Sports Hernia (Athletic Pubalgia)

What is a Sports Hernia?

A sports hernia, or athletic pubalgia, is not a true hernia but a strain or tear of soft tissues in the lower abdominal wall or groin. It’s common in athletes who perform repetitive twisting, cutting, or kicking, especially in hockey, soccer, and football.

Common Symptoms

• Deep groin or lower abdominal pain

• Pain with sprinting, cutting, or sit-ups

• Relief with rest, but symptoms return with activity

• Pain may radiate into the inner thigh or testicular area in males

Physical Therapist Diagnosis

A PT evaluates pain with resisted abdominal or hip movements, palpates the lower abdominal and groin region, and assesses hip and core mechanics. Differential diagnosis rules out true hernias or hip joint pathology.

Why it Happens

Repetitive high-intensity twisting or kicking causes strain where abdominal muscles attach near the pubic bone. Muscle imbalances or weakness in the core and hips contribute to excessive stress in this area.

Why it Doesn’t Always Heal on Its Own

Rest alone may reduce pain temporarily, but without addressing underlying weakness and movement dysfunction, symptoms return when activity resumes. Severe cases may require surgical repair.

Ideal Physical Therapy Treatment

Rehab focuses on strengthening the core and hips, restoring pelvic control, and reducing strain on the injured tissues. Dry needling may help decrease muscular tension in the hip flexors and adductors.

Key components include:

• Manual therapy for hip and pelvic mobility

• Dry needling for muscular tightness contributing to pain

• Progressive strengthening of core, hip flexors, and adductors

• Neuromuscular retraining for pelvic stability during sport movements

• Gradual return-to-sport drills for sprinting, cutting, and kicking

Expected Outcomes

With structured therapy, many athletes return to full activity. Persistent cases may require surgical consultation, but pre- and post-operative PT are key to recovery.