What Is a Sports Hernia (Athletic Pubalgia)?

Medically Reviewed by Tyler Wheeler, MD on February 24, 2024
3 min read

A sports hernia is a tear or strain of your muscle, ligament, or tendon in your groin area or lower abdomen.

You don’t need to play sports to get a sports hernia, but it’s more common in people who play sports.

Despite its name, there’s no true hernia involved in a sports hernia. Medical professionals consequently prefer to use the term athletic pubalgia, but it’s also known as sportsman’s hernia and Gilmore’s groin.

Sports hernias tend to happen in more vigorous sports like soccer, football, wrestling, and ice hockey. These sports involve twisting your pelvis when your feet are planted. This can cause the soft tissue of your groin or lower abdomen to tear.

Other situations that may cause this core muscle injury include:

  • Forceful hip movements that you keep repeating. This includes, jumping, kicking, and twisting.
  • Abdominal and hip exercises that are vigorous and unsafe
  • Weak abdominal muscles
  • Lack of proper sports conditioning
  • A difference in strength between your abdominal and hip muscles

This motion can cause injury to your muscles. It most frequently affects your:

  • Oblique muscles in your lower abdomen
  • Tendons that attach your thigh muscles to your pubic bone (adductors)
  • Tendons that attach your oblique muscles to your pubic bone

Sports hernias usually affect young men who play sports. Women get sports hernias too, but much less frequently.

Symptoms of a sports hernia include:

  • Severe pain during the moment of your injury
  • Difficulty pinpointing the exact area the pain is coming from
  • Pain, especially when twisting, kicking, sprinting, or sitting up
  • Groin pain when you sneeze or cough 
  • Pain gets better with rest but returns after you resume sports activities

Your doctor will ask you how your injury happened and talk to you about your symptoms. They will conduct a physical exam and will probably find tenderness in the area. In most cases, an actual hernia won’t be found.

You may also be asked to do a sit-up or flex your abdomen against some resistance. This will be painful if you have a sports hernia.

To rule out other possible causes of pain, your doctor may order some tests, including:

Treatment for a sports hernia can be surgical or non-surgical. Your doctor is likely to have you try non-surgical treatment first to see if it works.

Non-surgical treatment. Non-surgical treatment includes:

  • Rest and ice during the first 7 to 10 days after your injury. If there’s a bulge in your groin, try using a wrap or compression to reduce pain. 
  • To reduce your pain and swelling, your doctor may recommend non-steroidal anti-inflammatory medicines like ibuprofen. 
  • If your symptoms don’t go away, a cortisone injection may help.
  • Two weeks after your injury, you may begin physical therapy exercises for your inner thigh and abdominal muscles.

For many people, 4-6 weeks of physical therapy is likely to help with your pain. After that, if your pain returns when you resume sports, you may need surgery.

Surgery. Surgery for a sports hernia reinforces your abdominal wall. This may be done as traditional open surgery or as laparoscopic surgery. During laparoscopic surgery, some small cuts are made, and a small camera is inserted through the cut. This allows your surgeon to look inside your body while performing the surgery.

For some people, a procedure called an inguinal neurectomy may be done to relieve your pain. Your surgeon will cut into a small nerve in your groin called the inguinal nerve.

Some people may continue to have pain after surgery. Your doctor may then recommend an adductor tenotomy surgery. The surgeon will cut the tendon that attaches your inner thigh muscles to your pubic bone. This releases the tension on your tendon and gives you a greater range of motion.

A study of 60 people with sports hernias found that 90% of those who had surgery were able to get back to sports within 3 months. For those who had non-surgical treatment, this was only 27%. Within 12 months, 97% of those who had surgery were back at their sports, compared to 50% of those who didn’t have surgery.