You absolutely can pull a muscle in your pubic area, and it is one of the most common soft-tissue injuries in sports that involve kicking, sprinting, or quick direction changes. The muscle most frequently strained is the adductor longus, a large inner-thigh muscle whose tendon attaches directly to the pubic bone. Because that attachment point is surprisingly small relative to the forces it absorbs, the area is inherently vulnerable to strain. The catch is that “pulled muscle in the pubic area” can mean several different things clinically, some of which heal on their own and others that can sideline you for months.
Why the Pubic Area Is Prone to Muscle Strains
The pubic bone sits at the front of the pelvis, and it serves as an anchor point for muscles pulling in opposite directions. Your abdominal muscles pull upward from above, while the adductor muscles of the inner thigh pull downward and outward from below. The pubic symphysis, the joint where the left and right halves of the pelvis meet at the front, acts as a pivot between these competing forces.
The adductor longus muscle is the one that gets injured most often. Anatomical studies have found that its tendon at the pubic bone has a relatively small cross-sectional area, and a large portion of the muscle attaches directly to bone through muscle fibers rather than through a thick, robust tendon.1PubMed. Analysis of the cross-sectional area of the adductor longus tendon: a descriptive anatomic study That design puts a lot of mechanical stress through a small footprint. The adductor longus tendon also communicates with the rectus abdominis (your “six-pack” muscle), the pubic symphysis capsule, and even the opposite adductor tendon through a web of fibrous connections.2PubMed. Anatomical and mechanical relationship between the proximal attachment of adductor longus and the distal rectus sheath Those connections help transmit force across the pelvis during activities like sprinting and cutting, but they also mean that a strain on one side can create problems across the whole front of the pelvis.
Bipedal posture makes this worse. When humans evolved to walk upright, the pelvis reshaped itself to bear vertical loads it was never originally designed for. The direction of stress through the abdominal and pelvic regions changed dramatically compared to four-legged animals, substantially increasing the mechanical demands on the pubic area.3Asian Journal of Urology. Biomechanical analysis of female pelvic floor anatomy: A novel integrative framework In short, the pubic region is an engineering compromise that works well for everyday walking but is pushed to its limits during explosive athletic movements.
How the Injury Typically Happens
The classic mechanism is a sudden stretch of the adductor longus while the muscle is actively contracting. During a maximal-effort soccer kick, for example, the adductor longus reaches its fastest rate of stretch and its peak hip extension at roughly the midpoint of the leg swing, right as the muscle is firing to control the leg’s motion.4PubMed. Adductor longus mechanics during the maximal effort soccer kick That transition from hip extension to hip flexion is the danger zone: the muscle is lengthening under load at the same time it is trying to contract, and a miscalculation by even a fraction of a second can tear fibers.
This is why certain sports carry higher risk. Soccer, rugby, ice hockey, and other activities involving kicking, rapid acceleration, deceleration, and sudden direction changes place enormous repetitive stress through the pubic symphysis and adductor tendons.5PubMed Central. Osteitis pubis in elite athletes: Diagnostic and therapeutic approach But you do not have to be an elite athlete to strain this area. Weekend warriors who sprint without adequate warm-up, recreational tennis players lunging for a wide ball, or anyone who slips on ice and catches themselves with a leg splayed outward can tear adductor fibers at the pubic attachment.
What It Feels Like
An acute adductor strain at the pubic bone usually produces a sharp, sudden pain in the groin, often right at or near the pubic bone itself. You might feel a “pop” if the tear is significant. The pain typically gets worse when you squeeze your legs together, try to lift your leg, or perform any movement that loads the inner thigh. Coughing or sneezing can aggravate the pain because even those actions tense the abdominal wall and pull on the shared attachments at the pubic symphysis.
Physical examination tests used by sports medicine physicians include things like resisted sit-ups performed in specific positions and checking for adductor tightness. A cross-body sit-up test (done with one leg in a figure-of-four position) and checking for an adductor contracture are highly sensitive for detecting injuries in this region, meaning they almost always come back positive when the injury is present. However, they are not very specific, so a positive test alone does not pinpoint the exact structure involved.6PubMed. Diagnostic Accuracy of Physical Examination Tests in Core Muscle Injury This is why imaging usually follows when groin pain persists.
MRI is the go-to imaging tool for groin pain. It can visualize tears or strains of the adductor tendons, rectus abdominis injuries, pubic bone stress reactions, and other pathology within the hip and pelvis all in one scan.7PubMed Central. Hip Imaging of Groin Pain: Magnetic Resonance and Ultrasound Imaging Features Ultrasound is sometimes used as well, particularly because it can be performed in real time while the patient moves, which helps the clinician see how the tissues behave under stress.
Conditions That Mimic a Pulled Muscle
One of the tricky things about pubic-area pain is that several different conditions can feel almost identical. A straightforward adductor strain is the most common culprit, but if pain lingers or the story does not quite fit, your doctor will consider a few look-alikes.
Athletic Pubalgia (Sports Hernia)
This is not a hernia in the traditional sense. There is no visible bulge and no intestinal tissue poking through. Athletic pubalgia involves weakening or tearing of the abdominal wall near its attachment to the pubic bone, without evidence of a true hernia.8PubMed. Athletic Pubalgia (Sports Hernia): Presentation and Treatment Pain tends to be centered around the pubic symphysis and surrounding structures. MRI can help distinguish it from a pure adductor strain by identifying tears or strains specifically in the rectus abdominis or the aponeurosis where the abdominal and adductor tendons share tissue. Many athletes diagnosed with athletic pubalgia have a spectrum of musculotendinous injuries and instability of the pubic symphysis rather than a single discrete tear.9PubMed. Athletic pubalgia and “sports hernia”: optimal MR imaging technique and findings
Osteitis Pubis
Where a muscle strain damages soft tissue, osteitis pubis involves the bone itself. Repetitive stress transmitted through the pelvis during kicking, rapid acceleration, or sudden direction changes can cause a stress reaction in the pubic bone, leading to inflammation and sometimes a lytic (bone-eroding) response.10PubMed Central. Groin Injuries (Athletic Pubalgia) and Return to Play The classic symptom is pain centered right over the pubic symphysis. Adductor injuries and osteitis pubis frequently coexist: MRI studies in athletes with osteitis pubis classify adductor lesions into acute types (strains and tendon avulsions) and chronic types (tendinopathy and secondary cleft signs), highlighting how closely bone and soft-tissue problems in this area are intertwined.11PubMed Central. Prevalence and patterns of adductor lesions on MRI in athletes with osteitis pubis
Hip Joint Problems
A torn labrum inside the hip joint is one of the sneakier mimics. The labrum is a ring of cartilage around the hip socket, and tears there predominantly produce groin pain, not hip pain where most people expect it. In one study, groin pain was the primary complaint in over 90% of patients with confirmed labral tears.12Journal of Bone and Joint Surgery. Clinical Presentation of Patients with Tears of the Acetabular Labrum Athletes with labral tears sometimes also have persistent adductor strains that do not improve despite adequate therapy, which suggests the two problems can feed each other.13PubMed. Hip injuries and labral tears in the national football league If an apparent pubic-area muscle strain is not getting better after several weeks of rest and rehab, a hip-joint issue deserves investigation.
True Inguinal Hernia
An actual inguinal hernia, where abdominal contents push through the inguinal canal, can also cause groin pain. The term “pubalgia” is sometimes used when physical examination does not reveal a hernia and there is no other obvious cause for groin pain.14PubMed. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia The key differentiator is that a true hernia often produces a palpable bulge, especially with coughing or straining, while a muscle strain or athletic pubalgia does not.
Pregnancy and Pubic-Area Pain
Pubic pain during pregnancy is common enough to have its own name: symphysis pubis dysfunction (SPD). This is not the same injury as a sports-related adductor strain, but it can feel similar. Hormonal changes loosen the ligaments around the pubic symphysis to prepare the pelvis for delivery, and the resulting instability can cause pain at the front of the pelvis, inner thighs, and lower back. Case reports describe pregnant women presenting around 30 weeks with severe one-sided pubic dysfunction accompanied by low back or sacroiliac pain.15PubMed Central. Pregnancy-related symphysis pubis dysfunction management and postpartum rehabilitation: two case reports Postpartum rehabilitation typically focuses on restoring muscular endurance, control, and pelvic stability through progressive exercises.
If you are pregnant and experiencing sharp pain in the pubic area, it is worth mentioning to your provider rather than assuming it is just a normal pregnancy ache. SPD can often be managed with physical therapy, pelvic support belts, and activity modifications, but leaving it unaddressed can make daily tasks increasingly difficult.
Adolescent Athletes and Growth-Plate Vulnerability
Teenagers face a unique risk. Before the skeleton fully matures, the growth plates (apophyses) around the pelvis are the weakest link in the chain. Where an adult would strain a muscle or tear a tendon, an adolescent performing the same explosive movement might instead suffer an avulsion fracture, where the muscle literally pulls a piece of bone away from the pelvis. Awareness of these injuries has grown in recent years thanks to better imaging, but the nonspecific nature of the symptoms means there is still a high risk of misdiagnosis as simple muscle strain or bone bruising.16PubMed Central. Treatment of avulsion fractures of the pelvis in adolescent athletes: A scoping literature review Any adolescent with significant pubic or groin pain after a sudden, forceful movement should be evaluated with imaging rather than simply told to rest a “pulled muscle.”
Recovery and Rehabilitation
Most acute adductor strains in the pubic area heal with conservative management: initial rest, ice, and a gradual return to activity guided by pain. The rehabilitation phase matters more than the rest phase. Strengthening the adductor muscles through progressive loading has become the cornerstone of groin-pain rehab, and one exercise in particular has built a strong evidence base: the Copenhagen adduction exercise.
The Copenhagen exercise is a side-plank variation where the top leg rests on a bench and the bottom leg lifts to meet it, loading the adductors isometrically and eccentrically. Studies have shown it increases adductor muscle thickness by roughly 18% and adductor flexibility by about 7% over a training period.17PubMed Central. Effects of Copenhagen Adduction Exercise on Muscle Architecture and Adductor Flexibility In soccer players with groin injuries, adding the Copenhagen exercise to a standard rehabilitation program produced greater improvements in eccentric hip adduction strength and more pronounced pain reduction compared to standard rehab alone.18PubMed. The effectiveness of the Copenhagen adduction exercise on improving eccentric hip adduction strength among soccer players with groin injury: a randomized controlled trial Those gains disappear after detraining, though, which underscores the need to maintain the exercises long after the pain resolves.
A broader review of groin-pain prevention programs found that the Copenhagen exercise appeared in the majority of effective protocols, sometimes alongside Nordic hamstring exercises, abdominal strengthening, and trunk-hip coordination drills.19PubMed Central. A Scoping Review of Exercises for Preventing Athletic Groin Pain That said, the overall evidence for exercise-based prevention, while encouraging, remains limited in quality.20PubMed. Exercise Interventions for the Prevention and Treatment of Groin Pain and Injury in Athletes: A Critical and Systematic Review The exercises seem to help, but the research community has not yet produced the kind of large, definitive trials that would put the question to rest.
When the Pain Becomes Chronic
For most people, a pubic-area muscle strain resolves within a few weeks to a couple of months. But a subset of patients, particularly athletes who return to sport too quickly or who have underlying biomechanical issues, develop chronic groin pain that lingers for months or longer. Research on professional soccer academy players found that younger players in their teams were at significantly greater risk of developing long-standing pubic-related groin pain, especially during the first part of the competitive season when training loads ramp up.21PubMed Central. Long-standing pubic-related groin pain in professional academy soccer players: a prospective cohort study on possible risk factors, rehabilitation and return to play
Chronic groin pain tends to involve more than just a damaged muscle. Biomechanical analysis of soccer players with a history of adductor-related groin pain suggests the underlying problem is not isolated muscle weakness but rather poor adaptability in motor control, leading to inefficient load distribution across the pelvis.22Applied Sciences. Effects of a History of Adductor-Related Groin Pain on Kicking Biomechanics and HAGOS Subscales in Male Soccer Players This helps explain the frustratingly high recurrence rates: strengthening the adductor alone does not fix the movement pattern that overloaded it in the first place.
Chronic pelvic pain also carries a psychological burden. Fear of re-injury, known as kinesiophobia, and a tendency to catastrophize about pain are both common in people with long-lasting pelvic pain. Treatments that address the physical component while also reducing catastrophizing have shown better psychological outcomes.
Surgery for Groin Pain That Will Not Quit
Surgery is a last resort, reserved for cases where conservative treatment has failed over several months. The two main surgical scenarios are repair or reinforcement of the abdominal wall (for athletic pubalgia) and adductor tenotomy, where the surgeon partially releases the adductor tendon from the bone to relieve chronic tension.
In one study of 48 patients who underwent percutaneous adductor tenotomy for chronic sports-related groin pain, about 60% regained or exceeded their pre-injury activity levels after surgery. The average return to sport was around 18-19 weeks post-operatively, and roughly three-quarters of patients rated the outcome as excellent or very satisfactory. Mean improvements of about 78% in function and 87% in pain were reported.23PubMed. Adductor tenotomy: its role in the management of sports-related chronic groin pain However, average post-surgical activity scores still remained lower than pre-injury levels, meaning full restoration to the athlete’s original capacity is not guaranteed.
Adductor tendon problems can coexist with athletic pubalgia in roughly a quarter of cases, and when they do, the adductor component needs to be addressed surgically at the same time. Patients who had both an abdominal-wall repair and an adductor tenotomy returned to sport in an average of about 12 weeks, somewhat faster than those with isolated adductor surgery.24PubMed Central. Surgical treatment of chronic groin pain in athletes A systematic review of surgical outcomes found that return to pre-injury or higher-level play was more likely after surgery for inguinal-related chronic groin pain (around 92%) than for adductor-related chronic groin pain (around 75%), though the overall quality of the studies reviewed was low.25PubMed Central. Surgical Outcomes of Inguinal-, Pubic-, and Adductor-Related Chronic Pain in Athletes: A Systematic Review Based on Surgical Technique
An Old Injury With a Confusing Name
One reason pubic-area muscle strains are poorly understood by the general public is that clinicians themselves have struggled with terminology for decades. “Sports hernia,” “athletic pubalgia,” “Gilmore’s groin,” “hockey groin,” “osteitis pubis,” and “gracilis syndrome” have all been used to describe overlapping but not identical conditions in the same anatomical neighborhood. The gracilis syndrome, for instance, was described in the 1980s as a fatigue-type avulsion fracture at the pubic bone related to the pull of the gracilis muscle, a condition distinct from but easily confused with an adductor longus strain.26PubMed. Traumatic osteitis pubis: the gracilis syndrome
International consensus efforts in recent years have tried to simplify things by categorizing groin pain based on the structure primarily involved: adductor-related, inguinal-related, pubic-related, or hip-related. That framework is more practical for patients, too. If your doctor tells you the pain is “adductor-related,” that means the inner-thigh muscles at the pubic bone are the primary driver. If it is “pubic-related,” the bone itself or the joint is more involved. Knowing which category your pain falls into shapes everything from the rehab exercises you’ll do to whether surgery is ever on the table.