There are heaps of blog posts about women’s health and running. Breasts, periods, pelvic floors, you name it, there’s a post to put you off your lunch. Unfair on the men I thought, so, this month I’ve strayed from my usual niche to write about mens’ bits. Yes, let’s talk testicles! Aching, itching, lumps, they can all interfere with running. It’s an important topic because apathy, denial and embarrassment can cost lives.

Ball Ache

There are several reasons why you might get pain in your testicles when you run:
Lack of support: There’s a reflex called the cremasteric reflex which helps to keep your testicles drawn up close to you. If you want to see this is action just stroke your upper, inner thigh and watch the testicle on that side move upwards as the cremaster muscle contracts. Despite this, having your crown jewels bouncing around when you run is the number one cause of ball ache. Boxers or sports shorts with net lining aren’t the answer. If you’re uncomfortable, closer fitting briefs or lycra shorts will provide more support. Watch compression shorts though; if you’re getting pain or numbness it’s a sign they’re too tight. Testicles which are inflamed or infected can become uncomfortable when you run. If you find the discomfort isn’t settling with support or you have pain at other times too then see your GP.

Varicoceles: Blood enters your testicle via the testicular artery and leaves via a network of veins. Sometimes the valves in these veins fail and blood backs up; just like varicose veins in the legs. You can sometimes feel a swelling behind and above your testicle (usually the left one) which feels like a ‘squishy’ bag of worms. Varicoceles are common (one in seven men) and usually harmless but they might cause an ache when you run because of the increased blood flow during exercise and the effect of gravity with time on your feet. Again, supporting the testicles with good underwear can help. Don’t forget, if you find any sort of lump or swelling when you examine yourself you should visit your GP rather than diagnose yourself. See the section on self examination later this post.

Non-testicular cause: You might feel pain in your testicle but actually the cause of the problem is elsewhere. Pain from your lower back, pubic bone, urinary tract, trapped nerves, hips, abdomen and thighs can all radiate to and be felt in your testicles. Hernias where a section of your bowel pokes through a weakness in your muscular abdominal wall can cause testicular pain. You might see a swelling or bulge in your groin, particularly after exertion. You need to see your GP if this is happening to you as you may need to have surgery to repair the weakness. Rather confusingly, the term ‘sports hernia’ or ‘sportsman’s groin’ is often used to describe damage to the muscles, tendons and ligaments in the groin. It’s not a hernia in the traditional sense as there’s no bulging tissue and the name ‘Inguinal disruption’ is now the accepted term in the UK (your inguinal area is your groin area). It needs proper assessment, rehabilitation and occasionally surgery to correct it.

IF YOU GET SUDDEN ONSET OF A SEVERE PAIN IN YOUR TESTICLE THEN YOU SHOULD BE URGENTLY ASSESSED BY A DOCTOR IN CASE THE TESTICLE HAS TWISTED. THIS IS CALLED TESTICULAR TORSION AND THE BLOOD SUPPLY TO THE TESTICLE IS BLOCKED.

Skin problems

Chafing: Most male runners have had a bit of chafing in their nether regions and learnt that a good dollop of grease ‘pre-run’ does the trick. Vaseline, Body glide, whichever suits you best is fine. (NO ‘double-dipping from the communal pots please!) It’s a particular problem over long distances and when the weather is hot. If you do succumb to the chafe then wash the area well afterwards (it may bring tears to your eyes), pat it dry and apply a baby’s nappy cream like Sudocrem to protect the skin and help healing. Experimenting with different shorts and underwear is the only way to find what works for you.

Fungal infections: If you find that the skin over your scrotum, penis or in your groins is red, itchy or uncomfortable, then you may have a fungal infection. Candida (also known as thrush) is the commonest cause; it loves dark, sweaty places. Keep the area clean but avoid perfumed soaps and shower gels. Make sure you dry really thoroughly after you’ve washed. If it’s within your pubic hair, then waft the air from a hairdryer over the area too. You can buy anti-fungal creams such as clotrimazole from the pharmacy. You’ll find them in the section for athlete’s foot as it’s caused by the same germs. Speak to the pharmacist if you aren’t sure. If it’s very itchy then ask for one with hydrocortisone in too (this is a steroid which reduces itch). Choose technical, ‘breathable’ fabrics for your sports gear and wash them after each wear; no hanging them over the radiator for a second outing!

Other skin conditions: If you have a skin condition elsewhere like eczema or psoriasis it might affect your groin too but just a word of advice, rashes around the genitals can look completely different to those typical of your skin condition on other parts of your body.

Any rash that’s oozing, weeping, crusted or isn’t clearing up, obviously needs to be checked by your GP.

Self examination: It’s natural to worry about testicular cancer. It’s the most common cancer in young men in the UK. It’s unusual for it to cause pain though, it usually presents as a painless lump. The most important thing you can do is have a feel and get to know what’s normal for you. See your GP if you feel anything that’s unusual and don’t put off making an appointment because you’re embarrassed; your GP will have seen it all before and early detection saves lives. Don’t forget you can ask for a male or female GP, according to what you feel most comfortable with. You’ll be asked if you want a chaperone in the room with you as a matter of routine.

It’s best to check yourself after you’ve had a warm bath or shower. Here’s a link to a YouTube clip here, where a brave young man shows self-examination live on ITV for the #checkyourchaps campaign.

So in summary; keep them clean, support them, feel them and get them checked if you aren’t sure!