A sports hernia, also called athletic pubalgia, is a painful injury involving muscles, tendons, or other soft tissues in the lower abdomen or groin. Despite its name, a sports hernia is not the same as a traditional abdominal or inguinal hernia and usually does not cause a visible bulge.
Sports hernias are most often associated with activities that involve repetitive twisting, kicking, sprinting, or sudden changes in direction. Treatment may include rest, physical therapy, activity modification, and, in some cases, surgery.
What Is a Sports Hernia?
A sports hernia occurs when soft tissues in the lower abdomen or groin become strained, weakened, or torn. The injury commonly affects the area where the abdominal muscles and muscles of the inner thigh attach near the pubic bone.
Although athletes are commonly affected, athletic pubalgia can occur in anyone who regularly performs strenuous movements involving the hips, pelvis, and abdominal muscles.
Is a Sports Hernia a Real Hernia?
No. A sports hernia is not a true hernia.
With a traditional hernia, tissue or an organ pushes through a weakened area of the abdominal wall. An inguinal hernia, for example, may produce a noticeable bulge in the groin.
A sports hernia is primarily a soft tissue injury and typically does not cause a visible lump or bulge.
In some cases, weakness in the affected area may occur along with or contribute to the development of an inguinal hernia. Because several conditions can cause similar groin pain, an evaluation is important for determining the underlying cause.
What Causes a Sports Hernia?
Sports hernias are commonly associated with forceful or repetitive movements involving the lower abdomen, hips, and pelvis.
Activities that may contribute to athletic pubalgia include:
- Sudden changes in direction
- Twisting or pivoting
- Kicking
- Sprinting or accelerating quickly
- Jumping
- Repetitive high-intensity training
- Activities that place significant stress on the abdominal and inner thigh muscles
Sports such as soccer, football, hockey, and wrestling frequently involve these types of movements.
Muscle weakness, poor conditioning, or an imbalance between the abdominal and hip muscles may also contribute to injury.
What Does a Sports Hernia Feel Like?
The primary symptom of a sports hernia is pain in the lower abdomen or groin, particularly during physical activity.
Symptoms may include:
- Groin pain during running, kicking, twisting, or cutting movements
- Lower abdominal pain during strenuous activity
- Pain that improves with rest and returns when activity resumes
- Tenderness around the groin or pubic area
- Pain during sit-ups or other movements that engage the abdominal muscles
- Pain when coughing or sneezing
- Difficulty returning to sports because of recurring groin pain
Unlike an inguinal hernia, a sports hernia usually does not produce a visible bulge.
Sports Hernia vs. Inguinal Hernia: What Is the Difference?
A sports hernia and an inguinal hernia can both cause groin pain, but they are different conditions.
Because the symptoms can overlap, a physical examination is often necessary to determine what is causing the groin pain.
How Is a Sports Hernia Diagnosed?
Diagnosing athletic pubalgia usually begins with a review of your symptoms, activities, and how the injury occurred.
Physical Examination
During an examination, a provider may check for tenderness in the lower abdomen and groin and ask you to perform movements that engage the affected muscles.
This may include movements such as resisted abdominal contraction or a sit-up to determine whether they reproduce the pain.
The examination can also help determine whether a traditional inguinal hernia or another condition could be responsible for the symptoms.
Imaging
Imaging may be recommended when the diagnosis is unclear or when other causes of groin pain need to be evaluated.
Tests may include:
- MRI to evaluate muscles, tendons, and other soft tissues
- X-rays to evaluate certain bone or joint problems
- Ultrasound to examine structures in the groin and help distinguish between possible causes
- CT imaging in selected cases
The appropriate imaging study depends on the patient's symptoms and examination findings.
How Is a Sports Hernia Treated?
Treatment depends on the severity of the injury, how long symptoms have been present, and the patient's activity goals.
Nonsurgical Treatment
Conservative treatment is often considered first.
Treatment may include:
- Temporarily reducing activities that trigger pain
- Rest and other measures to manage discomfort after an acute injury
- Physical therapy
- Exercises to improve abdominal, hip, and inner-thigh strength and flexibility
- A gradual return to exercise or sports
The goal is to reduce pain, restore strength and mobility, and allow a safe return to normal activity.
Does a Sports Hernia Require Surgery?
Not everyone with athletic pubalgia needs surgery.
Surgery may be considered when symptoms continue despite an appropriate period of nonsurgical treatment or when the injury significantly limits sports, exercise, work, or everyday activities.
The surgical approach depends on the structures involved and the patient's individual condition. A surgeon can determine whether surgical treatment is appropriate after reviewing the symptoms, examination findings, imaging, and response to conservative treatment.
How Long Does a Sports Hernia Take to Heal?
Recovery from a sports hernia varies.
Factors that can affect recovery include:
- Severity of the injury
- Tissues involved
- Whether treatment is surgical or nonsurgical
- Physical demands of the patient's sport or occupation
- Response to physical therapy and rehabilitation
- Overall health
Returning to activity too quickly may cause symptoms to return. Patients should follow their healthcare team's recommendations for gradually resuming exercise, sports, lifting, and other strenuous activities.
Can a Sports Hernia Get Worse?
Persistent athletic pubalgia can cause chronic groin pain and make it difficult to participate in sports or other physical activities.
A sports hernia may also occur alongside other causes of groin pain, including an inguinal hernia. In some cases, weakness in the affected area may eventually be associated with the development of a traditional inguinal hernia.
Persistent or worsening symptoms should be evaluated rather than repeatedly exercising through the pain.
Can Sports Hernias Be Prevented?
Not every sports hernia can be prevented, but conditioning and training practices may help reduce stress on the muscles of the lower abdomen and groin.
Helpful strategies may include:
- Strengthening the abdominal, hip, and pelvic muscles
- Gradually increasing training intensity
- Warming up before strenuous activity
- Maintaining flexibility
- Using proper technique during lifting and athletic movements
- Allowing adequate recovery between demanding workouts
Learn more about proper lifting techniques and hernia prevention.
When Should You See a Doctor for Groin Pain?
Consider scheduling an evaluation if groin pain:
- Persists despite rest or activity modification
- Repeatedly returns when you exercise
- Makes it difficult to run, twist, kick, or participate in sports
- Interferes with everyday activities
- Is accompanied by a new groin bulge
Groin pain has many possible causes, so an evaluation can help distinguish athletic pubalgia from an inguinal hernia, muscle strain, hip problem, or another condition.
Sports Hernia Care in the East Bay
Hernia Innovations provides evaluation and treatment for patients with sports-related groin pain and other suspected hernias in the East Bay.
Our board-certified surgeons evaluate each patient individually to determine whether symptoms are related to a traditional hernia, athletic pubalgia, or another condition and discuss appropriate treatment options based on the diagnosis.
Call (925) 940-1025 or request an appointment online.
Frequently Asked Questions About Sports Hernias
Does a sports hernia cause a lump?
Usually not. Athletic pubalgia is a soft tissue injury and generally does not produce the visible groin bulge associated with a traditional inguinal hernia.
Can you have a sports hernia without being an athlete?
Yes. Although the condition is common in athletes, similar injuries can occur in active adults who perform repetitive twisting, kicking, sprinting, or other strenuous movements involving the lower abdomen and groin.
Does a sports hernia heal on its own?
Symptoms may improve with rest and conservative treatment, but persistent injuries may require physical therapy or additional treatment. An evaluation can help determine the severity of the injury and appropriate next steps.
Can a sports hernia turn into an inguinal hernia?
They are separate conditions, but a sports hernia can occur alongside an inguinal hernia. In some cases, weakness in the affected groin tissues may eventually contribute to the development of a traditional inguinal hernia.
What kind of doctor treats a sports hernia?
Treatment can involve sports medicine physicians, physical therapists, orthopedic specialists, or surgeons depending on the cause and severity of the groin pain. If a true hernia is suspected or surgical treatment is being considered, evaluation by a surgeon may be appropriate.
Take the Next Step Toward Hernia Relief
If you’re experiencing hernia symptoms or have already been diagnosed, our board-certified hernia specialists are here to help. We’ll evaluate your condition, explain your treatment options, and guide you through the next steps with expert care.
