Overcoming a sports hernia: What physical therapy for active recovery looks like

If you’re an athlete and you’ve been diagnosed with a sports hernia, often called athletic pubalgia, you know it’s a frustrating injury. It causes deep, nagging pain in your lower abdomen or groin, especially during running, kicking or twisting. Unlike a regular hernia, it doesn’t involve an organ pushing through a wall, but rather tears, strains or sprains to the muscles, tendons or ligaments in the lower core and groin area. It can feel like your body is telling you to stop doing the thing you love most. 

The good news is that for most athletes, surgery isn’t the first step. Physical therapy is the cornerstone of healing, focusing on active movement rather than rest. 

Physical therapy: Your game plan for recovery

A sports hernia happens because the deep core muscles and the muscles that attach to the pelvis are unbalanced. A PT recovery program focuses on restoring this balance and making your core stronger than it was before the injury.

Here are the key aspects of active physical therapy recovery:

• Core and hip stability

The injury often results from a weakness in the deep abdominal muscles, like the transversus abdominis. We start with gentle exercises to help you feel and activate these stabilizing muscles. This creates a strong base to protect the injured area. 

• Progressive groin strengthening

One of the most important steps is strengthening the adductor muscles, inner thigh and groin, and balancing them with the stronger abdominal muscles. We use controlled, progressive resistance exercises. This is done carefully to strengthen the injured tissue without pushing it too far, too fast. 

• Flexibility and mobility

Tight hip flexors or rigid hamstrings can put stress on the entire core-pelvic complex. Your physical therapist will introduce stretches and soft tissue mobilization techniques to restore healthy, balanced movement around the pelvis. This can help decrease chronic tension in the injured area. 

• Sport-specific movement

Once your strength is stable, we move into exercises that mimic your sport’s demands. This includes controlled twisting, cutting and rotational movements. We practice proper form and mechanics to ensure that your core is better prepared to handle the forces required for running, kicking or pivoting safely. 

• Return-to-play decisions

Your therapist works with you to decide when it’s truly safe to go back to full competition. We use clear, measurable milestones, not just how you feel, to ensure that your core and groin are ready to handle the highest levels of athletic stress, which can help prevent you from reinjuring yourself. 

Let REPAIR SI help you achieve your comeback

A sports hernia is a tough injury, but it doesn’t have to end your season or your career. Physical therapy offers the most effective, accessible path to recovery. The dedicated, empathetic team of professionals at REPAIR SI understands the athlete’s drive. We provide treatments focused on getting you back to your sport stronger and more resilient than before. 

Contact our team today for more information or to schedule an initial appointment.