Athletic pubalgia or "sports hernia" for runner
October 17, 2019 12:24 PM   Subscribe

Wondering if anyone's had experience with athletic pubalgia or "sports hernia" causing groin pain, especially runners. What should we know? What treatment did you do and how was the recovery?

This is for patient who's a cis male runner in his 40s, normally running around 30 miles a week. Has had MRIs and x-rays, which show signs of stress fracture in both sides of the pubic symphysis and tearing in the RA-AL muscles. Working with a doctor who has started him off with six weeks of rest, and will obviously follow what the doctor says.

Did you have this and get back to running?
posted by anonymous to Health & Fitness (1 answer total) 1 user marked this as a favorite
There's giant threads on and a triathlon forum whose name escapes me right now, both dating back years and years. Unsurprisingly, follow-through reporting from individual cases is pretty poor , but while trawling I did find a few reports from people who successfully returned to running or other activity. A common theme was greatly increased amounts of cross-training and stretching focused on the pelvic core and adjacent areas, often alongside reduced intensity and/or distance while running.

Then again, from my position (several months and three doctors into looking for the source of some pelvic pain that goes away when I stop running for a few weeks), athletic pubalgia is basically just the term they use when they run out of other options. There seems to be very little similarity between cases, some people respond to surgery and others don't, and there's rarely any smoking gun as to a root cause.

There's some evidence that a conservative approach (i.e. rest, then intensive PT for the core, then a very gradual return to activity with lots of focus on form and plenty of cross training) is successful at least some of the time. But given the grab-bag nature of the diagnosis it seems like in each individual case it's a try it and see approach. Good luck to you or your friend, I hope there's a path through.
posted by Jobst at 1:32 PM on October 17, 2019

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