance a hernia repair. The scar tissue from the incision can impinge on the nerve - which means it wasn't not able to glide properly through those muscular layers. ⁣⁣
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The ilioinguinal nerve exits the spine at L1 and wraps around the side of the abdomen, and crosses the hip joint underneath the inguinal ligament on males. ⁣⁣
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Different ways that this issue can present include: ribcage pain (usually lower ribs), lower abdominal pain, or as groin/testicular pain. Contributing factors can include posture, restricted hip joint mobility, scar tissue, poor abdominal coordination (weakness or overuse).⁣⁣
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In terms of treatment, both of these patients have benefitted from tissue release and scar tissue mobilization throughout that scar tissue area. ⁣⁣
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Here is a quick test you can do for your patients (or if you yourself are experiencing these symptoms) to test for this. ⁣⁣
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How to Test for Ilioinguinal Neuralgia

Put patient in "Captain Morgan position" and have the hips open, like a book. Note any feelings/sensations in this starting position.⁣
Have patient slump their shoulders forward, simulating poor posture⁣⁣
Have patient bring head or shoulders over to the same side that their leg is lifted. Note any pain in groin, rib cage, and abdomen. ⁣⁣
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If that's the case—you may have tension in your ilioinguinal nerve.⁣⁣ There you have it!

If this is the case with you, reach out to us here at Sarton Physical Therapy! We are proud to offer telehealth (online) services to serve you from the comfort of your home.⁣⁣

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