It's your nightmare if you're a guy. You're at sports practice, working hard to get ready for the next game. Just as you realize you forgot to put on your athletic cup, you take a hit to the testicles and drop to your knees in pain.

Ouch - you might be flinching just imagining it. No guy wants to experience testicular trauma, but you can prepare yourself by knowing the warning signs of a serious problem and when to call the doctor. Keep reading so you'll be ready if you're caught without a cup.

What Are Testicular Trauma and Torsion?
Because the testicles hang in a sac outside the body, they are not protected by bones and muscles like the rest of the reproductive system. The location of the testicles makes it easier for them to be injured or hit, a painful sensation most guys have experienced at some time. Generally, because the testicles are loosely attached to the body and are made of a spongy material, they are able to absorb the shock of impact without permanent damage. It's common for guys to experience testicular trauma, which is when the testicles are struck, hit, kicked, or crushed. Almost all testicular injuries occur during sports.

Another common type of testicular problem that occurs suddenly is called testicular torsion, and it occurs frequently in guys between the ages of 12 and 18. Within the scrotum, the testicles are secured at either end. Sometimes, a testicle can become twisted, cutting off the blood vessels that supply blood to the testicle. Testicular torsion might occur as the result of trauma to the testicles, strenuous activity, or it might develop while a guy is sleeping. In the United States, testicular torsion occurs in one out of 4,000 guys younger than 25.

An extremely rare type of testicular trauma is called testicular rupture. This condition may occur when the testicle receives a direct blow or when the testicle is crushed by some object. The testicle is compressed against the pubic bone, crushing the testicle against the bone and the object, causing blood to leak into the scrotum.

What Are the Signs and Symptoms?
If you are kicked or struck in the genital area, you may experience nausea, lightheadedness, dizziness, and sweating in addition to pain. For minor testicular injuries, the pain should gradually subside in less than an hour and the other symptoms should go away.

The signs and symptoms of testicular torsion are more severe and usually affect only one testicle, usually the left testicle. A guy with testicular torsion might experience rapid swelling and extreme pain in the scrotum that does not go away, nausea, vomiting, and abdominal pain.

Testicular rupture also causes extreme pain and swelling in the scrotum, nausea, and vomiting.

Dealing With and Preventing Testicular Injuries
If you've suffered a testicular injury, there are a few things you can do to feel better. Lie down, gently support the testicles with supportive underwear, and apply ice packs to relieve swelling and pain.

If you have had surgery for testicular torsion or rupture, your recovery time will be a little longer. According to T. Ernesto Figueroa, MD, a urologist who works with teens in Wilmington, Delaware, it can take weeks to months until a guy recovers from testicular surgery and can resume normal sports activities. Even then, Dr. Figueroa says, in teens "the genital area is more sensitive and prone to injury." Your doctor or urologist will give you specific instructions on pain relief and how to care for yourself after testicular surgery.

Do you have to worry that your sexuality or sperm production will be affected if you have a testicular injury? Your testicles, although sensitive, can bounce back pretty quickly and minor injuries rarely have long-term effects.

With treatment within 6 hours from the time pain starts, 80% to 100% of guys with testicular torsion do not have to have the testicle removed. However, after 6 hours, there is a much greater possibility that infertility and loss of the testicle could result, so that's why it's so important to get treatment immediately. If a testicle does have to be removed, a guy will still be able to have normal sexual function. And because both testicles produce sperm, a guy will probably still be able to have children someday, even if one testicle has been removed.

Reading this article probably has you wondering how you can keep these injuries from happening to you. Try these tips to keep testicular trauma away:

• Always wear an athletic cup and supporter when you are playing sports or doing strenuous activity. This is the single most important thing you can do to protect yourself from genital injury.

• Check your fit. Make sure the athletic supporter and cup you wear are the right size - safety equipment that is too small or too large won't protect you as effectively from injury.

• 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 because you might be prone to genital injury.

• Be aware of the risks of your sport. Dr. Figueroa says that lacrosse and baseball are the sports that have the highest incidence of testicular injury. Horseback riding may also put you at risk. If you play a sport with a higher risk for injury, talk to your coach or doctor about additional protective gear.

Sports are a great way to stay fit and relieve stress. Make sure that using protective gear is part of your pre-practice and pre-game routine and you'll be able to play hard without fear of testicular injury.