Understanding Athletic Pubalgia (Sports Hernia) and How to Recover
Athletes and active individuals constantly push their bodies to the limit, demanding strength, agility, and endurance. However, sometimes, with high-intensity movement, without proper rest or recovery, an injury may occur. One injury I would like to raise awareness of is often misunderstood yet quite debilitating: Athletic Pubalgia, commonly referred to as a sports hernia. Unlike a traditional hernia, this condition does not involve a visible bulge but can significantly impact performance and quality of life if left untreated.
What is Athletic Pubalgia?
Athletic Pubalgia is a soft tissue injury that occurs in the lower abdominal and/or groin region, often due to repetitive twisting, cutting, or explosive movements. This condition is common in athletes who participate in sports such as soccer, hockey, football, and tennis, where sudden directional changes and high-intensity movements place excessive strain on the core muscles and tendons.
Causes of Sports Hernia
A sports hernia typically results from:
Repetitive stress on the groin area from sudden twisting or cutting motions.
Muscle imbalances between the hip and lower abdominal muscles.
Weakness in the abdominal wall, which may lead to tearing or strain in the soft tissue.
Overuse injuries from inadequate recovery or poor biomechanical movement.
Symptoms and Diagnosis of Athletic Pubalgia
Unlike an inguinal hernia, a sports hernia does not show a visible bulge, making it challenging to diagnose. However, there are clinical criteria proposed by Kachingwe and Grech that suggest the presence of Athletic Pubalgia. The cluster of signs and symptoms indicative of Athletic Pubalgia include:
The presence of deep groin pain.
Pain that increases with exertion and decreases with rest.
Tenderness along the pubic rim 2-3cm lateral to the pubic tubercle.
Pain reported with resisted hip adduction.
Pain with resisted abdominal crunch.
The Role of Physical Therapy in Recovery
Physical Therapy treatment for Athletic Pubalgia focuses on restoring strength and mobility, while addressing the underlying causes of the injury. If not taken care of, the pain and symptoms may take a very long time to go away. Even after pain has gone away, if the person has not had proper rehab or reintroduction to their respective activity, they will be at a high likelihood of re-injury. At our performance-based physical therapy clinic, we prioritize a movement-based approach to recovery, ensuring that active individuals return to peak performance safely and effectively.
Key Components of Rehabilitation
Pain Management & Active Rest
Reducing inflammation through active rest, activity modification, and manual therapy.
Avoiding aggravating activities while promoting relatively pain-free movements.
Abdominal and Hip Strengthening
Targeted exercises to improve core stability and hip control.
Strengthening the lower abdominals, hip flexors/adductors/abductors, and glutes to support movement efficiency.
Mobility and Flexibility Training
Stretching and mobility work to relieve tension in the hip flexors and adductors.
Restoring and improving proper movement patterns to prevent compensation injuries.
Functional Movement Retraining
Gradual reintroduction of activity-specific movements.
Emphasizing proper movements to reduce reinjury risk.
Return to Sport or Activity Progressions
A structured program to rebuild power and agility.
Gradual exposure to cutting, sprinting, twisting(activity-specific) movements under supervision.
Preventing Athletic Pubalgia
While not all injuries are completely avoidable, taking proactive steps can reduce the chances of developing a sports hernia:
Consistently strengthen core and hip muscles to improve stability.
Prioritize flexibility and mobility work to maintain optimal functional movement.
Incorporate proper warm-up and cooldown routines before and after training.
Listen to your body—It’s okay to take rest days if you’re feeling beat up. Addressing minor discomfort early can prevent more serious injuries. Do not push through pain.
Move Better, Perform Stronger
At our clinic, we believe in movement as medicine and take a proactive, hands-on approach to helping athletes recover from injuries like Athletic Pubalgia (sports hernia). If you're experiencing persistent groin or abdominal pain that’s affecting your performance, we are here to guide you through a personalized recovery plan.
Don’t let a sports hernia sideline your performance—get back to doing what you love, stronger than before!
Book a Consultation Today
Ready to take the next step in your recovery journey? Contact us today to schedule an assessment and start your customized rehabilitation program
References:
Kachingwe AF, Grech S. Proposed algorithm for the management of athletes with athletic pubalgia (sports hernia): a case series. J Orthop Sports Phys Ther. 2008;38(12):768-781. doi: 10.2519/jospt.2008.2846
