Athletic Muscle Rehabilitation Program (AMRP) completing the surgical treatment of sportsmen’s hernia and athletes’ pubalgia: Clinical outcomes in 461 athletes
Moshe Dudai, Rut MeruhamAbstract
BACKGROUND:
Sportsman’s hernia and athletic pubalgia (SH/AP) represent a chronic microtrauma groin injury, distinct from typical inguinal hernia, characterized by exertion-related pain due to underlying groin and pubic injury results for muscular imbalance. Mild cases may respond to conservative management, but advanced cases often require surgical repair. Because persistent neuromuscular dysfunction may limit full recovery and contribute to recurrence, structured postoperative rehabilitation is considered an important component of care after surgery. This study aimed to describe the mandatory Athletic Muscles Rehabilitation Program (AMRP), a surgeon-supervised, three-component postoperative protocol initiated immediately after totally extraperitoneal release-and-reinforce technique (TEP-RRT) surgery, and to characterize long-term functional and patient-reported outcomes in athletes treated with TEP-RRT and AMRP, a protocol not widely recognized as essential for successful full recovery.
MATERIALS AND METHODS:
We retrospectively surveyed 461 athletes who underwent TEP‑RRT for SH/AP between 2016 and 2024 and completed a standardized AMRP. A structured telephone survey (October 2024–January 2025) captured return‑to‑sport status, time to return, recurrence, additional treatments, and patient satisfaction. Descriptive statistics were used.
RESULTS:
During the follow‑up of 6 months to 9 years, 98.5% of athletes returned to sports after completing the AMRP and remained active. Rehabilitation lasted 6–12 weeks. Most resumed full activity within 8 weeks, and nearly all resumed full activity within 12 weeks. No recurrences occurred. Additional treatments were required in 10% of the cases. Satisfaction was high (96.2% rated outcomes very good).
CONCLUSIONS:
Surgeon‑supervised, structured rehabilitation after TEP‑RRT for SH/AP was associated with favorable functional outcomes, including high return‑to‑sport rates and no reported recurrences during the long-term follow-up. Prospective comparative studies are needed.