Non-Operative — Athletic Pubalgia (Non-Operative)

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

WBAT; activity modification to avoid intra-abdominal pressure increases

Key Restrictions

Avoid lifting or activities increasing intra-abdominal pressure; criterion-based (NOT time-based — healing times vary greatly); covers adductor-related, inguinal-related, pubic-related, and iliopsoas-related groin pain

Timeline & Phases

4 criterion-based phases: Phase I Acute (pain control, adductor isometrics, TrA/quadruped/bridge progressions, walking/elliptical/bike), Phase II Subacute (PRE concentric/eccentric hip, Copenhagen adduction progressions, return-to-run protocol), Phase III Early RTS (plyometrics, agility, sprinting programs), Phase IV Unrestricted RTS (non-contact → full practice → full play)

Notes

Revised 1/2023; criterion-based not time-based; covers groin pain per DOHA 2015 classification (adductor-, inguinal-, pubic-, iliopsoas-related); RTS: hip index ≥90% HHD/isokinetic, adductor/abductor ratio >80%, hop testing ≥90%, HAGOS questionnaire >90%; 33 diagnostic terms in literature — DOHA umbrella term used. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2025-02-16.]

Surgeon / Author

MGH Sports Medicine

Published

January 2023