A sports hernia, medically termed athletic pubalgia, is a soft tissue injury that causes pain in the groin and lower abdominal area. Despite the misleading name, it is not a traditional abdominal hernia where an internal organ protrudes through a tear. Instead, it involves a strain or tear of the muscles, tendons, or ligaments in the lower abdominal wall where they attach to the pubic bone. Understanding the sensory experience of a sports hernia is the first step toward recognizing this often-misdiagnosed injury.
The Primary Location and Quality of Pain
The pain associated with a sports hernia is felt deep in the groin or lower abdomen, often concentrated near the pubic bone. This discomfort is usually unilateral, affecting only one side of the body, though it can occasionally be bilateral. When resting, the sensation may be a persistent, dull ache, sometimes mistaken for general muscle soreness.
Upon movement, the quality of the pain shifts. Patients describe a sharp, burning, or stinging sensation that flares up briefly before settling back into a dull throb. This pain is often challenging to pinpoint, sometimes radiating toward the perineum, the upper inner thigh, or the scrotum in males. The pain tends to be nagging, gradually worsening over weeks or months rather than occurring as a single, acute event.
Specific Movements That Worsen the Pain
The most telling symptom of a sports hernia is the intense, sharp pain triggered by activities that increase pressure within the abdominal cavity or require forceful twisting. High-speed athletic movements involving sudden acceleration, deceleration, or cutting—such as those common in hockey, soccer, or football—will intensify the discomfort. Specifically, forceful hip rotation, rapid pivoting, or a powerful kicking motion can cause a sudden, severe flare-up of the deep groin pain.
Activities of daily living that engage the core muscles also provoke symptoms. These actions include performing a sit-up or similar trunk flexion against resistance, coughing forcefully, or even sneezing. While the pain often subsides once the aggravating activity is stopped, the inability to perform these simple movements without discomfort is a hallmark sign of the condition.
How a Sports Hernia Differs from a Groin Strain
A common point of confusion is distinguishing a sports hernia from a simple groin strain, which is an injury to the adductor muscles of the inner thigh. A typical groin strain usually presents as an immediate, sharp pain localized clearly on the inner thigh muscle belly during an acute overstretching event. This muscular injury generally responds well to rest and is primarily aggravated by movements that stretch or contract the inner thigh muscles.
The sports hernia, in contrast, involves soft tissue damage closer to the junction of the abdominal muscles and the pubic bone. Its pain tends to be deeper, centered in the lower abdomen or the inguinal region. While a muscle strain is often felt immediately and acutely, the pain from a sports hernia develops gradually, worsening over time and often becoming most noticeable after a sporting activity has concluded.
What to Do After Recognizing the Symptoms
Recognizing the specific pattern of deep, exertion-dependent pain in the lower abdomen and groin suggests the presence of athletic pubalgia. The immediate next step is to reduce or stop the activities that cause the sharpest pain. Continued high-intensity training will likely worsen the soft tissue damage and prolong recovery.
Seek an evaluation from a healthcare professional, such as a sports medicine physician or an orthopedic specialist. Due to the complex anatomy of the groin and the potential for other conditions to mimic these symptoms, a medical professional is necessary for diagnosis. They will perform a detailed physical examination, often including specific maneuvers like a resisted sit-up to test the integrity of the abdominal wall. An MRI scan is frequently used to confirm the diagnosis by visualizing any tears or strains in the relevant soft tissues and ruling out other sources of pain.