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Hip Flexor Injury Overview

by Jaydee Vykoukal, PT, DPT November 11, 2020 0 Comments

hip pain

Do you experience sudden, sharp pain or a pulling sensation in the front of your hip when lifting your knee toward your chest? If so, you may be dealing with a hip flexor injury, a common condition in athletes and older adults that causes weakness and pain when you walk, climb stairs, or lift your thigh. Hip flexor strains lead to pain, inflammation, and reduced flexibility and mobility. Keep reading to learn more about hip flexor strain, from causes to treatment options.

What is Hip Flexor Strain?

A hip flexor strain is simply a stretch or tear in one or more of the hip flexor muscles, which leads to pain in the front of the hip. Hip flexor tendonitis is a different but related condition, which also leads to hip pain. However, in the case of hip flexor tendonitis, the tendon(s) that attaches muscles to the thigh bone or pelvis becomes damaged or inflamed.

So, what is a hip flexor? The hip flexor carries out a very important role by providing stability to the trunk and providing power to the legs for forward motion. The hip flexor consists of several muscles in the front of the hip and pelvis that work together to help you to lift your thigh toward your stomach and to bend at the waist. Therefore, any injury to the hip flexor can make running, walking, climbing stairs, or kicking a ball difficult.

Grades of Hip Flexor Strain

Not all hip flexor strains are equal—they vary in severity from grade 1 to grade 3. These grades take into account muscle damage, pain levels, and functionality. The injury’s grade indicates the required level of treatment and expected recovery time.

  • Hip Flexor Strain Grade 1

    Damage to a small number of muscle fibers, which causes some pain, but allows full hip functionality

  • Hip Flexor Strain Grade 2

    Moderate loss of functionality and moderate pain due to a moderate to significant number of torn fibers

  • Hip Flexor Strain Grade 3

    Major loss of functionality and severe pain due to damage to all the muscle fibers

Causes and Risk Factors for Hip Strain

Hip flexor strain is most common in athletes who continuously sprint, kick, or raise their legs. Cyclists, soccer players, runners, hockey players, and those who practice martial arts often find themselves with pulled hip muscles. However, anyone can strain their hip flexor from overuse or sudden movement.

Other factors that can cause hip strain:

  • Weak leg, hip, core or glute muscles
  • Tight leg, hip, or glute muscles
  • Stiff joints in the hip, knee, or lower back
  • Inadequate warmup before activities
  • Improper form during exercise or other activities
  • Hyperextended hip—the hip is moved beyond its normal extension range
  • Trauma or falls
  • Poor posture
  • Low level of fitness, strength, or flexibility
  • Previous hip flexor injury that did not heal properly


Where is Hip Flexor Pain Felt?

The pain associated with hip flexor strain is quite specific. You may notice:

  • Front hip pain-where the hip meets the thigh, the bony process of the pelvis, or deep into the stomach near the spine itself
  • Hip flexor pain when walking
  • Sudden, sharp pain in the hip flexor at the time of injury
  • Pulling sensation in the front of the hip
  • Muscle spasms along the front of the thigh or pelvis
  • Weakness with use of the leg
  • Tenderness upon touching the area around the hip flexor
  • Bruising
  • Swelling or inflammation
  • A limp while walking
  • Pain when lifting the knee toward the chest, during activities, or while climbing stairs
  • A visible muscle deformity, in cases of severe tears

Diagnosing a Hip Flexor Strain

While you may have an idea that you’re suffering from a pulled hip flexor, a professional diagnosis is always recommended if it’s affecting your daily activities or quality of life.

Your doctor or physiotherapist will ask about your history and perform a physical exam to check for pain, swelling, or muscle deformities. If necessary, imaging techniques—such as X-rays, ultrasounds, CT scans, or MRI scans—may be used to confirm the diagnosis or rule out other possible issues.

Preventing Hip Flexor Strain

When it comes to the hips, careful consideration is always required! The hip plays a vital role in bearing our weight during all our everyday activities and providing trunk stability.

Keep up with a consistent exercise program, give your legs ample resting periods, stretch out your hip flexor muscles regularly, and consider supportive braces or taping techniques during activity if you are prone to overuse injury.

Finally, if you think you have hip flexor strain, take action immediately, listen to your body, and talk to your doctor about what you can do next.


Hip Flexor Pain Products


Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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