Here's Exactly Why It Hurts So Much To Get Kicked In The Balls

When it comes to injury susceptibility, the testicles are low-hanging fruit.

We all pretty much know it hurts like hell to get kicked in the balls.

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Or for your testicles to endure any similar trauma — whether it’s catching an errant soccer ball with your crotch, a playful nut-punch gone wrong, or even just a gentle flick. But have you ever stopped to wonder why? BuzzFeed Health reached out to Dr. Seth Cohen, assistant professor in the department of urology at New York University, and Dr. Landon Trost, assistant professor of urology and head of male infertility and andrology at the Mayo Clinic, to understand more about just why a blow to the ‘nads is so uniquely and painfully unpleasant.

The first thing you need to know is that the testicles are so sensitive because they’re very important.

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Our bodies have various ways of ensuring that our most important parts are kept out of harm’s way. For example, the brain is protected by the skull. The ovaries, crucial to reproduction, are inside the body and further protected by the pelvic bone. On the other hand, testicles — which produce sperm and testosterone, making them essential for reproduction — lack protective armor like the skull and are external, making them ~low-hanging fruit~ when it comes to injury susceptibility. But testicles have something the brain doesn’t: pain fibers. Lots of them.

The genitals have a high number of nerves per surface area, says Trost, which makes them more sensitive and allows you to feel things more discriminately than you would on other, less sensitive parts of your body, like your back. Additionally, the brain devotes a lot of space to processing what the genitals feel, even though they're a relatively small part of the body. Just think about how gently you can touch the testicles and still cause intense sensation. So, in the same way that cuts on the lips or fingers often hurt more than, say, a cut in the middle of the back, “injuries to the penis and scrotum are more tender,” Trost tells BuzzFeed Health.

Also, the testicles hail from a land far far away from your crotch (i.e. your abdomen).

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After sustaining a blow to the testicles, you might have a stomach ache or feel pain ripping through your abdomen. One of the reasons for this probably has something to do with the fact that your testicles weren’t always where they typically end up, just behind and underneath the penis, says Cohen.

The testicles actually start developing in the abdomen, just underneath the kidneys. They start to descend just before birth, making their way from the abdominal cavity to the scrotum by way of a passage called the inguinal canal, and are typically in the scrotum by birth or within the first year of life. What this means is that the testicles’ nerve fibers travel from the scrotum back up the inguinal canal to where they developed, in the abdomen. As a result, pain from a kick in the nuts is not localized to the crotch — basically because your brain thinks it's your abdomen that’s been attacked.

You might also get sweaty and light-headed, or tear up or cry, and want to collapse into the fetal position.

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This is all part of the grand evolutionary plan that has made sure our bodies are programmed to freak out on a systemic level when we encounter trauma. Some people may feel faint or light-headed, weak, nauseated, or even pass out. This is called a vasovagal response, says Trost, and it occurs when the vagus nerves, which control heart rate, breathing, and blood pressure, and which are very sensitive to emotional response, are overstimulated. The vasovagal response can be triggered by lots of things — the sight of blood, fear of bodily trauma, and, in this case perhaps, severe pain.

Not every single person will have the same reaction, though. It is difficult to pin down exactly which autonomic systems are triggered when you get kicked in the balls because the testicles are “complicated from a nerve standpoint in that they have multiple different pathways, multiple different sources for pain, and take up a relatively large space in the brain,” Trost says.

If you take a hit to the crotchal area, there are a few things you should and shouldn't do.

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After you collect yourself, apply an ice pack to your testicles (but not directly; make sure there’s a towel between the ice and your balls). You can also take an OTC painkiller, like ibuprofen. Cohen says that the pain should subside in three to four hours. Depending on how bad the injury was, your scrotum will probably be sore for three to five days afterward. Cohen also recommends steering clear of cycling, running, and lower-body exercise for a couple of weeks after the injury or until the soreness abates. If you don't let them heal, the pain and discomfort can get worse and so can the swelling, which will prolong the healing process, Cohen says.

Don’t decide whether or not to see a doctor based on how hard the blow was, because even a lighter impact can be damaging if it hit the right place.

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For example, a light flick to the epididymis, the tube at the back of the scrotum that stores and carries sperm, could cause severe pain, Trost says. But there are a few things to be on the lookout for when deciding whether you need to go to the ER. The most likely result of getting kicked in the nuts is pain and soreness, but in some cases the injury can be severe enough to cause a testicular torsion (which is when the spermatic cord that supplies the scrotum with blood gets twisted and cuts off blood supply to the testicles) or a testicle rupture.

If the pain doesn’t subside in a few hours, or is getting worse, you should see a doctor. If your testicle is very swollen, red, and hard to the touch, or if it’s black and blue, you should go to the doctor or ER immediately. If, after the impact, you’re experiencing “severe rapid onset pain,” that’s definitely another sign that you should seek medical care, says Trost. You want to keep an eye on any severe reactions for the sake of testicle health and fertility.

And if you get cut or the blow breaks the skin, keep an eye on it.

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Even though the testicles are very sensitive, scrotal skin is actually robust AF; Trost says it’s similar to the webbing between the thumb and forefinger. That said, if your scrotum does get cut in the course of a blow to the junk or for some other reason (we don’t know your life), clean it with soap and water (nothing fancy) and keep it dry. Also keep an eye on it for redness, or any signs of pus or bumps larger than a zit. The scrotum is perilously close to the anus, which is basically a bacteria pleasure palace — and because the testicles are so vascular, infections there spread super quickly, says Cohen. That, along with the fact that you’re probably only looking at your balls a couple of times a day, means that if you’re not paying close attention, an infection could start and spread before you even know you have it.

PSA: Consider wearing a cup or other protective gear if you play sports.

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While lots of competitive athletes wear cups during practice and play, even casual and recreational athletes who, say, join a pickup soccer game on the weekends should consider genital padding of some kind too, says Cohen.

TL;DR: Protecting your junk isn’t just for competitive athletes.

In conclusion, your balls hurt so bad when you get kicked because they’re super smart and want to protect you.

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So, thank them for their service! (After the pain subsides and you catch your breath, of course.)