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Sports Hernia / Athletic Pubalgia

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Sports hernias were first described in the early 1980s, and are an increasingly recognised as a cause of chronic groin pain. Injury to a number of high profile athletes has raised the public awareness of this condition. Typically occurring in young athletic males, sports hernias usually present with gradual onset exercise-related groin pain. However, ‘sports hernia’ has been so widely popularised by the media that it is now commonly used by the medical profession, media, and public alike. It is also referred to, and synonymous with, sportsman’s hernia, athletic pubalgia, and Gilmore’s groin. Essentially, sports hernias involve a set of injuries to the area where the abdominal and groin musculature meet known as the inguinal region where the inguinal ligament is located.

Causes & Prevalence

Sports hernias typically affect young males who actively participate in sport. Females are affected, but much less commonly than males, comprising just 3–15% of all sports hernia referrals. It is rare in children and older people. It presents more in patients who actively engage in sport (particularly elite athletes), but it can occur in those that do not. It is more common in patients that participate in football, hockey, and athletics which involve explosive, dynamic movements.


The symptoms of sports hernias are quite consistent and patients will usually present with a combination of:


  • Vague unilateral or bilateral groin pain, difficult to localise, but above the inguinal ligament (line between the tip of the pelvic bone and the pubic bone).
  • Dull/burning in nature.
  • Pain radiates towards the scrotum and inner thigh and can cross mid-line of the body.


Patients complain that the pain occurs on exertion, in particular sprinting, cutting or twisting, side-stepping, kicking, or sitting up. Pain can last for varying periods of time following exertion (ranging from days to weeks). These symptoms tend to be disabling and patients will report that they have had to reduce or cease their participation in sport altogether. Patients will often be unable to recall the exact onset of the pain.


Imaging is useful in patients presenting with chronic groin pain as it can be used to both exclude other pathologies and assist in the diagnosis of sports hernia. The main two imaging modalities used to assist in the diagnosis of sports hernia are MRI and ultrasound.

Treatment & Management

Sports hernias can be managed either non-operatively or operatively.


Non-operative management consists of a combination of:

  • Rest.
  • Physiotherapy.


When the patient is pain free, following this they should attempt to return to sport; if this is unsuccessful, operative management should be considered.


Operative management primarily involves reinforcement of the posterior abdominal wall, which can either be performed open or laparoscopically. Post-operative management includes analgesia and Physiotherapy. Patients can expect to return to full activity between 6 and 12 weeks.



Physiotherapy treatment is important following the surgical repair of a sportsman’s hernia. Your Physiotherapist at Pure will be able to provide you with a personalised rehabilitation plan to strengthen your lower abdominal and pelvic floor muscles. This can accelerate your return to participation in sports and prevent further problems.


Physiotherapy treatment could also include:

  • Mobilisation.
  • Core Exercises.
  • Soft Tissue Treatment.
  • Hydrotherapy pool exercises.


All our Physiotherapists are highly skilled in providing complimentary hands on treatment and will work with you to develop a bespoke  treatment plan to help you recover and return to the activities which are important to you.


Garvey, J. F. W., Read, J. W., & Turner, A. (2010). Sportsman hernia: what can we do?. Hernia14(1), 17-25.


Meyers, W. C., McKechnie, A., Philippon, M. J., Horner, M. A., Zoga, A. C., & Devon, O. N. (2008). Experience with “sports hernia” spanning two decades. Annals of surgery248(4), 656-665.

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