Athletes, that nagging pain one feels could be a sports hernia

If you play sports like hockey, soccer, wrestling or football, you probably know someone who has experienced a sports hernia — a painful, soft tissue injury that appears in the abdomen.

“Though symptoms are similar to a traditional hernia, a sports hernia is not really a hernia at all, the conditions are very different,” said Geisinger fellowship trained family and sports medicine physician, Dr. Aaron Dawes.

Both injuries occur in the abdomen as a result of overuse, but with a traditional hernia the abdominal wall weakens and eventually a hole forms in this wall, allowing tissue or organs to push through and create a bulge. This can be very painful. A sports hernia is actually called an athletic pubalgia and is caused when the tendons that attach to the pelvis are torn. A sports hernia doesn’t have the telltale abdominal bulge.

Now that you know the difference, here’s what else you need to know about the diagnosis, treatment and prevention of a sports hernia.

Cause, symptoms and diagnosis

Sports hernias are most common in elite athletes because of the force they exert when twisting their bodies, all while keeping the feet planted — think movements of basketball, baseball, hockey and soccer players. This repeated motion can cause inflammation or a tear in the tendons of the lower abdomen, especially those that connect with the pubic bone.

“Repetitive or explosive motions that affect the lower abdomen are almost always the culprit of a sports hernia,” Dawes said. “But sports hernias can also affect the tops of the thighs.”

Your doctor will test for a sports hernia first with their hands, feeling for inflammation or swelling in the area, but may also recommend an X-ray or MRI to confirm the injury.


In many mild cases, a sports hernia can be healed with rest, regular icing and anti-inflammatory medications like ibuprofen.

“With moderate cases, a patient may need to do several weeks of physical therapy to relearn good habits, in addition to the anti-inflammatory measures like ibuprofen and ice,” Dawes said.

In the case of a severe tear, your doctor may recommend surgery.

“Fortunately, most sports hernia surgeries can be performed with a minimally-invasive endoscopic procedure,” Dawes said. “During the procedure, your orthopaedic surgeon will reattach the tissue or close the tear with a combination of glue, synthetic mesh or sutures. Following the surgery, you will need several weeks of physical therapy, but can expect to be pain-free.”


“The best way to prevent a sports hernia — as well as any many other sports injuries — is through regular symmetrical exercise and thorough stretching,” Dawes said.

Symmetrical exercise will ensure that your core isn’t pulling when your thighs aren’t able to handle the pressure, or vice versa.

Regular stretching keeps the muscle supple and flexible, giving them an added defense against tears.


This is one of a series of articles provided by Geisinger on health and sports.