A sports hernia is a painful injury to the soft tissue of the lower abdomen or groin. A sports hernia is not actually a true hernia. There is no bulge and no organ pushing through a weak spot in the muscle wall. That is why providers often call it athletic pubalgia, which is the more accurate medical name.

The injury usually happens when the muscles or tendons that attach to the pubic bone get strained or torn. Most cases involve muscles in the lower belly or the tendons that connect the thigh muscles to the pelvis. A sports hernia can cause chronic pain that makes it hard to play sports or exercise. The condition can even make routine daily activities uncomfortable or impossible.

Sports Hernia Symptoms

Sports hernia symptoms often start with sharp, sudden pain at the time of the injury. The pain may diminish with rest, but it tends to come back when you return to athletic activity.

Common signs include:

• Groin pain
• Lower belly pain
• Pubic bone tenderness
• Pain when twisting
• Pain with sit ups
• Pain when coughing
• Pain when sneezing
• Inner thigh soreness

The pain can be hard to pin down. It may feel dull or burning, and some people find it hard to explain the exact source of the pain. Many people notice the pain gets worse the day after a sports game or workout. Getting out of bed or stepping out of a car can be difficult. Unlike a regular hernia, you will not see a visible bulge in the groin.

Causes and Risk Factors

Sports hernias usually happen during activities that involve planting your feet and twisting your upper body with force. Repeated kicking, cutting and sprinting can also put a lot of stress on the soft tissue around the pelvis. Over time, this stress can lead to a strain or tear.

Sports that most often lead to athletic pubalgia include:

• Ice hockey
• Soccer
• Football
• Rugby
• Tennis
• Wrestling
• Track and field

You do not have to be a pro athlete to get a sports hernia. Weekend enthusiasts and people who do intense workouts can also develop the condition. Men are affected more often than women. A weak core, poor conditioning and a muscle imbalance between the hips and the abdomen can all raise your risk.

Diagnosis

Diagnosing a sports hernia can be challenging. Groin pain has many possible causes, and more than one problem may be causing pain at the same time. Your Baptist Health provider will start with a careful review of your symptoms and medical history. They will ask about how the injury happened and what activities tend to make it worse.

Next comes a physical exam. Your provider will check for tenderness over the pubic bone and lower belly. They may ask you to do a sit up or tighten your core against resistance. If that feel painful, it is a strong sign of a sports hernia.

Your provider may also order imaging tests to confirm the diagnosis and rule out other problems. Magnetic resonance imaging, or MRI, is the most common test for spotting tears in soft tissue. X rays or a computed tomography (CT) scan may also be used to check for bone issues. In some cases, a small injection of numbing medicine into the area can help pinpoint the origin of the pain.

Treatment

Treatment for a sports hernia almost always starts with conservative care. The goal is to relieve the pain, let the tissue heal and rebuild strength. Surgery is only considered if these steps do not bring enough relief.

Non Surgical Treatment

Most people with a sports hernia start with non surgical care. Your provider may recommend:

• Rest and ice for the first 7 to 10 days after the injury.
• Anti-inflammatory medication to reduce pain and swelling.
• Physical therapy to strengthen the core, hips and inner thigh muscles.
• Activity changes to avoid movements that make the pain worse.
• Cortisone or platelet rich plasma injections.

Physical therapy is a big part of recovery. A structured program usually starts about two weeks after the injury. Four to six weeks of therapy is often enough to ease the pain and get back to sports or exercise.

Surgery

If the pain does not go away with conservative care, surgery may be the next step. Surgery repairs the torn tissue and reinforces the wall of the lower abdomen. Your provider may use open surgery or a minimally invasive approach with small incisions and a tiny camera. In some cases, a small piece of mesh is used to support the repair.

Most athletes are able to return to sports 6 to 12 weeks after surgery.

Prevention

You cannot prevent every injury, but a few habits can lower your risk of a sports hernia:

• Warm up properly before exercise or games.
• Build core and hip strength as part of your training.
• Stretch regularly to keep muscles flexible.
• Use good form during exercises and sports movements.
• Give your body time to recover between hard workouts.

If you notice groin pain that does not go away after a few days of rest, do not push through it. Getting it checked early can help you avoid a longer injury. A Baptist Health sports medicine provider can help you build a plan to get back in the game safely.