Hip Flexor Pain: Symptoms, Diagnosis and Treatment

Severe hip pain
Medically reviewed by Dr. Ola Tarabzuni

Key Takeaways

  • Hip flexor pain is discomfort in the front of the hip or groin caused by overuse, sudden movements, or tight muscles.
  • Treatment includes rest, ice, and physical therapy exercises to stretch and strengthen the hip flexors.
  • Recovery requires a gradual return to activities and ongoing prevention through exercises.

Hip flexor strain is the repairable muscle injury that occurs when you move or stretch your hip muscles to more than their normal stretching capacity. Our muscles get strained when we get involved in extreme physical exercises that involve our hip muscles (the muscles that join our legs with the hips). You might feel difficulty in walking, sitting or pain during leg movement.

Hip flexors are a group of muscles located in the front of the hip and are responsible for flexing the hip joint, which is essential for activities like walking, running, and kicking.

Find below what hip flexor strain is, as well as other closely related injuries that might cause strain in the legs leading to pain and difficulty in daily activities.

What are hip flexor strains and other injuries?

Hip flexor strains are injuries to muscle tissue that occurs when the muscles and tendons in the hip flexor region become overstretched or torn. These strains can vary in severity, from mild stretching to partial tears or complete ruptures.

Some of the related injuries that cause flexor strains are clotted blood, Herniated disk, continuously pushed nerves and hip impingement strains. They can hinder the activity to an extent.

How common are hip flexor strains?

Hip flexor strains are one of the most common types of flexor strains caused by common physical activities. It is also called “sport’s injury” as it occurs mostly to athletes while performing different games.

The highest rates of strains were found in men’s soccer and men’s ice hockey (range, 2.47-3.77% per 10,000 Athletes) as per NIH

Some of the factors that contribute to the commonality of hip flexor strains are overuse, less warming up before starting a workout, weak muscles, age group variations and previous injuries.

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How do hip flexor strains affect my body?

You will experience pain and discomfort in your body accompanied by limited range of motion, muscle weakness, muscle spasms, altered moving patterns, tenderness, swelling and sometimes bruising.

Pain and discomfort: The first symptom of a hip flexor strain is pain in the front of the hip area.

Impaired motion: Hip flexor strains can lead to reduced motion making it difficult to perform activities that involve hip movement, such as walking, running, or climbing stairs.

Muscle weakness: In more severe cases, the strain can cause muscle weakness in the affected area, which may further limit your ability to move comfortably.

Muscle spasms: Strained hip flexor muscles may experience involuntary contractions or spasms, which can contribute to pain and discomfort.

Difficulty with activities: Everyday activities like standing up from a seated position, lifting objects, or even getting out of bed may become challenging due to the strain.

Compensation and altered movement patterns: When you have a hip flexor strain, you might unconsciously modify your movement patterns to avoid pain, which can lead to altered posture and put strain on other muscles, potentially leading to additional injuries.

Tenderness and swelling: Inflammation and swelling often accompany muscle strains, leading to tenderness and discomfort in the affected area.

Bruising: In more severe strains, bruising may develop around the hip area due to blood leaking from damaged blood vessels.

“People with hip flexor injuries will experience sharp pain in the front of the hip along with pulling and tightness in the same area” by Dr. Shane Arnold DC.

What are hip flexor strain symptoms?

Hip flexor strain symptoms will appear as:

  • Visible bruising
  • Muscle spasms
  • Pain in the front hip area
  • Pain in groin areas
  • Disturbed moving patterns.
  • Impaired/limited physical activity

What causes hip flexor pain?

Overuse: Performing physical activities without a break involving hip flexion can lead to muscle fatigue/ lethargic feeling and increased risk of strain.

Less warm-up before physical activity: Failing to warm up properly before physical activities can make the muscles more prone to hip flexor strain.

Weak muscles: Individuals with weak hip flexor muscles or imbalances in the surrounding muscle groups may be more prone to strains.

Age: With age, their muscles become weak and more prone to injury.

Sedentary lifestyle: People who lead sedentary lifestyles or have poor posture may develop tight hip flexors, increasing the risk of strains during physical activities.

Previous injuries: If a person has had a previous hip flexor strain or injury, there may be an increased risk of re-injury.

Difference between muscle strains and pulled muscles: There is no difference between these two terms as they both are used interchangeably. They both are used to describe strains, tightness and pulled muscles due to expanding muscles more than their contraction limit.

How are hip flexor strains diagnosed?

Hip flexor strains will only be diagnosed by a healthcare provider by performing a physical examination.

History

During the initial information-gathering phase, medical providers gather details about the patient’s symptoms, medical background, and any relevant incidents that led to the injury. This may include inquiries about the timing and causes of the injury, the nature and location of discomfort, factors that worsen or alleviate the pain, and any past occurrences of similar injuries.

Physical Examination

Thoroughly examining the body is critical to assessing the extent and specific location of the hip flexor strain. Healthcare providers perform various assessments to figure out the range of motion, muscular strength, and pain experienced in the affected area. They may also apply manual pressure to the hip flexor muscles and adjacent structures to identify regions of sensitivity and precisely identify the origin of discomfort.

Imaging

Visual confirmation of the injury and the exclusion of other potential pain causes can be accomplished through imaging techniques. Common imaging methodologies utilized for diagnosing hip flexor strains include:

X-ray Imaging: X-rays aid in excluding fractures or other bone-related abnormalities that might contribute to the symptoms. Nonetheless, hip flexor strains primarily involve soft tissues and might not be prominently visible on X-ray images.

Ultrasound Imaging: Ultrasound technology provides real-time visualization of soft tissues like muscles and tendons. It assists in evaluating the degree of damage sustained by the hip flexor muscles and offers guidance for treatment decisions.

Magnetic Resonance Imaging (MRI): MRI, a potent diagnostic tool for soft tissue injuries, offers detailed images of muscles, tendons, and related structures. This facilitates determining the strain’s severity and the extent of tissue impairment.

Functional Tests

Functional assessments ascertain the hip flexor muscles’ capacity to execute specific movements and tasks. These evaluations appraise the hip joint’s strength, flexibility, and stability. Examples of functional tests that may be utilized include:

Test for Straight Leg Elevation: This test measures the flexibility and strength of hip flexors by assessing the patient’s ability to elevate the leg while lying on their back.

Treatments Are Available for Hip Flexor Pain

In mild cases of hip flexor injuries rest, ice packs for 10 to 15 minutes daily, anti-Inflammatory medication like Ibuprofen (Advil, Motrin) or Naproxen (Aleve, Naprosyn), and physical therapy are prescribed. In severe cases, surgery can also be prescribed to you according to the condition of the hip flexor strain.

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How to prevent hip flexor strains?

Hip flexor injuries can be prevented by following some easy precautionary measures including proper warm-up before getting involved in physical exercise, practicing some preventive exercises will help prevent the strains to a great extent.

Recovery Time

It will take a week or two to get back to normal activity after you have taken care of the diagnosis and treatment. Physical exam by a healthcare provider at the right time, medications like NSAID, rest and home remedies like ice will help you recover early so you can resume your daily activities.

FAQs About Hip Flexor Strain

How long does a hip flexor strain last?

Generally, it will last for a week or in severe cases two. It entirely depends on the cause and extent of hip flexor strain.

What medications are used to treat hip flexor strains?

Muscle relaxants like Cyclobenzaprine (Flexeril) are used (5 mg to 10 mg three times a day), Methocarbamol (Robaxin) and Baclofen are used.
NSAIDs including Ibuprofen (Advil, Motrin) 200 mg to 400 mg every 4 to 6 hours and naproxen (Aleve, Naprosyn) 220 mg to 550 mg every 8 to 12 hours is used

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