What is pubalgia?

Pubalgia is a common injury in the groin area. It’s also known as a hockey hernia, Gilmore’s Groin, or a sports hernia.

Despite its many names, pubalgia isn’t a hernia. A hernia happens when an organ or tissue sticks through the muscle or tissue that holds it in place. Pubalgia refers to any strain or tear of the soft tissue in the groin. Over time, pubalgia may turn into a hernia.

It’s often called athletic pubalgia because it’s usually caused by playing sports, especially ones that involve twisting the body, sudden direction changes, or repetitive movements.

The main symptom of pubalgia is sharp pain in the groin. The pain may go away when you’re resting, but it usually returns once you start moving. You might also feel the pain when you cough or sneeze. In addition to pain, you may also feel stiffness or tenderness in your groin.

Pubalgia is caused by damage to the muscles, ligaments, or tendons in the groin area. The injury is usually caused by twisting the body, suddenly changing directions, or doing repetitive movements. Sports and activities that tend to involve these types of movement include:

  • soccer
  • running
  • hockey
  • football
  • wrestling
  • rugby
  • skiing
  • hurdling
  • cricket
  • tennis

Pubalgia can affect anyone, but it’s most common in athletes. Men are also at a higher risk of having pubalgia because the male pelvis is narrower, making it less stable and more likely to get injured.

In addition to giving you a physical exam, your doctor will likely ask you to do a few movements. This will give them an idea of which body parts are affected. They may also perform imaging tests to get a better look at your groin and to see any other injuries, such as a hernia. Imaging tests may include:

While the pain caused by pubalgia might go away when you’re resting, the actual injury usually needs treatment. There are both nonsurgical and surgical options for treating pubalgia. Treatment depends on how serious the injury is.

Nonsurgical treatment

For the first week after the injury, resting and applying an ice pack to your groin can help with pain. You can also take anti-inflammatory medications, such as ibuprofen (Advil, Motrin), to ease the pain. If the pain continues, your doctor might give you a hydrocortisone injection.

After a week or two of rest, your doctor may refer you to a physical therapist. They’ll work with you to rebuild strength in your groin through stretching and strengthening exercises. Some people with pubalgia make a full recovery after four to six weeks of physical therapy.

Surgical treatment

Many people with pubalgia eventually opt for surgery after physical therapy for a better outcome. If you still have pain after several months of physical therapy, you may need to have surgery.

Traditional surgery for pubalgia involves making a cut near the groin and fixing the damaged tissue. Recovery takes about 6 to 12 weeks.

Another surgical procedure called laparoscopy is becoming a common way to both diagnose and treat groin injuries. This involves inserting a thin tube with a tiny camera, called a laparoscope, into your groin to give your surgeon a better view of the damaged tissue. Small instruments can be inserted through another nearby tube to perform the actual surgery.

Recovering from laparoscopy only takes about a week, but you may need to avoid vigorous activity for three to four weeks.

You’ll likely be able to return home the same day after having either traditional or laparoscopic surgery. Your doctor may also suggest doing physical therapy after surgery to rebuild your abdominal strength.

If you regularly play sports, there are several things you can do to reduce your risk of developing pubalgia, including:

  • doing stretches to strengthen your groin
  • warming up and cooling down before and after playing sports
  • using proper form and techniques while playing sports

Most people fully recover from pubalgia, either with physical therapy or surgery, and can return to playing sports within several months. Just make sure to follow any instructions from your physical therapist or surgeon to avoid reinjuring your groin.