All you need to know about hip flexor strain
Damage to the hip area can vary from minor injuries that require little treatment, to more severe injuries that result in the muscles ceasing to connect with the bone.
The most serious hip flexor injuries are third-degree sprains where the bone breaks alongside the muscle sprain.
- Flexors are flexible muscle tissues that help a person stretch and move.
- If overused, overstretched, or forced to hyperextend, injury can occur.
- Some instances of hip flexor injury require medical treatment.
What are hip flexors?
The psoas muscles are part of the hip flexor muscles.
Image credit: Anatomography, 2013
The hip flexors can be found connecting the top of the femur, which is the largest bone in the body, to the lower back, hips, and groin.
There are various hip flexor muscles that all work to enable a person to be mobile.
- the iliacus and psoas major muscles that are also referred to as iliopsoas
- the rectus femoris, which is part of a person's quadriceps
Overuse or overstretching of these muscles and tendons can result in injury and accompanying pain and reduced mobility.
Symptoms of hip flexor strain
Many people who experience hip flexor strain will have these symptoms as well:
- sudden, sharp pain in the hip or pelvis after trauma to the area
- a cramping or clenching sensation in the muscles of the upper leg area
- the upper leg feeling tender and sore
- loss of strength in the front of the groin along with a tugging sensation
- muscle spasms in the hip or thighs
- inability to continue kicking, jumping, or sprinting
- reduced mobility and discomfort when moving, including limping
- discomfort and pain in the upper leg area, which feels constant
- swelling or bruising around the hip or thigh area
- tightness or stiffness after being stationary, such as after sleeping
Dancing and running may put the hip flexor muscles under strain.
A person's hip flexors are engaged when they bring their knee up towards their torso.
Hence, activities such as dancing, martial arts, or running are where hip flexors are put under the most strain.
Athletes who use the hip flexors in their sport and training are more susceptible to hip flexor strain or injury that can cause the muscles to tear.
In sports medicine, it is thought that many hip flexor wounds are associated with hamstring strains.
Exercises to keep the hip flexors supple and flexible can help prevent injury.
Many people have jobs where they sit down for a large part of the day. This inactivity can result in tight hip flexors, causing lower back pain, hip pain, strain and damage to the area.
Hip exercises can help to strengthen the hip flexor muscles. Most exercises can be done at home and are gentle stretches, which will help to reduce tension and prevent further or future injury.
As well as exercises that can be done at home, gentle swimming and cycling can be beneficial to improve strength and prevent hip flexor strain.
Warming up muscles before beginning exercises will help to ensure they are ready to be stretched and may prevent further straining.
Applying heat to the area and going for a gentle walk for a few minutes are ideal ways to warm up before beginning the stretches.
Stretches to help with hip flexor strain?
The seated butterfly stretch may help with hip flexor strain.
The following stretches can help to reduce tightness, increase flexibility, strengthen muscles and help prevent injury.
Seated butterfly stretch
Sitting up straight on the floor, place the soles of the feet together letting the knees bend outwards. The heels should be pulled gently inwards, and the knees dropped further towards the floor. Hold the stretch for 10 to 30 seconds.
Starting in the elevated plank position, the individual brings the left leg forward, so the knee is on the ground by the left hand. The right leg then slides back as far as possible. Hold the position and then swap sides.
To do this pose a person should lie on their back with their knees bent and feet on the floor. They then take a deep breath before raising the hips off the floor while squeezing the glutes. Hold for a moment, gently lower, and repeat.
A person should begin by standing straight with their feet together. They then take a step forward with the right foot, bending the knee and transferring the weight onto that leg before lowering their hips to the floor and holding the position. This should then be repeated on the other side.
Wall psaos hold
To do this stretch a person should start in a standing position then bend their right knee lifting the upper part of the leg towards the ceiling and balancing on the other foot. They then try to hold for 30 seconds before switching sides.
With their legs together a person should bed their knees while keeping their back straight and chest up. Once in the squat position, they should then lifting each leg off the ground one at a time, stretching it out and pointing the toes, while transferring the weight to the other.
Straight leg raises
Lying on their back, palms either side, a person should pull up the left leg and bend at the knee while keeping the foot on the floor. The right leg is then extended up towards the ceiling, without bending the knee. Hold the stretch for a few seconds and then switch sides.
Starting by lying flat on their back with their legs straight, a person then slowly pulls the knee of their right leg towards their chest, as close as possible, without straining. After slowly lowering the leg, the same is repeated on the opposite side.
What other treatments are there?
For minor hip flexor injuries, people do not usually visit their doctor but prefer to treat themselves from home.
Some common ways to help treat hip flexor strain are:
- Resting the muscles to help them to heal while avoiding activities that could cause further strain.
- Wearing a compression wrap around the area. These are available to buy in pharmacies or online.
- Applying an ice pack to the affected area. These are available to buy in pharmacies or online.
- Applying a heat pack to the affected area. These are available to buy in pharmacies or online.
- A hot shower or bath.
- Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin), acetaminophen (Tylenol), naproxen sodium (Aleve).
When taking these medicines, it is important to follow the instructions and not to use them for more than 10 days.
If the pain persists after 10 days, a person may wish to make an appointment with their doctor to discuss alternative treatments.
When the damage is unusually extensive, a doctor may recommend that an individual sees a physical therapist or undergoes surgery to repair the muscle. However, instances of damage this severe are rare.
If hip flexor strain causes a limp or the symptoms do not get better after resting and treating at home for a week, it may be advisable to see a doctor.
Tips for prevention
People who are particularly vulnerable to hip flexor strain, such as athletes or those who regularly participate in vigorous activities that could damage or overstretch the hip flexors, can take precautions to avoid injury.
Ensuring muscles are properly warmed up before taking part in physical activity, and doing exercises to strengthen the muscles, can help to keep the area flexible and strong, and reduce the chances of damage occurring.
Hip flexor strain can be painful and uncomfortable but is rarely a cause for concern. How long the strain takes to heal will depend on the severity of the injury but is usually a few weeks for mild strains and up to 6 weeks for more serious damage.
Rest and stopping activities that might have caused the strain will give a person the best chance to heal and recover quickly.