Is a Sports Hernia a Real Hernia? Understanding Athletic Pubalgia

No. A sports hernia is not considered a true hernia. Despite its name, a sports hernia usually involves an injury to muscles, tendons, or other soft tissues in the lower abdomen or groin rather than tissue pushing through a weakness in the abdominal wall.

Healthcare providers often use the term athletic pubalgia or core muscle injury to describe this condition. It is especially common in people who participate in activities involving twisting, kicking, sprinting, or sudden changes in direction.

Because a sports hernia and a traditional hernia can both cause groin pain, understanding the difference can help you know when to seek an evaluation.

Why Is It Called a Sports Hernia if It Is Not a Hernia?

The term “sports hernia” can be misleading.

A traditional hernia occurs when tissue pushes through a weak area or opening in the abdominal wall. This may create a visible or noticeable bulge.

A sports hernia, by contrast, generally involves damage or weakness in the muscles, tendons, or connective tissues around the lower abdomen, pelvis, and groin. There is usually no tissue protruding through the abdominal wall and no typical hernia bulge.

The term became widely used because the injury occurs near the same area as an inguinal hernia and can produce similar symptoms.

What Is Athletic Pubalgia?

Athletic pubalgia is a soft tissue injury affecting structures where the lower abdominal and groin muscles connect around the pelvis.

The injury may involve weakening, straining, or tearing of muscles or tendons in this area. Symptoms are often triggered by movements that place significant stress on the abdominal and hip muscles.

Common examples include:

• Sprinting
• Kicking
• Twisting or pivoting
• Sudden changes in direction
• Cutting movements
• Jumping
• High-intensity exercise

Although sports hernias are frequently associated with athletes, you do not have to play a competitive sport to develop this type of injury.

What Is the Difference Between a Sports Hernia and a True Hernia?

The main difference is what is causing the groin pain.

An inguinal hernia is one example of a true hernia that can cause groin discomfort.

Can a Sports Hernia Cause a Bulge?

Usually not.

A sports hernia generally causes pain without the visible groin bulge commonly associated with an inguinal hernia. This is one reason athletic pubalgia can be more difficult to recognize.

A new bulge in the groin, particularly one that becomes more noticeable while coughing, lifting, standing, or straining, may suggest a traditional hernia and should be evaluated.

What Does a Sports Hernia Feel Like?

Sports hernia symptoms commonly involve pain in the lower abdomen or groin.

You may experience:

• Groin pain during exercise or sports
• Pain during sprinting, twisting, kicking, or changing direction
• Lower abdominal discomfort
• Tenderness around the groin or pubic area
• Pain during sit-ups or other abdominal movements
• Pain with coughing or sneezing
• Symptoms that improve with rest but return when activity resumes

Recurring activity-related groin pain is one of the characteristics that may lead a provider to consider athletic pubalgia.

Can a Sports Hernia Become an Inguinal Hernia?

A sports hernia and an inguinal hernia are separate conditions, but they can sometimes occur together.

Weakness or injury in the groin area associated with athletic pubalgia may also be present in someone who develops an inguinal hernia. However, it is more accurate to think of these as related conditions that can coexist rather than saying every untreated sports hernia eventually becomes a traditional hernia.

If groin symptoms change or a new bulge develops, another evaluation may be appropriate.

How Do Doctors Tell a Sports Hernia From an Inguinal Hernia?

Diagnosis usually starts with your symptoms and a physical examination.

A healthcare provider may examine the lower abdomen and groin for tenderness, weakness, or a bulge. You may also be asked to perform movements that reproduce your symptoms, such as contracting your abdominal muscles.

Imaging may sometimes be used to evaluate the injured area or rule out other causes of groin pain.

Possible imaging studies include:

• MRI
• Ultrasound
• X-rays
• CT imaging in selected cases

Groin pain can also come from muscle strains, hip conditions, tendon injuries, and other problems, so the goal is not simply to determine whether a hernia is present but to identify the actual source of the symptoms.

Does a Sports Hernia Need Surgery?

Not necessarily.

Treatment often begins with nonsurgical approaches, particularly when symptoms are caused by a soft tissue injury rather than a traditional hernia.

Initial treatment may include:

• Activity modification
• Rest
• Physical therapy
• Strengthening and flexibility exercises
• Gradual return to exercise or sports

Surgery may be considered when persistent symptoms do not improve with appropriate conservative treatment or prevent a patient from returning to normal activities.

The appropriate treatment depends on the structures involved, severity of the injury, symptoms, and individual activity goals.

When Should Groin Pain Be Evaluated?

Groin pain should be evaluated if it persists, repeatedly returns, or interferes with physical activity.

Consider scheduling an evaluation if:

• Groin pain continues despite rest
• Symptoms repeatedly return during exercise
• Pain prevents you from running, kicking, twisting, or exercising normally
• You develop a new groin bulge
• Symptoms are worsening rather than improving
• Groin discomfort begins interfering with everyday activities

Because athletic pubalgia, inguinal hernias, muscle strains, and hip conditions can cause overlapping symptoms, an examination can help determine what is actually causing the pain.

Sports Hernia and Groin Pain Evaluation in the East Bay

Hernia Innovations provides evaluation and treatment for patients experiencing suspected hernias and persistent groin pain throughout the East Bay.

Our board-certified surgeons can evaluate whether symptoms may be related to an inguinal hernia, athletic pubalgia, or another condition and discuss appropriate next steps based on the diagnosis.

Learn more about sports hernias and athletic pubalgia, or call (925) 940-1025 to request an evaluation.

Frequently Asked Questions

Is a sports hernia actually a hernia?

No. A sports hernia is generally a soft tissue injury involving structures in the lower abdomen or groin rather than tissue protruding through an opening in the abdominal wall. Athletic pubalgia is a more medically descriptive term for the condition.

Is athletic pubalgia the same as a sports hernia?

The terms are commonly used to describe the same general type of activity-related soft tissue injury in the lower abdomen and groin. “Sports hernia” remains widely used, although athletic pubalgia or core muscle injury may more accurately describe what is happening.

Can you have a sports hernia without a lump?

Yes. In fact, the absence of a visible bulge is one of the major differences between athletic pubalgia and many traditional inguinal hernias.

What is the difference between a sports hernia and an inguinal hernia?

A sports hernia involves injured or weakened soft tissues in the lower abdomen or groin. An inguinal hernia occurs when tissue protrudes through a weakened area of the abdominal wall in the groin.

Can someone have both a sports hernia and an inguinal hernia?

Yes. Athletic pubalgia and a traditional inguinal hernia are separate conditions, but they may occur together. An examination can help determine which condition is responsible for a patient's symptoms.