Return to Sport After Surgical Treatment of Athletic Pubalgia - A Review of Current Evidence
DOI:
https://doi.org/10.12775/QS.2026.60.72847Keywords
athletic pubalgia, sports hernia, core muscle injury, groin pain, return to sport, return to play, surgical treatment, athletesAbstract
Athletic pubalgia, also referred to as sports hernia or core muscle injury, is a common cause of chronic groin pain in athletes participating in high-intensity sports involving sprinting, kicking, cutting, and rapid directional changes. Although conservative management is considered the first-line treatment, surgical intervention is frequently performed in athletes with persistent symptoms and unsuccessful rehabilitation.
This review summarizes current evidence regarding return to sport after surgical treatment of athletic pubalgia, focusing on return-to-sport rates, time to return, surgical techniques, rehabilitation, complications, and limitations of the available literature.
A structured literature search was conducted in PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, and ClinicalTrials.gov using terms related to athletic pubalgia, sports hernia, core muscle injury, surgical treatment, and return to sport. Studies published between 2019 and 2025 were prioritized, while landmark earlier studies were included when clinically relevant. Systematic reviews, randomized controlled trials, cohort studies, and high-quality reviews were included.
Current evidence suggests that surgical treatment is associated with high return-to-sport rates, generally ranging from 80% to 95%. Athletes undergoing surgery may return to sport earlier than those treated conservatively, particularly in inguinal-related pathology. However, interpretation of outcomes is limited by heterogeneous terminology, variability in surgical techniques and rehabilitation protocols, and inconsistent definitions of return to sport.
Surgical treatment appears effective in carefully selected athletes who fail conservative therapy. Nevertheless, the certainty of evidence remains moderate to low because most studies are retrospective and heterogeneous. Future prospective multicenter studies using standardized diagnostic criteria and clearly defined return-to-sport outcomes are needed.
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Copyright (c) 2026 Michał Śmigielski, Norbert Czarny, Liwia Karbownik, Natalia Kasterka, Magdalena Kolasa, Anna Broniecka, Kinga Dzitkowska, Krzysztof Figwer, Agnieszka Figwer, Jędrzej Garbaciak
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