What is a Sport Hernia (Athletic Pubalgia): Diagnosis, Symptoms, Treatment

In the last few decades, athletes appear to be suffering more injuries as competition on the field becomes intense. In the 1980s the Gilmore’s groin became a recognizable sport’s injury. It started to be referred to a common and fairly frequent core muscle injury, laughingly hockey groin syndrome, technical osteitis pubis or the less than humorous slap shot gut. Any sport that requires side-wise ambulation, twisting of the torso or waist and speedy rotations with twist changes in direction often leads to athletic pubalgia. The only way to accurately describe the pain from the injury is debilitating and enough to make a grown man drop on the field in tears. In the medical community diagnostic confusion runs rampant because of the complex anatomy involved. The biomechanics that abounds in the pubic symphysis region means that the source of the discomfort is hard to pinpoint.

Understanding What is Sports Hernia?

The term athletic pubalgia, is not just a single injury but a spectrum of problems that are all related pathologic conditions that occur as a direct result of musculotendinous injuries. The answer to the question, ‘What is a sports hernia’ is not clear-cut. There is a definite instability in the pubic symphysis, but there is no actual inguinal hernia.

Most physicians refer to large-field-of-view MRI to access the severity of the situation. They can narrow down the region of the complaint plus delineating the situation to underscore the severity of the injury. To find specific pathologic conditions, the physician should have a very detailed understanding of the anatomy. Please see the pictures.

Understanding Sports Hernia Diagnosis

If you participate in a sport that mandates a quick acceleration, kicking, back-and-forth side-to-side motion, stretches, and quick changes in direction then you are at risk of developing a hockey hernia. Fending, football, soccer, ice hockey, and baseball are just a few such activities that put you at risk. Up to eight percent of all athletes suffer groan and 13 percent of all soccer players complain of the injury. In fact, research reveals that 58 percent of those who thrive in soccer experience a groin injury during their career. The pain first becomes noticeable in the adductor muscle. Many sufferers also have involvement of the testicles and scrotum. Testicular pain is a primary complaint. Tenderness is often noticed at the head of the pubic tubercle. Some also have discomfort at the pubic symphysis. In some circumstances, the lower rectus abdominis musculature is also involved. However, there is no protrusion or noticeable hernia detected. Sports hernia diagnosis is difficult. The injury can occur suddenly or have an insidious onset. The injury can cause suffering from weeks or months. They use conservative treatment regimes that include ample rest.

Using Sports Hernia Treatment Exercises. Sports hernia treatment exercises

An athlete exhibiting signs of groin injury should undergo a period of non-surgical treatment. Non-narcotic analgesics such as acetaminophen and nonsteroidal meds can be used if the player plans to exercises and stay on the field. Corticosteroid injections often enable the player to complete the contract while undergoing sports hernia treatment exercises. Many question the effectiveness of the injections. In the off-season, surgical treatments might be considered.

Nonsurgical Physical Therapy

The proven technique of physical therapy to create core stabilization, normalize the dynamic existence and co-existence of both the hip, groin and pelvic regional muscles plus combine postural retraining is imperative as an aggressive way to improve mobility combined with range of motion. Stretching is also beneficial. Deep hip flexion, heavyweight strength training, and low repetitions should be avoided. Sadly, with nonsurgical therapy, only 50 percent of athletes can play the game again after one year. With surgery, 99 percent can return to the field. The signs must be monitored closely to determine if the physical therapy is working and if it does not appear to be helping, then surgery must be discussed.

Surgical Treatment Options

Surgical treatment is an effective option for Gilmore’s groin. Many seek it out first.

Pain of the Athletic Pubalgia

The hallmark of any sports injury is a pain. As many as 18 percents of all athletes experience sharp groin pain.

Other symptoms include:

  • Sharp pain that feels like a knife has been jammed into the groin occurs when the athlete tries kicking, sprinting, running, pivoting, or twisting.
  • Pain is also experienced whenever you try to sit up from a prone position.
  • The sharp pain reaches deep into the inner thigh.
  • Often only one side of the groin experiences discomfort.
  • There is no pain when laying in bed or asleep
  • The region feels tender to the touch or pressure
  • The lower abdominal area may also hurt if you press on it.
  • Experience pain when bearing down.

What Can be Done to Ease the Groin Pain?

If you are in pain, then you are probably seeking solace and relief. Here are a few tricks that can ease your discomfort.

  • Icing Combined with Compression: Using ice cubes in a pack and also consider compression.
  • Stretching: Exercises to stretch the muscles in a goal to improve flexibility.
  • Manual therapy: Try hands-on stretching.
  • Return-to-sports drills: Depending on your sport of choice, you will need to focus on preparing your body. Light running, leg movements, core stretching, and hip swivels are beneficial.
  • Strengthening: Hip and core strengthening



Article References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931344/
  2. https://pubs.rsna.org/doi/10.1148/rg.285075217#R4
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931344/#bibr4-1941738114523557
  4. https://www.moveforwardpt.com/SymptomsConditionsDetail.aspx?cid=b6f21623-ecb5-41a6-9774-8d48711075d9