What is pubalgia or sports hernia, the recurring muscle injury that troubles Franco Mastantuono and Lamine Yamal alike

Franco Mastantuono, who joined Real Madrid from River Plate in the summer, has missed several games due to pubalgia, a groin-related condition that often demands rest and gradual recovery. According to reports, the Argentine attacker was ruled "totally recovered" in mid-December by Real Madrid's medical team and has returned to team training after having missed several key fixtures due to fitness concerns. However, Real Madrid are unwilling to take any chances with the teenager and want to avoid any risk of relapse, which could slow his steady rise in the first team.

Mastantuono is just one of many youngsters who have been diagnosed with pubalgia. Barcelona's Lamine Yamal, another superstar in the making, is also being handled with extreme care by the Spanish side after suffering from the same condition. Pubalgia is becoming increasingly common among young players, reportedly because of tight match schedules and limited recovery periods. It is also blamed by many for the rapid decline of Brazil legend Kaka, as he never managed to get back to his prime after suffering a pubalgia during his time in the Italian capital.

What is Pubalgia?

Sometimes known as a "sports hernia" or "Gilmore’s groin", it is an injury to a tendon or muscle in the lower abdomen or groin. Sports hernias are characterised by chronic pain and are often caused by repetitive and forceful twisting of the pelvis.

"Although hernia and sports hernia symptoms are similar, the pain of a sports hernia is caused by soft tissue damage, such as a tear, in the lower abdomen or groin. A muscle or tendon is usually torn. The pain from a traditional hernia is due to a gap in your abdominal muscle that causes your intestine or other soft tissue to protrude through, creating a bulge under the skin. A sports hernia (athletic pubalgia) can lead to a hernia, but in that case, the traditional hernia is considered a separate injury from the athletic pubalgia," the Cleveland Clinic states on its official website.

Apart from football, professionals in ice hockey, skiing, rugby, and wrestling are most prone to pubalgia, the website added. Weakness in the abdominal muscles and a lack of proper sports conditioning can also cause it. It can be difficult to pinpoint the exact area of the lower abdomen and groin where the pain originates; in most cases, the burning pain will travel downwards to the scrotum and/or inner thigh regions.

Diagnosis and treatment

According to the American Academy of Orthopaedic Surgeons (AAOS), this soft tissue injury often occurs where the abdominals and adductors attach at the pubic bone. In many cases, the tendons that attach the thigh muscles to the pubic bone (adductors) are also stretched or torn. It does not cause a visible bulge in the groin, and while the pain gets better with rest, it mostly returns when the affected person returns to sports activity. Without treatment, however, the injury can result in "chronic, disabling pain."

Medical professionals may use X-rays or MRI scans to help determine whether a patient has a sports hernia. In most cases, a patient will not be able to perform sit-ups, which is often read as a clinical sign of the injury.

Anti-inflammatory medications, physical therapy, and rest are pivotal components of pubalgia treatment. Physical therapy exercises are typically prescribed two weeks after the injury. Surgery options are considered only if the pain returns once the player is back on the field after four to six weeks of physical therapy.