It hurts to even think about it. A baseball takes an unexpected bounce when you're crouched and waiting to field a grounder, an opponent misses a kick on the soccer field and his foot has only one place to go, or you're speeding along on your bike and you hit a big bump. All result in one really painful thing — a shot to the testicles, one of the most tender areas on a guy's body.

Testicular injuries are relatively uncommon, but guys should be aware that they can happen. So how can you avoid injury?

Why Do Testicular Injuries Happen and What Can You Do?

If you're a guy who plays sports, likes to lift weights and exercise a lot, or leads an all-around active life, you've probably come to find out that the testicles are kind of vulnerable and can be injured in a variety of ways.

Because they hang in a sac outside the body (the scrotum), the testicles are not protected by bones and muscles like other parts of your reproductive system and most of your other organs. Also, the location of the testicles makes them prime targets to be accidentally struck on the playing field or injured during strenuous exercise and activity.

The good news is that because the testicles are loosely attached to the body and are made of a spongy material, they're able to absorb most collisions without permanent damage. Testicles, although sensitive, can bounce back pretty quickly and minor injuries rarely have long-term effects. Also, sexual function or sperm production will most likely not be affected if you have a testicular injury.

You'll definitely feel pain if your testicles are struck or kicked, and you might also feel nauseated for a short time. If it's a minor testicular injury, the pain should gradually subside in less than an hour and any other symptoms should go away.

In the meantime, you can do a few things to help yourself feel better such as take pain relievers, lie down, gently support the testicles with supportive underwear, and apply ice packs to the area. At any rate, it's a good idea to avoid strenuous activity for a while and take it easy for a few days.

However, if the pain doesn't subside or you experience extreme pain that lasts longer than an hour; if you have swelling or bruising of the scrotum or a puncture of the scrotum or testicle; if you continue to have nausea and vomiting; or if you develop a fever, get to a doctor immediately. These are symptoms of a much more serious injury that needs to be addressed as soon as possible.

Serious Testicular Injuries

Examples of serious testicular injury are testicular torsion and testicular rupture. In the case of testicular torsion, the testicle twists around, cutting off its blood supply. This can happen due to a serious trauma to the testicles, strenuous activity, or even for no apparent reason.

Testicular torsion isn't common, but when it does happen, it most often occurs in guys ages 12 to 18. If it occurs, it is crucial to see a doctor as soon as possible — within 6 hours of the time the pain starts. Unfortunately, after 6 hours, there is a much greater possibility that complications could result, including reduced sperm production or the loss of the testicle. The problem may be fixed by a doctor manually untwisting the testicle. If that doesn't work, surgery will be necessary.

Testicular rupture can also happen, but it is a rare type of testicular trauma. This can happen when the testicle receives a forceful direct blow or when the testicle is crushed against the pubic bone (the bone that forms the front of the pelvis), causing blood to leak into the scrotum. Testicular rupture, like testicular torsion and other serious injuries to the testicles, causes extreme pain, swelling in the scrotum, nausea, and vomiting. To fix the problem, surgery is necessary to repair the ruptured testicle.

Seeing a Doctor

If you have to see a doctor, he or she will first need to know how long you have been experiencing pain and how severe your discomfort is. To rule out a hernia or other problem as the cause of the pain, the doctor will examine your abdomen and groin.

In addition, the doctor will look at your scrotum for swelling, color, and damage to the skin and examine the testicle itself. Because infections of the reproductive system or urinary tract can sometimes cause similar pain, your doctor may do a urine test to rule out a urinary tract infection or infection of the reproductive organs.

Preventing Testicular Injuries

It's wise to take precautions to avoid testicular injuries, especially if you play sports, exercise a lot, or just live an all-around active life. Here are some tips to keep your testicles safe and sound:

• Protect your testicles. Always wear an athletic cup or athletic supporter when playing sports or participating in strenuous activity. Athletic cups are usually made of hard plastic, are worn over the groin area, and provide a good degree of shielding and safety for the testicles. Cups are best used when participating in sports where your testicles might get hit or kicked, like football, hockey, soccer, or karate.
  
  An athletic supporter, or jock strap, is basically a cloth pouch that you wear to keep your testicles close to your body. Athletic supporters are best used when participating in strenuous exercise, cycling, or doing any heavy lifting.
• Check your fit. Make sure the athletic cup and/or athletic supporter is the right size. Safety equipment that's too small or too big won't protect you as effectively.
• Keep your doctor informed. If you play sports, you probably have regular physical exams by a doctor. If you experience testicular pain even occasionally, talk to your doctor about it.
• Be aware of the risks of your sport or activity. If you play a sport or participate in an activity with a high risk of injury, talk to your coach or doctor about any additional protective gear you should use.

Participating in sports and living an active life are great ways to stay fit and relieve stress. But it's important to make sure your testicles are protected. When you're exercising or playing sports, make sure that using protective gear is part of your routine and you'll be able to play hard without fear of testicular injury!

Reviewed by: T. Ernesto Figueroa, MD
Date reviewed: September 2010