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Sports hernia
Other Resources UpToDate PubMed

Sports hernia

Contributors: Scott Levy, Katie Rizzone MD, MPH
Other Resources UpToDate PubMed


A sports hernia (also known as athletic pubalgia) is a clinical diagnosis characterized by persistent groin pain resembling hernia pain but not attributed to abdominal or groin wall damage and, therefore, not considered a true hernia. The pathophysiology is believed to be an imbalance between the adductor muscles in the thigh and the abdominal muscles, leading to areas of weakness within the groin. It has gradual onset, is typically unilateral, and occurs more often in men than women. Sporting activities with repetitive high-speed twisting, bending, and torqueing that can cause damage to the abdominal, thigh, and groin muscles are often implicated, particularly when the patient lacks appropriate preconditioning. Sports hernias are most often reported in ice hockey players, football players, rugby players, soccer players, and sprinters, but they are not uncommon in recreational athletes of any sport.


S39.011A – Strain of muscle, fascia and tendon of abdomen, initial encounter

285348005 – Strain of abdominal muscle

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential diagnosis can be split up into 3 categories:

Intra-articular pathologies
Extra-articular pathologies
  • Tendon strain or tendinopathy of hip flexor or adductor origin or rectus abdominis insertion – Physical examination may show focal pain.
  • Adductor muscle strain – Physical examination may show focal pain. MRI may help to confirm.
  • Osteitis pubis – Pubic symphysis tenderness may be present.
  • Pubic ramus stress fracture – Focal tenderness. Plain radiographs and MRI show bony changes.
  • Apophyseal avulsion fracture
  • Snapping hip syndrome – Characteristic "snap" heard by patient or observer.
  • Sacroiliac joint disorder – Tests of pelvic symmetry may be helpful.
  • Lumbar radiculopathy – Characteristic clinical diagnosis.
  • Nerve entrapment (ilioinguinal, obturator)
Non-musculoskeletal disorders

Best Tests

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Management Pearls

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Last Reviewed:11/08/2020
Last Updated:04/26/2023
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Sports hernia
Copyright © 2023 VisualDx®. All rights reserved.