Testicular trauma
Testicular trauma most often occurs after a direct blow or compression to the scrotum and can range from a minor contusion to more serious injuries such as hematoma or testicular rupture. Sudden severe pain after trauma must also be assessed for possible testicular torsion.
Short-lasting pain and tenderness after a minor direct impact, without significant swelling or other obvious changes.
In football, testicular trauma is most often caused by a ball, kick, knee, or other direct impact to the groin. Significant trauma can damage the testicle itself or surrounding tissues.
Common causes
- •Direct impact from a ball
- •Kick or knee impact to the groin
- •Player-to-player collision
- •Fall onto a hard surface or object
Protective equipment can reduce the risk of direct testicular trauma, particularly in contact sports.
- •Use appropriate approved athletic genital protection where suitable
- •Ensure protective equipment fits correctly
- •Teach players safe techniques for contact situations
- •Take persistent pain or swelling after an impact seriously
Stop activity until the acute pain has settled. Rest and brief cooling through a cloth may be used for symptom relief. Do not return to play if pain persists or worsens.
Symptom control
Allow pain to settle and avoid activities that provoke the area.
Goals
Pain-free daily activities and normal function.
Progression criteria
Walking, light running, and daily movements are pain-free.
Gradual return
Return to football through gradual progression of running and football-specific activity.
Goals
Tolerate normal football demands without pain.
Progression criteria
Full training is tolerated without recurrence of pain or swelling.
- Pain-free daily activities
- No persistent swelling or significant tenderness
- Can run and train without symptoms
- No pain during relevant football activities
The information in the Injury Center is for educational purposes and does not replace professional medical advice. Always consult a qualified healthcare professional for diagnosis and treatment.
Testicular trauma
Testicular trauma most often occurs after a direct blow or compression to the scrotum and can range from a minor contusion to more serious injuries such as hematoma or testicular rupture. Sudden severe pain after trauma must also be assessed for possible testicular torsion.
Mild — Mindre kontusioner kan förbättras inom några dagar, men längre besvär bör bedömas.
Symptoms
Short-lasting pain and tenderness after a minor direct impact, without significant swelling or other obvious changes.
Acute Treatment
Stop activity until the acute pain has settled. Rest and brief cooling through a cloth may be used for symptom relief. Do not return to play if pain persists or worsens.
Rehabilitation
Allow pain to settle and avoid activities that provoke the area.
Goals
Pain-free daily activities and normal function.
Progression criteria
Walking, light running, and daily movements are pain-free.
Return to football through gradual progression of running and football-specific activity.
Goals
Tolerate normal football demands without pain.
Progression criteria
Full training is tolerated without recurrence of pain or swelling.
Return to Play
- ☐ Pain-free daily activities
- ☐ No persistent swelling or significant tenderness
- ☐ Can run and train without symptoms
- ☐ No pain during relevant football activities
Moderate — Varierar från dagar till flera veckor beroende på skadans omfattning.
Symptoms
Significant pain, tenderness, or swelling after trauma. Bruising or a hematoma may occur, and pain may make normal walking or movement difficult.
Acute Treatment
Stop sports participation and seek medical assessment when there is significant pain or swelling. Rest and brief cooling may be used for symptom relief. Avoid massage or firm pressure on the area.
Rehabilitation
Assessment is needed to exclude more serious injury and determine whether imaging is required.
Goals
Establish the extent of injury and a safe treatment plan.
Progression criteria
Medical assessment allows gradual activity.
Load is gradually increased as pain and swelling settle.
Goals
Restore normal movement and football function.
Progression criteria
Football-specific loading is tolerated without pain or increased swelling.
Return to Play
- ☐ Medical assessment has excluded significant injury
- ☐ Pain and swelling have resolved or are fully controlled
- ☐ Normal walking and running
- ☐ Football-specific training is tolerated
- ☐ Protection is used when appropriate
Severe — Varierar kraftigt från veckor till längre tid beroende på skadans omfattning och eventuell kirurgisk behandling.
Symptoms
Severe or worsening pain, marked swelling, a large hematoma, abnormal testicular position, blood in the urine, nausea, or vomiting may occur with more serious injury or testicular torsion.
Acute Treatment
Seek emergency medical care. Suspected testicular rupture or torsion should not be observed at home or managed by a coach. Do not press, massage, or attempt to correct the position of the testicle.
Rehabilitation
Serious injury requires prompt medical assessment and may require surgical treatment.
Goals
Ensure blood supply and treat any tissue damage.
Progression criteria
Medical treatment has been completed and a healthcare professional has approved rehabilitation.
Activity and return to sport are guided by the treating healthcare professional.
Goals
Restore normal function without pain or complications.
Progression criteria
Medical assessment confirms that return to sport is safe.
Return to Play
- ☐ Medical diagnosis and treatment have been completed
- ☐ Pain and swelling are controlled
- ☐ Normal function in daily activities and training
- ☐ No persistent complication affecting sport
- ☐ Medical clearance before returning to contact sport
When to Seek Medical Care
Testicular trauma with persistent or severe pain, swelling, or changes in appearance should be medically assessed. Sudden severe testicular pain should be treated as an emergency until proven otherwise.
- Sudden or severe testicular pain
- Increasing swelling
- Large or rapidly increasing hematoma
- The testicle appears higher or in an unusual position
- Nausea or vomiting together with testicular pain
- Blood in the urine
- Difficulty walking because of pain
- Pain that does not improve after direct trauma
References
- The Risk of Athletic Genital Injuries in Boys and Young Men — Urology Care Foundation (https://www.urologyhealth.org/healthy-living/care-blog/the-risk-of-athletic-genital-injuries-in-boys-and-young-men)
- Testicular Torsion — Urology Care Foundation (https://www.urologyhealth.org/urology-a-z/t/testicular-torsion)