Everything you need to know about pain and how we can help you

Athletic pubalgia or sports hernia is a painful soft tissue injury of the groin area which can become chronic and disabling if not treated. It most often occurs during sports that require sudden changes of direction or twisting movements. Groin pain might be the result of something as simple as a muscle strain or a much more serious injury.

The anatomy involving athletic pubalgia is complex. From an anatomic perspective, all the muscles that attach to the pubic symphysis are important. There are many different types of tissue in the lower abdomen and upper thigh and pelvis that can be involved, including muscles, tendons, nerves, and ligaments that are connected to either the lower abdominal muscles (especially the obliques) or the adductors (inner thigh muscles), or both. A number of different types of soft tissue injuries occurring in this pelvic area are included in the diagnosis of athletic pubalgia.

Following sporting activity, the person with athletic pubalgia will often be stiff and sore. The day after a match, just getting out of bed or a car might be difficult.


  • The initial treatment for any kind of muscle injury often involves rest from sports, ice, and compression using a special type of shorts.
  • Anti inflammatory medications.
  • Physical therapy which involves core and pelvic stabilization, strengthening, and flexibility training.
  • Surgery: There are many types of surgeries depending on the origin of the problem, varying in effectiveness and success. Adductor tenotomy may be recommended for inner thigh pain, for example. The tendon that attaches the inner thigh muscles to the pubis is cut to release tension. The tendon will then heal at a greater length to relieve the problem. Surgery isn’t always effective and post-operative pain is sometimes treated with a procedure called inguinal neurectomy in which the inguinal nerve is cut.


Prevention, of course, is the best medicine. In most cases, especially those of non-athletes, the problem originates in muscles that are too tight to begin with. Working with athletes I find that strength and performance training often lacks the flexibility component that is so necessary for avoiding this type of injury.

Athletic pubalgia is often no more than a case of overly tense muscles resulting in tension on the attachment to the pubic bone, causing inflammation and frayed tendons. A common pattern is hyper-extension of the abdominals and hyper-abduction of the inner thigh muscles. Techniques are used in DMR Therapy® to release the tension in all the affected muscles. This, in itself, can bring immediate relief. It also creates an environment for healing by increasing blood and lymph flow to the area. By working carefully on the attachments, pain often decreases significantly.

As I mentioned above, it is difficult to generalize because of the imprecision of the term athletic pubalgia, but I’ve found that in many cases, these techniques can be much more effective than cutting tight tendons or undergoing surgery to release entrapped nerves. Relief can be immediate in a way that surgery never is.

See also Osteitis Pubis

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