Sports hernia: causes, symptoms, and treatments
Learn about sports hernia causes, symptoms, treatments, and exercises. Discover how to recover safely and prevent future injuries with expert advice.
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Despite its name, a sports hernia isn’t actually a hernia. It refers to a strain or tear in the muscles of the lower abdomen and groin area, often caused by athletic activities. “But nothing is herniating or bulging through the abdominal wall,” explains Samantha Stewart, PT, DPT, a physical therapist at Hinge Health.
While it’s not a true hernia, a sports hernia can still be painful and disruptive if left untreated. Over time, it may even increase your risk of developing a true hernia, which occurs when internal organs push through a weak spot in the abdominal muscles. Fortunately, most sports hernias improve with conservative treatments like exercise and physical therapy.
Read on to learn more about sports hernias, including their causes, treatments, and exercises recommended by Hinge Health physical therapists to aid recovery.
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Samantha Stewart, PT, DPT
Dr. Stewart is a Hinge Health physical therapist with over 8 years of experience. She is certified in myofascial trigger point therapy. Read More
Bijal Toprani, PT, DPT
Dr. Toprani is a Hinge Health physical therapist. She is a movement specialist and an experienced PT with 10 years of combined experience in the fitness and physical therapy industries. Read More
What is a sports hernia?
A sports hernia, also known as athletic pubalgia, occurs when a muscle or tendon in your lower abdomen or groin is overstretched or torn. This area between your lower abdomen and upper thighs can be affected during intense physical activity.
A sports hernia is often confused with an abdominal or groin strain, but a sports hernia specifically affects muscles that attach to your pelvis, such as the adductors in your inner thighs and the obliques in your abdomen. It’s generally more severe than a groin strain and is more likely to result from strenuous sports activities.
Causes of a sports hernia
A sports hernia is often the result of high-intensity movements that place significant stress on your abdominal and hip muscles. Activities like jumping, twisting, kicking, or sudden directional changes — especially when your feet are firmly planted — can lead to this type of injury. Sports hernias are common among athletes across a variety of sports, from football and soccer to tennis, skiing, and even recreational pickleball.
Other factors that can contribute to a sports hernia include:
Lack of conditioning. Jumping into a sport without adequately preparing your body can increase your risk of injury, including a sports hernia.
Muscle weakness. Weakness in your core and lower body muscles may limit your ability to handle the physical demands of an activity, leading to strain in your groin or lower abdomen.
Muscle imbalances. Disparities in strength between abdominal and hip muscles, like the adductors, can place extra strain on certain areas, raising your risk of a sports hernia.
Muscle tightness. Limited flexibility can make muscles more susceptible to strains and other injuries.
Fatigue. Playing a sport or exercising while exhausted can increase your injury risk, even if you’re otherwise well-conditioned. Similarly, insufficient recovery time between intense workouts or games can lead to overuse injuries.
Symptoms of a sports hernia
Most of the time, you can pinpoint the moment you get a sports hernia. “People will say, ‘I went to kick the soccer ball’ or ‘I was tackled,’” says Dr. Stewart. “You can tie it to a precise moment of pain.” The initial pain is usually sharp and shooting, but over time becomes more diffuse and harder to pinpoint.
Other common symptoms of a sports hernia include:
Pain in your lower abdomen, pelvis, or groin.
Pain that radiates to other areas like your inner thigh.
Pain that becomes more dull or burning after the initial injury.
Pain that gets better with rest.
Pain that tends to increase with specific movements, like twisting, kicking, and sitting up.
Worsening pain after sneezing or coughing.
Exercises for sports hernia
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- Seated Hip Adduction
- Seal Stretch
- Plank on Knees
- Side Plank on Knees
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
These exercises, recommended by Hinge Health physical therapists, are specifically designed to stretch and strengthen your lower abdomen and groin muscles, which play a critical role in supporting your body during physical activity. By improving mobility and stability, they aid in a safe recovery and also help reinforce the area to reduce the risk of future injuries. “Strengthening these muscles is important because weakness and lack of activation in this region are common contributors to sports hernias,” explains Dr. Stewart.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Treatments for a sports hernia
“You can get a lot of benefit from conservative treatments for a sports hernia,” says Dr. Stewart. “Making time for physical therapy and exercise can make a big difference in getting back to the activities you love.” With the right care, a sports hernia can often be managed successfully, helping you avoid complications like chronic pain or the need for surgery. Here’s how to effectively treat and recover from a sports hernia.
Do physical therapy. Recovery from a sports hernia requires balancing rest and activity. Rest helps ease pain, but movement is essential for healing. A physical therapist can design a personalized plan to restore strength, mobility, and function while preventing further aggravation. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.
Rest strategically. “Take time to back off from intense activities like sports,” advises Dr. Stewart. However, complete rest isn’t ideal. Gentle movement can support blood flow and healing better than prolonged inactivity.
Use ice for pain relief. Applying an ice pack for 10–15 minutes, two to three times a day during the first week after injury can help reduce pain and inflammation. “Ice can be particularly useful after exercise to help manage discomfort,” says Dr. Stewart. If icing continues to provide relief, you can keep incorporating it into your routine as needed.
Stay active with gentle movement. “When you have a tear or strain, the body’s natural response is to tighten up,” explains Dr. Stewart. This tightness can reduce flexibility and increase the risk of reinjury. Incorporating gentle stretches and mobility exercises can help restore range of motion without putting too much strain on the injured area.
Strengthen the affected muscles. Once your initial pain has subsided, targeted strengthening exercises help rebuild the stability and function of weakened muscles. A gradual approach to strength training will help restore balance and support to your groin and abdominal area.
Use over-the-counter (OTC) pain relievers. Pain relievers, such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol), can help ease the pain and reduce inflammation to aid in healing. They should be a short-term tool to help you get back to your normal activities and increase movement. It's important to make sure that you can safely take these medications based on your medical history.
PT tip: Ensure a complete recovery
“A weak core or muscle imbalances are common risk factors for a sports hernia,” says Dr. Stewart. “Unfortunately, a sports hernia can also cause these issues, increasing the risk of developing an abdominal hernia. That’s why it’s important to focus not just on recovery but also on strengthening and addressing these underlying factors. By doing the work now, you can prevent the injury from becoming a chronic problem or leading to further complications.”
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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References
Brown, A., Abrahams, S., Remedios, D., & Chadwick, S. J. (2013). Sports hernia: a clinical update. British Journal of General Practice, 63(608), e235–e237. doi:10.3399/bjgp13x664432
Kopscik, M., Crisman, J. L., Lomasney, L., Smith, S., & Jadidi, S. (2023). Sports Hernias: A Comprehensive Review for Clinicians. Cureus, 15(8). doi:10.7759/cureus.43283
Witstein, J. R., & Wilkerson, R. (2022, June). Sports Hernia (Athletic Pubalgia). OrthoInfo - American Academy of Orthopaedic Surgeons. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/sports-hernia-athletic-pubalgia/