Trauma & Sports

    Groin and Pubic Pain in the Young Athlete

    Groin pain during sports? Pubalgia affects young soccer players and athletes. Learn about causes, diagnosis, and recovery. Milan specialist.

    Medically reviewed: April 2026·Dott. Daniele Priano

    Quick Answers

    Does pubalgia heal on its own?
    With relative rest and a targeted rehabilitation program, youth groin pain generally improves, but there is no single fixed timeline: recovery depends on which structure is involved (adductors, iliopsoas, inguinal region, pubic symphysis or hip) and on how early load is adjusted. The key is not to ignore the pain and to start an evaluation and a specific rehabilitation program.
    Does my child have to stop playing soccer?
    Not necessarily stop completely, but it is important to reduce the load and modify training during the acute phase. Return to sport occurs gradually after a specific strengthening program.
    See all 7 questions →

    Groin and pubic pain ("pubalgia") in young athletes is not a single condition but an umbrella term covering several possible sources — particularly relevant in those who play soccer, hockey, rugby or sports with repeated direction changes, sprints and kicks.

    In children and adolescents, groin pain is rarely related to a single major trauma. It usually develops as chronic functional overload, and the pain generator can vary: adductor-related (overload or tendinopathy of the adductor insertions on the pubis), iliopsoas-related, inguinal-related (including the rare inguinal hernia), pubic-related (symphyseal overload), or hip-related (pain referred from the hip joint itself). A temporary muscle imbalance between the abdominal chain and the adductors, or a phase of rapid pubertal growth in which muscles cannot keep up with bone elongation, can also contribute.

    During the evaluation we reconstruct the history of pain, its evolution over time and its impact on sports activity, and work to localize which structure is generating the pain. In adolescents, the differential diagnosis also includes apophyseal avulsion fractures (ASIS, AIIS, ischial tuberosity), slipped capital femoral epiphysis (SCFE) and other hip pathology, which must be actively excluded, especially when pain is atypical, persistent or associated with limping. Distinguishing groin pain from these other causes is essential for the right treatment plan. In most young athletes, a personalized rehabilitation program and careful load management lead to good recovery, though the timeline varies with the underlying cause.

    Assessment and treatment

    When to seek evaluation

    • Groin pain during or after sports activity
    • Pain on palpation of the pubis or adductors
    • Difficulty with kicks, direction changes, or sprints
    • Pain that worsens progressively despite rest
    • Morning stiffness in the groin region

    What is evaluated

    • Palpation of the pubic symphysis and muscle insertions
    • Adductor strength testing (squeeze test) and abdominals
    • Hip and pelvis flexibility assessment
    • Gait and sports biomechanics examination
    • Ultrasound or MRI to exclude structural injuries
    • Exclusion of differential diagnoses (inguinal hernia, hip pathology)

    Treatment options

    • Relative rest from causative sports activity
    • Targeted physical therapy: abdominal and adductor strengthening
    • Progressive return-to-sport program
    • Posterior chain and adductor stretching
    • Gradual return to sport with load management

    Frequently Asked Questions

    Does pubalgia heal on its own?▼
    With relative rest and a targeted rehabilitation program, youth groin pain generally improves, but there is no single fixed timeline: recovery depends on which structure is involved (adductors, iliopsoas, inguinal region, pubic symphysis or hip) and on how early load is adjusted. The key is not to ignore the pain and to start an evaluation and a specific rehabilitation program.
    Does my child have to stop playing soccer?▼
    Not necessarily stop completely, but it is important to reduce the load and modify training during the acute phase. Return to sport occurs gradually after a specific strengthening program.
    Can pubalgia be related to growth?▼
    Yes, during the pubertal growth spurt, muscles may not keep pace with bone growth, creating imbalances that predispose to pubalgia. A preventive stretching and strengthening program is recommended for young athletes in rapid growth phases.
    How is pubalgia distinguished from an inguinal hernia?▼
    Pubalgia causes pain related to sports activity and to muscle contraction, while a hernia presents with a palpable swelling. The specialist can distinguish the two conditions through clinical examination and, if needed, an ultrasound.
    Which exercises are most useful in recovery?▼
    An effective program combines progressive strengthening of adductors and deep abdominals, work on pelvic control, and mobility of the hip and lumbar spine. It is a gradual path, to be built with the physical therapist, that starts from low-load exercises and progresses over time to sport-specific movements. Progression is guided by symptoms: no exercise should trigger significant pain.
    Can the pain come back after it has gone?▼
    Yes, relapses are not uncommon if predisposing factors are not corrected: excessive training loads, muscle imbalances, suboptimal technical movements, insufficient rest. To reduce the risk of recurrence we work together on adequate planning, good general athletic preparation, and careful load progression during rapid growth phases.
    Are imaging tests always needed?▼
    Not always. In the typical clinical picture, the diagnosis is mainly clinical. Ultrasound or MRI are used selectively to rule out structural injuries or in cases that do not respond as expected to the rehabilitation program.

    Important Notice: The information on this page is for educational and informational purposes only and does not constitute medical advice. Each clinical case is unique: the appropriate treatment is determined during the specialist consultation, based on a thorough clinical examination and, where necessary, diagnostic imaging. For any doubts or concerns, please consult a specialist.

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