What Is a Sports Hernia?

A sports hernia, also known as athletic pubalgia, occurs when muscle tissue deep in the lower abdomen or groin tears or pulls. Because you can’t see a bulge, it is not a “true” hernia. However, it still hurts. An injury typically occurs in the area where your abdominal and inner thigh muscles connect near the pubic bone. The area takes a lot of force during initial bursts of activity, such as during a sudden twist or sprint, which can lead to a failure of the tissue to withstand the force over time.

Common Causes of Sports Hernia

A sports hernia isn’t just an athlete’s injury, but sports do set the stage. Quick turns, stops, or explosive movements create the perfect storm, especially when your core or hips aren’t quite pulling their weight.

Common culprits include:

• Sharp twisting motions while running or pivoting
• Sudden stops or changes in direction mid-play
• Overuse, especially in contact or field sports
• Weakness or imbalance in your pelvic stabilizers
• Limited hip flexibility or poor movement control

A sports hernia shows up most often in soccer, hockey, football, and rugby. Some basketball or tennis players also develop it. Basically, any sport where fast direction changes are part of the game.

Sports Hernia Symptoms

The pain doesn’t usually come out of nowhere. It builds. One day, you sprint and feel a slight twinge. Then, turning too quickly or even coughing sets it off. Rest helps at first, but the pain often returns the second you push.

What you might notice:

• Pain in your groin or lower stomach that gets worse with activity
• Tenderness near the pubic bone or where your abs meet your thigh
• Discomfort when doing sit-ups, sprints, or directional drills
• No visible lump, but a deep ache that keeps coming back
• Some people feel it radiate into the inner thigh or up toward the core

That last bit is what separates this from a plain groin strain. With a sports hernia, the discomfort spreads more and lingers longer. Basic stretching doesn’t cut it.

Sports Hernia Treatment

You don’t have to jump straight to surgery for a sports hernia. In fact, it’s not always the first option. Many athletes improve with conservative treatment that targets the root cause. Your care plan may involve a combination of guided injections and structured physical therapy, both designed to relieve pain, restore stability, and support a full return to activity.

Physical Therapy for Sports Hernia Rehabilitation

This is where most recoveries start. Physical therapy for sports hernia rehabilitation focuses on what your body’s not doing well. Usually, that’s weak core activation, poor hip control, and muscle tightness throwing things off.

You’ll rebuild from the center outward by doing the following:

• Core and pelvic stability
• Strength, especially in your hip adductors
• Mobility drills to free up your motion
• Eventually, sport-specific movement to prep for return

At University Orthopaedic Associates, our physical therapy and sports rehabilitation team is used to working with athletes and anyone trying to stay active. Therapy won’t feel like a generic workout. It’s personalized, progress-based, and includes testing to track how far you’ve come.

Cortisone or PRP Injections

In some cases, your provider may recommend an injection, such as corticosteroid or platelet-rich plasma (PRP), to help reduce inflammation or support tissue healing. These options are typically reserved for persistent or localized symptoms and are used in combination with other therapies. Your care team will walk you through the risks and benefits to determine if this approach fits within your broader treatment plan.

When Surgery Becomes the Next Step

If therapy doesn’t help after several weeks or you plateau, surgery might be necessary. Procedures vary, but the goal is the same: repair the torn tissue and stabilize the area.

Recovery and Return to Sports

There’s no universal clock for recovery. Some people bounce back fast, while others need time to retrain their movement patterns and rebuild strength. Your path back to full activity will depend entirely on the severity of your injury, the nature of your sport, and whether your treatment is non-surgical or requires surgery.

At UOA, we understand every case is different. We are committed to helping you get back to your best with a care plan tailored to your individual needs. We don’t just clear you when the pain stops.

Request an Appointment With Our Non-Operative Sports Medicine Specialists

If you’ve been dealing with groin pain that won’t go away or keeps coming back after rest, it’s worth getting checked. A sports hernia is easy to overlook, especially early on. But catching it now means a smoother path back.

Our non-operative sports medicine specialists will examine how you move, where you hurt, and what’s behind it. We’ll talk through your goals and build a plan that helps you reach them. If surgery’s the right call, we’ll guide you there, but more often, we help people get better without it.