Gilmore’s Groin: Understanding and Treating the Hidden Cause of Groin Pain

Struggling with groin pain that won’t go away? It could be more than a muscle strain.

Gilmore’s Groin, also known as sportsman’s hernia or athletic pubalgia, is a complex and often misunderstood cause of chronic groin pain, especially in athletes. Unlike a traditional hernia, there’s no visible bulge, which can make diagnosis tricky and frustrating for those affected.

At our physiotherapy clinic, we often see athletes with persistent groin pain that hasn’t responded to rest or standard treatment. Gilmore’s Groin may be the missing diagnosis, and with the right physiotherapy, recovery is absolutely achievable.

What Is Gilmore’s Groin?

Gilmore’s Groin is a soft tissue injury where there is a tear or weakening of the abdominal wall muscles where they attach near the pubic bone, often involving:

  • The external oblique aponeurosis

  • The conjoint tendon

  • And sometimes the inguinal ligament

It commonly affects athletes in sports requiring sudden changes in direction, football, rugby, hurling, and hockey are frequent culprits.

Causes & Risk Factors:

  • Repetitive twisting, turning, and kicking

  • Core muscle weakness or imbalance

  • Poor pelvic and hip stability

  • Previous groin or abdominal injuries

  • Inadequate warm-ups or return-to-play protocols

Common Symptoms:

  • Groin pain during sport, especially twisting or sprinting

  • Pain with coughing, sneezing, or sit-ups

  • Tenderness near the pubic bone

  • Pain that settles with rest but quickly returns with activity

  • No visible hernia or bulge

  • Diagnosing Gilmore’s Groin

Diagnosis can be challenging. It typically involves:

  • A detailed clinical exam

  • Ruling out adductor strain or hip joint pathology

  • Possible MRI or ultrasound referral

  • Collaboration with sports medicine or surgical teams, if needed

Physiotherapy Treatment for Gilmore’s Groin

Physiotherapy is vital both pre- and post-surgery, and in many cases, it can be the primary treatment to avoid surgery altogether.

1. Initial Pain Management

  • Rest from high-load activities

  • Ice therapy and anti-inflammatory advice

  • Gentle core engagement exercises

  • Manual therapy to release tight adductors or hip flexors

2. Core & Pelvic Stability Training

A weak or poorly coordinated core is a major contributor. Key areas we target:

  • Transversus abdominis activation

  • Obliques and lower abdominals

  • Pelvic floor and diaphragm coordination

  • Integration of hip stabilisers and glute activation

3. Movement Re-education & Sports-Specific Rehab

Once pain subsides, we build a graded return to sport with:

  • Dynamic balance and agility work

  • Multi-directional strength training

  • Sprint mechanics

  • Sport-specific drills tailored to your activity

4. Surgical Consideration

If physiotherapy fails after 8–12 weeks, a referral to a sports hernia specialist may be needed. Post-op rehab is essential for full recovery and return to play.

When to See a Physio

If groin pain has lasted longer than 2–3 weeks despite rest, or if it keeps returning when you train, book a physiotherapy assessment. Early intervention can prevent chronic pain and get you back on the pitch sooner.

Final Word from the Physio

Gilmore’s Groin is a complex but treatable condition. A targeted physiotherapy program focusing on core stability, hip control, and sport-specific rehab can make the difference between ongoing pain and a full recovery.

Lesley Lowe leads the Sports Physio Clinic. She has worked with multiple sports clubs over the years including rugby, football, hurling and hockey clubs and she has worked at the Dublin city Marathon.

 

Sports Physio Clinic

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