Chronic groin pain in an active person — with no visible bulge. A sports hernia (athletic pubalgia) is not a true hernia at all, which is exactly why it is so often missed. Accurate diagnosis is the treatment.
A sports hernia is chronic pain at the lower abdomen or groin caused by strain or tearing of the soft tissues — muscles, tendons, and the posterior wall of the inguinal canal — where the abdominal wall meets the pelvis. Unlike a classical inguinal hernia, there is usually no defect for tissue to bulge through, which is why examination and even imaging can look deceptively normal.
It is most common in sports that involve repeated twisting, kicking, and explosive change of direction — football, kabaddi, hockey, tennis, sprinting, and fast bowling. But it also occurs in gym-goers and people with physically demanding jobs.
Because the pain overlaps with adductor strains, hip pathology, and early inguinal hernias, patients often spend months bouncing between physiotherapists, orthopaedic clinics, and scans. A focused assessment by a surgeon who sees groin pain every week shortens that journey considerably.
Sports hernia pain has a characteristic pattern. Recognising it early avoids months of frustration.
Deep groin or lower-abdominal pain triggered by sprinting, kicking, twisting, or sit-ups — settling with rest, and returning when you return to sport.
Tenderness over the pubic bone or just above the inguinal ligament; pain on resisted sit-up or resisted hip adduction is typical.
Unlike a classical hernia, there is usually nothing to see or feel — which is why the condition is so frequently dismissed.
Assessment at THI starts with a focused history and examination, dynamic ultrasound, and MRI where indicated — both to characterise the injury and to rule out an occult (hidden) inguinal hernia and hip pathology.
First-line treatment is a structured 6–8 week rehabilitation programme focused on core and adductor strengthening, run with our physiotherapy team. A majority of athletes improve without an operation.
For pain that persists despite proper rehab, laparoscopic (TEP) reinforcement of the posterior inguinal wall with lightweight mesh has strong published outcomes, returning most athletes to full sport within 4–8 weeks. Where the adductor origin is involved, treatment is planned jointly with the rehabilitation team.
Not in the classical sense — there is usually no defect and no bulge. It is an injury of the muscles and tendons of the groin wall. The name is confusing, but the condition is real, common in active people, and very treatable.
Most people do not. A structured 6–8 week rehabilitation programme is first-line treatment and resolves the majority of cases. Surgery is reserved for confirmed cases where pain persists despite proper rehab — in those patients, keyhole repair has excellent outcomes.
Clinically, first — a focused examination by a surgeon experienced in groin pain, supported by dynamic ultrasound and MRI where indicated. The work-up also needs to exclude an early true inguinal hernia, adductor injury, and hip problems, which can all mimic it.
Most athletes return to running by 2–3 weeks and full competitive sport by 4–8 weeks after laparoscopic repair, following a graded return-to-play programme with our physiotherapy team.
Yes — this is the classic sports hernia story. Normal scans do not exclude the diagnosis. Book a consultation; the assessment is clinical, and you will leave with a specific diagnosis and a written plan.
Most consultations result in a clear, written plan within 30 minutes. For outstation patients, we offer teleconsultation before any travel is required.