Conditions
Groin pain in athletes (pubalgia)
Pubalgia is pain in the groin and around the pubic bone that appears mainly in sports with running, changes of direction and kicking: football, rugby, padel, tennis or hockey. It is not a single injury: it can come from the adductors, the pubic bone itself, the abdominal wall, the iliopsoas or the hip, and several are often combined. Identifying the source is what allows a return to sport without relapses. Drawing on fourteen years at Real Madrid and his work in rugby, Dr Julio De la Morena assesses it at Hospital Memorial Publio Cordón (Pozuelo de Alarcón, Madrid).
Common symptoms
- Pain in the groin or pubic area when running, kicking, twisting or accelerating.
- Pain when doing sit-ups, coughing or sneezing.
- Pain that starts mildly after matches and gets worse.
- Groin stiffness in the morning or the day after exertion.
Where the pain comes from
- Adductors: pain on the inner thigh next to the pubic bone, when squeezing the knees together.
- Pubic bone: pain in the central front area.
- Abdominal wall and inguinal area: higher pain that increases with coughing or sit-ups.
- Iliopsoas: deeper pain when lifting the leg.
- Hip: deep pain with twisting, which requires ruling out a joint problem.
How it is diagnosed
Examination with strength and pain tests for each structure is the most important part. Ultrasound in the consultation examines the adductor tendons, the abdominal wall at rest and under strain, and the hip joint. MRI is requested when the pubic bone or the hip needs to be assessed in more detail.
Treatment and return to sport
- Strength programme for the adductors, abdomen and hip, progressing in phases with objective criteria.
- Training load adjustment, without stopping completely when possible.
- Reconditioning with running, changes of direction and kicking before returning to competition, coordinated with physiotherapists and strength and conditioning coaches.
- Ultrasound-guided treatments, including autologous growth factors, in selected chronic adductor tendinopathies.
- Surgical assessment only in specific cases that do not respond.
Frequently asked questions
How long does pubalgia take to heal?
It depends on the structure involved and how long it has been going on. With well-directed treatment, many athletes return within weeks; chronic cases can take several months.
Do I have to stop playing with pubalgia?
Not always. Often you can keep training with adjusted load while following the strength programme. What should be avoided is playing with pain that increases match after match.
Is pubalgia a hernia?
Not exactly. In some cases the pain comes from the abdominal wall of the groin, sometimes called a sports hernia, but many cases of pubalgia come from the adductors or the pubic bone and have nothing to do with a hernia.
Which doctor treats groin pain in athletes in Madrid?
Dr Julio De la Morena, specialist in Sports and Exercise Medicine, at the Regenerative Therapies and Sports Medicine Unit of Hospital Memorial Publio Cordón (Pozuelo de Alarcón, Madrid). Appointments on +34 913 548 990.
Would you like your case assessed?
Examination and ultrasound in the same appointment: you leave with a diagnosis and a plan. First appointment with no commitment to treatment: if nothing is indicated, we tell you.
Hospital Memorial Publio Cordón · Pozuelo de Alarcón · +34 913 548 990 · Mon–Fri, 3 pm to 9 pm
Written and reviewed by Dr Julio De la Morena Garzón, specialist in Sport and Exercise Medicine (Madrid Medical Council no. 281903698). Last reviewed: October 2026. General information that does not replace a medical consultation.