Groin pain is one of the first and most telling signs of a sports hernia, a condition that affects up to 25% of athletes at some point in their careers. But sports hernias aren’t limited to sports-related injuries. With the right approach, including physical therapy, most individuals can recover well and return to the activities they love.
What Is a Sports Hernia?
A sports hernia (technically known as athletic pubalgia) is a soft tissue injury involving a tear or strain in the muscles, tendons, or ligaments of the lower abdominal or groin region. Although it’s referred to as a “hernia,” this injury doesn’t produce a visible bulge like a traditional inguinal hernia. Instead, it leads to persistent groin pain that worsens with activity.
The most commonly affected tissues include:
- The oblique muscles along the sides of the abdomen
- Tendons that connect these muscles to the pubic bone
- Tendons that anchor thigh muscles to the pubic bone
While frequently seen in athletes who play sports that involve sprinting, twisting, and pivoting—such as hockey, soccer, tennis, and basketball—sports hernias can also occur in non-athletes. Contributing risk factors include:
- Weak abdominal or core muscles
- Overuse from repeated kicking or twisting
- Muscle imbalances between the core and the hips
- Poor technique in high-intensity workouts
Sports Hernia vs. Inguinal Hernia
Although often confused, these are distinct conditions. An inguinal hernia occurs when abdominal contents, such as intestines, protrude through a weak spot in the abdominal wall, often creating a visible bulge. In contrast, a sports hernia involves internal soft tissue damage without a protrusion. Both can cause pain, but the treatment paths may differ.
What Does a Sports Hernia Feel Like?
Most individuals with a sports hernia describe:
- Sharp or burning groin pain during movement
- Discomfort that lessens with rest but returns with exertion
- Pain that radiates into the inner thigh or lower abdomen
- Difficulty with everyday actions like coughing, sneezing, sprinting, or sitting up
The pain often lacks a clear point of origin, making diagnosis more challenging.
Diagnosing a Sports Hernia
Physical therapists play an essential role in identifying sports hernias. A thorough evaluation typically includes:
- Medical history review
- Movement assessments (such as resisted sit-ups or leg raises)
- Palpation of the groin and abdominal regions
If needed, your therapist may refer you for imaging studies like MRI or ultrasound to confirm the diagnosis and rule out other causes.
How Physical Therapy Can Help
For most mild to moderate cases, surgery isn’t necessary. Physical therapy provides a comprehensive and non-invasive path to recovery that focuses on:
- Pain relief and inflammation control through manual therapy, soft tissue techniques, and gentle stretching
- Strengthening exercises for the core, hips, and pelvis to restore muscular balance and stability
- Mobility and flexibility training to reduce stiffness and promote healthy movement
- Postural and movement education to prevent re-injury and protect the opposite side
- Gradual return-to-sport conditioning, incorporating sport-specific drills tailored to your needs
Your therapist may also recommend temporary training adjustments to reduce aggravating movements.
Physical Therapy After Sports Hernia Surgery
For more severe cases requiring surgical repair, physical therapy remains crucial to recovery. Post-operative rehab can:
- Reduce swelling and scar tissue formation
- Restore core strength and coordination
- Improve flexibility and range of motion
- Support pain-free return to daily activities and athletics
In fact, pre-surgery therapy (or prehab) is often recommended to help patients build strength and resilience ahead of their procedure—leading to better surgical outcomes and faster recovery.
How Long Does Recovery Take?
Recovery times vary based on severity and treatment. With physical therapy alone, mild injuries may resolve within 6 to 12 weeks. If surgery is required, it may take several months to fully return to sport, depending on adherence to rehab and individual healing rates.
Take the First Step Toward Healing
If you’re experiencing groin pain—especially during twisting, running, or core workouts—it may be more than a simple muscle strain. Early intervention can prevent the need for surgery and get you back to full strength faster. A licensed physical therapist can help pinpoint the issue and build a treatment plan that gets you moving confidently again.
