The testicles, or balls, contain many nerve endings, making them very sensitive and susceptible to pain. As they hang loosely in the scrotum, they are vulnerable to injury from blunt trauma such as a kick.

A blow to the testicles may result in pain, bruising, and swelling. In more severe cases, testicular trauma may cause a rupture, potentially leading to a hematocele, which is an accumulation of blood in the scrotal sac. If a person sustains a blow to the testicles and is experiencing chronic pain and swelling, it is advisable to seek immediate medical attention.

In this article, we explain why testicular injuries hurt so much. We also discuss the risk of permanent injury and suggest some prevention tips.

A person holding their stomach after a blow to the testicles.Share on Pinterest
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People experience pain when nerves detect tissue damage and transmit information about the damage to the brain. The testicles contain a great number of densely packed nerve endings in a small area. This high concentration of nerves makes them very sensitive and susceptible to pain.

Unlike other organs, which may be internal and receive protection from muscles and bones, the testicles are external and more vulnerable to injury.

The testicles receive protection from various factors, including mobility, elasticity, reflexes, and a layer of fibrous tissue called the tunica albuginea. Although these provide some protection and may help prevent serious injury, they do not completely prevent pain.

After receiving a blow to the testicles, people may notice pain elsewhere in the body, such as in the abdomen. Doctors refer to this sensation as referred pain.

People may experience this due to the testicles developing in the abdominal cavity — which means that they share nerves with this area — before descending into the groin.

This connection may cause a feeling of pain in the stomach as the overlapping and intermingling nerve pathways mean that the brain cannot discern that the pain originates from the testicles. This also explains why some people may feel nauseated after sustaining a blow to the testicles.

If a person receives a minor blow to the testicles, the pain should subside within a short while. However, people can try the following methods to find relief:

  • lying down and avoiding any strenuous activities
  • taking an over-the-counter pain reliever
  • applying a cold compress to the area
  • wearing supportive underwear to limit movement

The sensation of pain usually prevents certain behaviors. However, some people may derive sexual pleasure from pain, such as testicular trauma. These individuals may experience sexual pleasure or arousal following blunt trauma, such as kicks, to their testicles.

It is important to note that while some people may find it pleasurable, “ball busting” or similar practices still pose the risk of bruising, swelling, and more severe injuries, such as rupture.

If people wish to indulge in these practices, they should do so in a safe environment that includes mutual consent, open communication, clear boundaries, and an agreed safe word. If the pain becomes too much, people should stop.

According to research, the incidence of scrotal or testicular trauma in the United States is rare. Studies suggest that blunt scrotal trauma accounts for less than 1% of the trauma cases that emergency departments encounter.

Researchers previously thought that blunt trauma was the most common mechanism for testicular injury. However, 2018 research indicates that a penetrating mechanism, such as firearm assault, is now more common in the U.S.

Evidence also suggests that testicular trauma may be more common in those who frequently play sports or drive a vehicle.

Trauma to the testicles or scrotum can harm the contents and cause complications. Without treatment, trauma may result in infertility or loss of the testicles. Possible complications include:

Testicular rupture

A testicular rupture is when an injury causes a rip or tear to the protective tunica albuginea and results in damage to the testicles. Some research suggests that rupture occurs in roughly 50% of cases of direct blunt scrotal trauma.

Testicular torsion

Testicular torsion occurs when the testicle rotates on the spermatic cord, which supplies the testicle with blood. When this happens, it cuts off the blood flow to the testicle. Sometimes, an injury can prompt testicular torsion.


Epididymitis occurs when the tube that carries and stores sperm, called the epididymis, becomes inflamed. Some research suggests that epididymal injury due to trauma is fairly common, being present in 25% of scrotal ultrasounds for trauma evaluation.

Although it may not always be possible to prevent testicular injuries, a person can take precautions in situations where they may be more likely to occur. For example, people may consider:

  • wearing a jockstrap or cup while playing sports
  • wearing a seatbelt at all times while in a vehicle
  • being cautious when on a bike, motorcycle, all-terrain vehicle, or similar vehicle
  • being extra careful when operating machinery that could catch loose clothing

While a person may experience severe pain after blunt testicular trauma, the pain will usually subside quickly. However, it can be concerning if a person notices chronic testicular pain or other unusual symptoms.

It is advisable to seek immediate medical help if any of the following symptoms develop:

  • bruising
  • swelling
  • difficulty urinating
  • blood in the urine
  • puncture wounds
  • nausea and vomiting
  • fever

It is possible that an injury may alert people to a lump on the testicle. Although this is unlikely to relate to the injury, they should see a doctor immediately for an evaluation.

It is important that people regularly perform testicular self-exams to check for any abnormalities.

The testicles are two small organs in the scrotum. As they contain many nerve endings, they are very sensitive and susceptible to pain. Blunt trauma, such as a kick, to the testicles can be extremely painful, although the pain will usually subside fairly quickly. People can take precautions, such as wearing a cup while playing sports, to prevent injury.

However, if the pain is chronic or people notice other severe symptoms, it may indicate a serious injury, such as a rupture. Anyone who continues to experience pain, feel unwell, or have problems urinating should seek immediate medical assistance.