To start here, we need to understand that the groin/hip area is incredibly complex anatomically and biomechanically, with nothing working in isolation. Finding a true, singular, isolated cause of pain in this region is difficult and takes time and patience.
Sometimes called ‘Gilmore’s Groin’, or its most common nickname “sports hernia,” athletic pubalgia is not a true hernia, in that there is no ‘bulge’ or lump, like the more common inguinal hernia.
Instead, it’s a strain or tear in the soft tissues – typically muscles, tendons, or ligaments – in the lower abdomen or groin area.
Symptoms
As mentioned already, the condition can be tricky to diagnose because its symptoms often mimic other groin injuries.
Common signs include:
- Chronic deep groin pain, especially during activity
- Pain that radiates to the lower abdominal area
- Discomfort when coughing, sneezing, or doing sit-ups
- Pain that improves with rest but returns with movement or exercise
- Weakness or instability in the core or hip region
If left untreated, athletic pubalgia can sideline an athlete indefinitely.
Who is at Risk?
Athletic pubalgia is most common in male athletes, particularly in sports that require explosive movements, pivoting, or repetitive twisting. However, it can occur in anyone – from weekend warriors to high-level competitors – who push their core and groin muscles beyond their limits.
Athletes with pubalgia often have an imbalance of the adductor and abdominal muscles, which leads to an increase in the weakness of the posterior (back) wall of the groin
Diagnosis
Assessment should never be rushed (for any condition), and we need to take the time to properly assess your pain using:
- Detailed history
- Physical examination and testing
- Movement assessments
- If some cases, musculoskeletal ultrasound or MRI referrals, when necessary, to rule out true hernias or other hip joint pathology
Accurate, considered diagnosis by an experienced therapist is key because misdiagnosed groin pain can delay recovery and in some cases worsen the condition.
Conservative Treatment?
While some severe cases may require surgical intervention, most patients recover without surgery when managed early and relevantly.
Conservative, non-surgical approach includes:
Soft Tissue Therapy – addressing any tension in soft tissue can ease symptoms and make rehab easier and more comfortable
Rehabilitation/Strength Program – We tailor a strengthening and stability program focused on the core, hip adductors, and lower abdominal muscles.
Sports-Specific Return-to-Play Plans – Gradual reintroduction to activity to ensure you’re not just pain-free, but also more robust, and performing better than before.
Don’t Play Through the Pain
It’s easy to try and “push through” groin pain, but that can make the condition worse.
If you’re experiencing lingering groin or lower abdominal pain – especially if it returns every time you train – please do let me know. Early diagnosis and focused rehab are the fastest way back to where you were.