Athletic Pubalgia

Not to be confused with a traditional hernia, an athletic pubalgia is a sports hernia that occurs in the groin area. It most commonly occurs during activities that require sudden direction changes or intense twisting motions.

A sports hernia can lead to a traditional abdominal hernia, but the two injuries are different. An athletic pubalgia is a strain or tear of any soft tissue in the groin area – whether it be a muscle, tendon, or ligament.

Anatomy

The muscles most often affected by a sports hernia are the obliques in the lower abdomen. Additionally, the tendons that attach those muscles to the pubic bone are especially vulnerable. In many instances, the tendons that attach the thigh muscles to the pubic bone are also injured.

Symptoms

The primary symptom of an athletic pubalgia is severe pain in the groin area at the time of injury. The pain may subside with rest, but can return when trying to engage in athletic activity, especially that which requires twisting.

An athletic pubalgia won’t have a visible bulge like the more common abdominal hernia. However, a sports hernia can eventually lead to an abdominal hernia, and organs may press against the weakened soft tissues in the affected area to form a bulge.

Without treatment, the injury can result in chronic pain that can be debilitating and prevents resuming sports activities.

Treatment

• Nonsurgical treatment.For the first 7 to 10 days, treating with rest and ice can be helpful. A compression or wrap may help further alleviate painful symptoms. Physical therapy exercises can begin after two weeks to help improve strength and flexibility in your abdominal and thigh areas. Your doctor may recommend non-steroidal anti-inflammatory (NSAID) medications to reduce swelling and control pain. Four to six weeks of physical therapy will resolve pain in most cases and allow someone to return to athletic activity. If the pain comes back, however, surgery may be the best permanent solution.
• Surgical treatment. Surgery to repair torn tissues in the groin can be done as a traditional procedure with a long incision, or in a less invasive, endoscopic way. The end result of the two procedures is the same, but in an endoscopy, the surgeon makes smaller incisions and uses a small camera to see the affected area. Your doctor will work with you to create a rehab plan after surgery, and most are able to return to sports 6 to 12 weeks after.

If pain persists after surgery, an additional procedure called an adductor tenotomy may be recommended to address this. This procedure involves cutting the tendon that attaches the inner thigh muscles to the pubis, allowing it to heal at a longer length and relieve tension.

If you are experiencing pain or stiffness in your groin or abdomen, request an appointment with the orthopaedic specialists at Orthopaedic Associates of St. Augustine online or by calling 904-825-0540.