The groin surgery that gets footballers back competing in 87 days

A study by the Cugat Institute involving one hundred professional footballers has found that a minimally invasive surgical technique for treating groin pain allows players to return to competition in an average of 87 days. The research also shows that 98 % of operated players recover exactly the same competitive level they had before suffering the injury. The findings open up a much shorter recovery path for one of the most feared and persistent problems in elite football.

• The procedure is called bilateral adductor tenotomy and is performed through two incisions of between two and three centimetres.
• The average return to competition time is 87 days, compared to the six months often required by more aggressive surgical techniques.
• 98 % of the footballers who underwent surgery returned to the same division they played in before the groin injury.
• The Spanish Footballers' Mutual records around 400 pubic bone injuries every season in Spain.
• Ramón Cugat, founder of the institute, says his team has already operated on more than one thousand cases of groin pain in amateur and professional players.

Why groin pain derails footballers' careers

Groin pain, also known as chronic groin strain, is one of the most common and stubborn injuries in elite football. It appears when conservative treatment —physiotherapy, re-adaptation and muscle strengthening— fails to eliminate pain in the pubic area. The problem worsens because footballers spend months dealing with discomfort that limits their performance and affects their availability to play.

The scale of the issue is significant. Data from the Spanish Footballers' Mutual, the mandatory medical insurance for federated players in Spain, shows around 400 pubic bone injuries every season. Lamine Yamal, the FC Barcelona player, suffered a groin problem that disrupted part of his previous campaign, a recent example of how this injury can slow down even football's brightest prospects.

How bilateral adductor tenotomy works

The technique proposed by the Cugat Institute is based on bilateral adductor tenotomy. It is a surgical procedure in which two small incisions of between two and three centimetres are made to release, in a controlled way, the tendons of the long adductors located on both sides of the groin. The goal is to reduce tension in the pubic region and minimise the risk of relapses or repeat operations.

Ramón Cugat, the trauma surgeon and founder of the medical centre, told EFE that the procedure has been used for years and has established itself as a particularly effective option when a player needs to go through the operating theatre. The surgeon, regarded as one of the world's leading specialists in sports medicine, describes it as a simple, quick and low-risk intervention.

When conservative treatment fails, the player feels their career is stuck.

87 days on average to return to full competition

The study results place the average time for returning to unrestricted competition at 87 days, with a recovery window ranging from 62 to 128 days. These figures make the surgery a key tool for medical and sporting planning at clubs, especially when compared to the roughly six months usually demanded by more invasive surgical options.

The analysis also reveals a significant finding: 98 % of the footballers who underwent surgery returned to compete in the same division they played in before the injury. Only one player dropped to a lower division and another left professional football for reasons unrelated to the groin problem. The researchers found no link between athlete age and recovery time, which they put down to the physical preparation and medical follow-up typical of professional sport.

Why both adductors are operated on even when only one hurts

The Cugat Institute's approach involves operating on both adductors even when pain appears on just one side. The reason is biomechanical: correcting the pelvic imbalance reduces the risk of overloading the apparently healthy side in the future. This strategy aims to prevent relapses and provide a more stable long-term solution.

We have seen that within a period of just a few months they can be back competing with a simple technique that is much more effective than the others, which stretch the timeline significantly.

Results that back surgery as an effective alternative

Across the series of one hundred cases analysed, no serious complications were recorded and the reoperation rate was just 2 %. For the Cugat Institute, these figures support minimally invasive surgery as an effective alternative when conservative treatment does not work after several months of physiotherapy and re-adaptation work.

Cugat's team has built up experience of more than one thousand operated cases of groin pain in amateur and professional footballers. That extensive track record strengthens the reliability of the results and positions the technique as a growing reference point within sports medicine for treating chronic groin strain.