Pubalgia, commonly referred to in athletic contexts as a sports hernia or athletic pubalgia, is a condition characterized by chronic pain in the groin and lower abdominal region often seen in athletes. It typically arises from overuse or imbalance of the muscles and connective tissues that attach around the pubic bone, including the adductors, rectus abdominis, and obliques, and often involves weakness or tearing of the soft tissues at the posterior inguinal wall rather than a true hernia. Key points to know
- Symptoms: Gradual, persistent groin or lower abdominal pain that may worsen with running, cutting, twisting, kicking, or resisted abdominal actions; pain can be felt near the pubic bone and may radiate to the inner thigh. Some individuals notice tenderness or a pinching sensation in the groin area, especially with sudden movements.
- Common at-risk sports: Soccer, ice hockey, football, track and field, and other sports requiring frequent rapid directional changes or kicking.
- Differentials: True inguinal hernia, osteitis pubis (pubic bone inflammation), adductor tendinopathy, hip joint pathology (labral tears, femoroacetabular impingement), and other groin injuries. Proper assessment is important because treatment differs.
- Diagnosis: Often based on history and a focused physical examination. Imaging (ultrasound or MRI) may be used to exclude a hernia or to evaluate soft tissue structures around the groin and pubic region.
- Treatment approach: A typical plan includes a period of relative rest from aggravating activities, a structured rehabilitation program focused on restoring core stability and muscular balance, and gradual progressive loading. In some cases, especially when conservative care fails to resolve the pain, surgical options targeting the posterior inguinal wall or related muscular attachments may be considered. Return-to-play is usually gradual and guided by pain-free function and objective strength and flexibility milestones.
- Prognosis: With appropriate management, many athletes can return to sport, but recovery times vary depending on the severity of tissue involvement and adherence to a supervised rehab program.
What to discuss with a clinician
- Onset and activity-related patterns of pain
- Prior injuries to the groin, abdomen, or pelvis
- Specific movements or tests that provoke symptoms
- Any swelling, numbness, or changes in sensation
- Your sport, level of competition, and timelines for return
If you’d like, I can tailor a concise summary for you based on your sport, symptoms, and whether you’re aiming to continue training during evaluation, and I can also outline where to seek a specialist (sports medicine physician, orthopedic surgeon with groin-pain expertise, or physical therapist) for a precise diagnosis and individualized rehab plan.
