Why your athletic son needs to wear a cup

You’ve likely seen a male athlete taking a hit where it hurts. It makes us cringe and often, reflexively, cover our own private parts. In movies or on television, such a scene can be added for comedy, but protecting the testicles is serious.

If your son is gearing up for football, or if he plays baseball in the spring and summer, you probably spend a good amount of time making sure he has the right cleats, pads and gloves. Remember to include that vitally important piece of gear, an athletic supporter that fits properly.

Robert Grife, MD

A Geisinger Heath System study showed that 18 percent of athletes experienced a testicular injury, and 36.4 percent observed injuries in team members, yet only 12.9 percent of athletes reported wearing athletic cups.  According to the study, the prevalence of testicular injuries was highest for lacrosse, followed by wrestling, baseball and football.  Football is fourth on the list of sports that cause the most testicular injuries, however it typically produces the most severe injuries.

As a father of six kids, including four boys, and as a physician, a coach, and a guy who has played sports, I am especially concerned about the results of this study.

A hard hit to the groin can cause severe pain and even nausea or vomiting for boys and men. If the hit is hard enough, it can also lead to testicular fracture or testicular rupture, which occurs when blood leaks into the scrotum from the testicles and requires surgery. Testicular torsion, when at least one testicle gets twisted inside the scrotum to the point where the blood is cut off, could also result from a blow to the testicular area.  Left untreated, the affected testicle could have to be surgically removed.

Risks for testicular injuries increase once boys hit puberty when their testicles grow in size and the scrotum drops.  Even if your son plays sports and is under the typical puberty age, it’s a good idea to get him in the habit of wearing a cup.

An alternative option is a jockstrap without a cup than fits snuggly enough to keep the testicles comfortably pressed against the body; this could also help mitigate the effects of a blow to the testicular area.

Some athletes avoid the use of a cup due to its restrictive nature or because the waistband of the jockstrap may shift position during the course of an athletic event, becoming uncomfortable to wear or inhibit movement and athletic performance.  Sometimes athletes don’t wear a cup because they don’t know the risk, or they don’t know how to properly fit it and are not comfortable asking for help.

If your son does take a hit, even when wearing a cup, watch for symptoms of testicular trauma.  These include, but are not limited to, bruising or swelling of the scrotum, fever, and trouble urinating.  If this type of trauma does occur, call your primary care provider, or if more urgent, visit your urgent care or emergency provider.

It may be much easier to ask, “Do your shoulder pads fit you?” than it is to question, “Is your cup the right size?”, or even, “Are you wearing a cup?” but we want our sons to be in the game, scoring and learning about teamwork, not on the sidelines or in a doctor’s office or hospital because of an injury.  Talk about a cup with your kid, your coach, or your primary care provider. 

Robert Grife, MD, of AtlantiCare Primary Care Plus, Ocean City, is board certified by the American Board of Family Medicine and a member of AtlantiCare Regional Medical Center’s Medical Staff. His clinical interests include stress management, chronic pain, and lifestyle medicine.