Sports hernia (athletic pubalgia)

You may be experiencing a sports hernia if you notice: 

• Sharp or burning pain in the lower abdomen or groin after activity
• Pain that improves with rest but returns during exercise
• Discomfort when twisting, coughing or sneezing
• Tenderness near the pubic bone
• Pain that radiates into the inner thigh
• Weakness or instability during sprinting, cutting or core exercises 

Unlike a traditional inguinal hernia, a sports hernia usually doesn't produce a visible bulge. Because symptoms can overlap with other conditions, an accurate evaluation from a specialist is essential.

Sports hernias typically develop from a combination of overuse, muscular imbalance and mechanical strain. Contributing factors may include: 

• Repeated twisting, cutting or pivoting movements
• Sudden changes in direction while running or skating
• Core muscle weakness or tight hip flexors
• Muscle fatigue that increases stress on the lower abdomen
• Direct trauma to the groin area 

Understanding how your injury developed allows your care team to address not only the tear itself but also the underlying factors that contributed to it. 

Certain factors can raise your risk of developing a sports hernia, though having one or more of these doesn't mean you'll experience this injury: 

• Participation in sports with frequent twisting, cutting or kicking, such as soccer, hockey, football or tennis
• Core muscle weakness or tight hip flexors
• Muscle fatigue from intense or repetitive training
• A history of groin or lower abdominal strain 

Knowing your personal risk factors can help your care team guide training adjustments and recovery planning. 

At Novant Health Orthopedics & Sports Medicine, diagnosing a sports hernia starts with a detailed discussion of your symptoms and activity history, followed by a physical examination to identify areas of tenderness and weakness. Your care team may also use movement testing to reproduce your pain pattern and imaging studies, such as MRI or ultrasound, to assess the soft tissue injury. Because conditions like hip impingement and adductor strain can mimic athletic pubalgia, precise diagnosis is key to an effective treatment plan.