Athletic pubalgia is an injury that causes groin and lower abdominal pain in athletes. It is thought to involve injury to tissue of the lower abdominal wall and adductor region in the groin. While many athletes and physicians previously called this injury a sports hernia, the term athletic pubalgia has replaced it since a true hernia of these tissues does not always exist. These injuries often occur in soccer, hockey and football players due to the nature of those sports and the changing of directions required. Nonsurgical treatments are often attempted to try to relieve the athlete’s pain initially. Occasionally surgical treatment is needed.

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MECHANISM OF INJURY
Athletic pubalgia is diagnosed most often in hockey and soccer, probably related to the movements involved in these sports. This is usually an acute, or traumatic, injury. For example, a soccer player might try to cross a ball across his body while an opponent also tries to kick the ball at the same time. When the players leg forcibly stops while the muscles contract, he could injure the muscles and tissues in this region. Athletic pubalgia can also develop with repetitive stress over time.

SIGNS, SYMPTOMS AND DIAGNOSIS
Athletes with athletic pubalgia usually complain of groin pain. Often physical examination can be difficult in these patients, as there is no definitive test for this condition. X-rays and even MRIs often are unremarkable, making this diagnosis even more challenging.

TREATMENT OF ATHLETIC PUBALGIA
Patients can often recover from this condition without surgery. Rest or avoiding offending activities is the first line of treatment. In high-level athletes, especially hockey and soccer, nonsurgical treatment often fails. Symptoms often return when the athletes get back into their sports. Occasionally surgery to address the tendon insertions of the abdominal and adductor muscles to the pubic bones is needed. Fortunately surgery for athletes who truly have athletic pubalgia has good results. Return to sports can occur in 4 to 12 weeks.

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