By By Abby McCoy, RN. Medically Reviewed by Scott Haak, PT, DPT, MTC, CSCS,
5 hours ago
Causes of hip flexor pain include injuries from overuse and chronic conditions such as fibromyalgia and rheumatoid arthritis. Canva (2); Everyday Health Hip flexors, the muscle group that stretches over the front part of each hip, are used for movements like lifting your knee toward your chest. "The hip flexor is one of the most powerful muscles in the body and is constantly in use," says Andrew Carbone, MD , an orthopedic surgeon at Orlando Health Jewett Orthopedic Institute in Orlando, Florida. When these muscles get too tight or weak, you can feel pulling, cramping, or a sharp pain in your hip, groin, and lower back. "This pain can occur with basic activities such as going up or down stairs, lifting the knee to chest, bending over to pick something up, standing after prolonged sitting, or while running or skating," says John Pinnello, MD , an orthopedic surgeon at Rush Orthopaedics and Sports Medicine in Aurora, Illinois.
Hip flexor pain can make it difficult to live your daily life, but these symptoms can be treated and prevented. Below, we'll share the causes and symptoms of hip flexor pain, exercises to strengthen and stretch this important muscle group, and when it's time to seek professional help for your pain.
Causes of Hip Flexor Pain
Causes of hip flexor pain can vary depending on your lifestyle and activities. For example, hip flexor injury is more common in athletes, whereas pain related to poor posture may affect someone who sits for much of the day. Hip flexor pain can be caused by the following:
Hip flexor strain is most common in athletes and happens when the hip flexor muscle gets overstretched or strained, causing pain.
Hip flexor tear means the muscle has torn. A hip flexor tear can happen suddenly, through direct injury, or with chronic overuse. Psoas syndrome describes injury to one of the hip flexor muscles called the iliopsoas muscle, and is sometimes called "jumper's hip" or "dancer's hip."
Chronic conditions like rheumatoid arthritis (RA) and fibromyalgia can cause muscle pain in your hip muscles and throughout the body. Hip osteoarthritis (a breakdown of the cartilage in your hip joint) can also cause hip pain.
Overuse injuries describe muscle tears that come from a repetitive motion over time, which breaks down the muscle and causes an injury. These hip flexor injuries are most common in athletes and in the military population.
Muscle weakness and imbalance caused by poor posture or a lifestyle with little physical activity can leave the hip flexor muscles open to strain and injury.
Symptoms of Hip Flexor Strain or Injury
Hip flexor pain typically feels like pulling, cramping, and a sharp pain in the front part of the hip. Severe hip flexor pain can involve spasms, bruising, and swelling to the area.
"Weakness or pain with active hip flexion, which is the hallmark of hip flexor pain, can have a significant impact on everything, from walking and getting into and out of the car, up to high-level athletics," says Brett Shore, MD , an orthopedic surgeon in Marina del Rey, California.
You can differentiate hip flexor pain from other types of hip pain by its position: Hip flexor pain is most noticeable at the front of the hip. Other hip muscle injuries, like lateral and posterior muscle strains, cause pain in your hip's side or rear. However, you can also have pain at the front of the hip from other causes inside the joint, such as a labral tear (injury to the tissues in the ball and socket part of the hip) or osteoarthritis. Some common signs that come along with hip flexor pain include:
Hip muscle weakness
Limited range of motion
Bruising down the top of your thigh
Swelling
Difficulty walking without a limp
Spasms
A bulge at the top of your thigh
Occasionally, a hip flexor injury can cause more severe symptoms. "Inability to bear weight is the warning sign that it may be more than a strain," says Dr. Pinnello.
How to Treat Hip Flexor Pain
Hip flexor pain can often be treated at home, but if the injury is more severe, you may benefit from physical therapy, injections, or - in rare cases - surgery.
Hip Flexor Pain Relief at Home
When you notice hip flexor pain, stop the activity that's causing discomfort, and rest. You can lessen swelling by applying ice or a cold pack wrapped in cloth to the injury for 20 minutes at a time, several times per day. Compression with a soft bandage or compression shorts can also prevent swelling to the area. You can use over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) - medications like ibuprofen (Advil) or naproxen (Aleve) - to lessen swelling and pain. Acetaminophen (Tylenol) helps with pain, but not with swelling. Be sure to follow the labeled instructions and ask a healthcare provider or pharmacist if you have any questions about dosage. Do some gentle stretches as you rest to help your hip flexor muscle recover faster, but be careful not to push through sharp pain. Over the following weeks, you should be able to slowly increase your stretches and activity level. "If the hip flexor strain is the result of an acute injury, rest and avoiding activities that exacerbate the pain - [with] stretching in addition to NSAIDs - generally produce favorable results in the short term," says Dr. Carbone. For a mild injury or strain, you should start to notice improvement within a few weeks, but a more severe strain may take longer.
Physical Therapy
If your pain doesn't go away after a few weeks of home care, you may need to see a physical therapist, who can develop a personalized exercise program for you. "Therapy can be extremely helpful for these patients to mobilize the tendon and improve core and gluteal strength," says Carbone, "which can stabilize the area and quicken recovery."
During your first visit with a physical therapist, they will assess your injury and see what you can do without pain. Once they have a sense of your mobility, they will teach you exercises to do at appointments and at home. As your pain improves, your physical therapist will help you make a plan to continue your exercises at home and discharge you from their care.
Medications and Injections
The only oral medications recommended for hip flexor pain are NSAIDS, but if your pain continues after NSAID use and physical therapy, your provider may recommend corticosteroid injections, which relieve pain by decreasing inflammation, to your hip flexor muscles.
"If the hip pain [continues despite] these treatments, then a cortisone injection can be performed, which is extremely effective at relieving pain," says Carbone.
Some providers also offer platelet-rich plasma injections for hip flexor injuries, says Dr. Shore. Plasma is part of your blood and contains proteins and other components that boost your body's natural healing processes.
Surgery
If your pain stays persistent despite injections and physical therapy, your provider may consider further evaluation and surgery, says Carbone.
It's rare to need surgery for hip flexor pain. In very severe hip flexor injuries, the tendon (the tissue connecting muscle to bone) can get ripped away from the bone. When this happens, you may need surgery to repair it.
How to Prevent Hip Flexor Pain
You can prevent hip flexor pain by consistently doing stretch and strengthening exercises, maintaining good posture and ergonomics, and making some lifestyle changes.
Avoid Injury With a Warm Up and Cool Down
Prevention of hip flexor pain primarily consists of daily stretching and making sure to do a proper warmup and cooldown before and after any athletic activity, says Shore.
Warming up before exercise prepares your body for the upcoming demands by increasing your range of motion, raising your muscle temperature, and increasing your heart rate. It's also important to cool down after intense activity with slowly deepening stretches to keep your muscles from tightening up.
Stretch Every Day
Daily stretching can keep your hip flexors from becoming too tight, especially if you sit for many hours per day. Here are some simple hip flexor stretches to try:
Half-Kneeling Hip Flexor Stretch
Kneel on the floor and bring your right leg in front of you, placing your foot flat on the floor so your right thigh is parallel to the ground.
Keep your left knee on the ground and make sure your left leg points straight backward.
With hands on your hips, contract your glutes (butt muscles), keep your back straight, and shift your weight forward until you feel a stretch through the front of your left thigh and groin.
Switch legs and repeat.
Side-Lying Hip Flexor Stretch
Lie down on your left side with your knees bent at a 90-degree angle.
Slide your right foot back and grab your ankle with your right hand, slowly pulling your leg behind you.
Be careful to keep your back straight and move only your leg - not your hips.
Roll over and repeat on your other side.
Make Exercise a Part of Life
You can reduce your chance of hip flexor injury by keeping your hips and the muscle groups around them strong, flexible, and stable. If you're new to exercise, try to choose low-impact options that don't put too much pressure on your hips, like swimming . Take the stairs whenever you can to give an added strength boost to your hip flexors. You can also do these simple exercises in your home to strengthen your hip flexors and stabilizing muscles nearby: Glute Bridges
Lie down on your back and place your arms at your sides with palms up.
Bend your knees and place your feet flat on the floor six to eight inches in front of your glutes, hip-width apart, with your toes pointed straight ahead.
Squeeze your glutes and stomach muscles and lift your hips up as high as you can without arching your back.
Hold for two seconds, then slowly lower to the floor and repeat.
Clamshells
Lie on your left side, legs together, with knees bent.
Keeping your hips straight, lift your right knee as high as you can, then lower back down.
Repeat this 15 times, then switch to the other side and repeat.
Side-Lying Leg Raises
Lie down on your side.
Bend your bottom leg and roll forward slightly for extra support.
Keeping your top leg straight, slowly lift it and hold for one to three seconds.
Slowly lower that leg, then repeat as many times as you can without pain.
Roll to your other side and repeat.
Choose a Healthy Diet
The right nutrition can help limit inflammation and keep connective tissue (like tendons) healthy. Anti-inflammatory foods include dark leafy greens, berries, seeds, and healthy oils (like olive oil). Foods packed with vitamin C - like oranges and broccoli - can strengthen your tendons.
Practice Good Posture and Ergonomics
Good posture (how you position your body) and ergonomics (designing work conditions to prevent injury) can both keep your hip flexors and their supportive muscles strong. Globally, adults sit almost five hours per day, on average. When you sit down, your hip flexor muscle shortens, and too much time in this position can lead to stiffness. Here are some tips to practice good posture and ergonomics for hip strength and flexibility:
Get up every hour and walk around.
Sit with your feet hip-width apart and hips straight.
Avoid crossing your legs while sitting.
Keep your back straight - try not to lean.
Try a standing desk, but avoid standing in one position for too long.
Wear supportive shoes.
When to See a Doctor for Hip Pain
Some hip flexor pain may require a visit to your doctor, says Shore. He recommends seeing a healthcare provider if your pain:
Interferes with activities of daily living
Doesn't improve or gets progressively worse over time despite treatment
Wakes you from sleep
You should also see a doctor if you have increasing difficulty moving your hip or leg.
Complications
If you leave unmanaged hip flexor pain too long, it can tilt your pelvis forward, placing extra strain on your lower back, hips, and knees, says Carbone. "Over time these compensatory motions can become permanent as the muscles become contracted and result in a poor posture and potentially degenerative disk disease in the lumbar spine," he says.
Repeated hip flexor strains also warrant a provider visit, as it may point to another cause for the pain, such as a condition involving the hip joint itself, like osteoarthritis, says Shore.
Other conditions can cause referred pain; it feels like your hip hurts, but the cause lies somewhere else. For example, appendicitis , hernias , and ovarian cysts can also cause pain in the front of your hip. Rarely, hip flexor pain can be an emergency, and if you experience the following symptoms, head to an urgent care or emergency room right away:
Hip joint looks out of place
Inability to move your leg or hip at all
Very intense pain
Inability to put any weight on your leg
Sudden swelling to your hip or leg
Fever or chills
Bleeding in or around the strained muscle (will look like sudden bruising)
The Takeaway
Hip flexor pain can feel like a sharp, pulling, and cramping in the front part of the hip and is typically caused by hip flexor muscle strain, injury, or overuse.
It's important to address hip flexor pain early with rest, ice, and anti-inflammatory medications to decrease swelling and promote healing. Let a healthcare provider know if your pain doesn't improve after a few weeks, or if symptoms worsen.
To prevent hip flexor pain and injury, you can keep your hip and supportive muscles strong with daily stretch and strengthening exercises.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Sources
Ma CB. Hip Flexor Strain - Aftercare. MedlinePlus . April 24, 2023.
Bustos AO et al. Overuse-Related Injuries of the Musculoskeletal System: Systematic Review and Quantitative Synthesis of Injuries, Locations, Risk Factors and Assessment Techniques. Sensors . April 2021.
Scott Haak, PT, DPT, has been a member of the Mayo Clinic staff since 2000. Dr. Haak serves as faculty for the Sports Medicine Fellowship program at Mayo Clinic Florida. He is certified by the NSCA (National Strength and Conditioning Association) as a CSCS (Certified Strength and Conditioning Specialist), is a Certified USA Weightlifting Coach and Certified USA Football Coach, and possesses a MTC (Manual Therapy Certification) from the University of St. Augustine for Health Sciences.
Haak is an exercise enthusiast and enjoys running, weightlifting, and sports performance training. He is the president and director of coaching of a youth tackle football organization, JDL Providence Football, and currently coaches high school football and weight lifting.
Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus - that is her home! She has family all over the world, and loves to travel as much as possible.
McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.
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