Hip Flexor Strain Causes, Symptoms & Treatment Options

Overview

The hip flexors are a group of muscles that link the thighbone (femur) to the pelvis. They help you bend and lift your knee toward your body. These muscles can be injured if they are overstretched or torn.

Although anyone can experience a hip flexor injury, it is most commonly seen in athletes and is often referred to as a hip strain. Hip strains can cause significant pain and restrict movement. Most athletes can fully recover and return to their sport with adequate rest and proper treatment.

What causes Hip Flexor Strain?

Athletes, especially those involved in sports that require kicking, sudden changes in direction, or quick movements, are more likely to experience a hip flexor injury. These actions can overstretch or tear the hip muscles, resulting in a hip muscle pull. 

• How the Injury Occurs: Overstretching or sudden contraction of the hip flexor muscles during kicking, sprinting, or rapid directional changes can cause tears or groin/upper thigh pain, sometimes worsened by direct impact.
• Common Everyday Causes: This can occur when lifting heavy objects, causing sudden slips or falls, or performing rapid movements without proper warm-up or stretching.

Sports strains commonly linked to hip flexor injuries include:

• Football – Rapid sprints and sudden tackles can strain the hip muscles.
• Hockey – Quick stops, starts, and directional changes stress the hip flexors.
• Soccer – Frequent kicking and sprinting can overstretch the muscles.
• Martial Arts – High kicks and sudden movements increase the chance of a strain.

Symptoms

Pain in the front of the hip is the most common symptom associated with a hip flexor injury. This thigh pain can range from mild to intense, depending on the severity of the strain. Other common symptoms include:

• Tenderness, swelling, and bruising
• Muscle spasms
• Cramping and/or sharp pain
• Increased pain when you lift your knee
• Decreased mobility and difficulty walking without limping

Non-operative treatment

Hip flexor strains often heal naturally over time, but there are ways to reduce pain and swelling while recovering. Your doctor may suggest several measures, including:

• Rest: Avoid activities that worsen the pain to allow the muscles to heal.
• Ice: Applying ice can help reduce swelling and discomfort.
• Compression: Wrapping the area may limit swelling and provide support.
• Elevation: Keeping the leg raised can help reduce inflammation.
• Over-the-counter medications: Pain relievers like acetaminophen (Tylenol) or NSAIDs such as ibuprofen can help manage pain and inflammation.

Once pain decreases, your doctor may recommend gentle stretching and strengthening exercises. These help improve hip flexibility, restore range of motion, and support faster recovery from a groin or iliopsoas strain.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Hip Flexor Strain

Surgical Treatment

Most hip flexor injuries are treated without surgery. Surgery is rarely needed and is usually only considered in severe cases, such as a major iliopsoas tear that does not respond to non-surgical treatments.

Even in these situations, surgery is generally a last resort, as most patients recover well with conservative care.