How to manage hip flexor pain: exercises and tips from physical therapists
Learn what causes hip flexor pain and how to prevent and treat it, especially with exercises recommended by physical therapists.
Table of Contents
Key takeaways:
1. Hip flexor pain is common and often improves with strengthening and stretching.
2. Staying active, adjusting activities, and using ice, heat, or physical therapy can help you recover and prevent future strains.
3. Targeted exercises to improve hip strength and flexibility can reduce pain and build resilience for daily activities (see videos below).
Hinge Health offers virtual physical therapy and more to help you manage hip pain. Learn more.
If you’ve experienced hip flexor pain, you're not alone — it's a common issue, especially among athletes. The hip flexors, a group of four muscles along the front of your upper thigh, help with everyday movements like walking, bending, and standing. Because they’re heavily used and strong, they can be prone to overuse or injury from sudden movements, like pivoting during sports, or from overexertion, such as lifting a heavy object or increasing activity levels too quickly.
Hip flexor pain can temporarily impact daily activities. “A mild strain might limit how long you can walk, while a moderate strain might affect climbing stairs or getting out of a chair," says Maureen Lu, PT, DPT, a physical therapist at Hinge Health. More severe strains can take a little longer to bounce back from, but you can always take steps to help the healing and recovery process along. Fortunately, most cases are mild to moderate and can be managed with conservative treatment.
Read on to learn more about hip flexor pain, including its causes and treatments — especially hip flexor exercises recommended by Hinge Health physical therapists.
Reviewed by our clinical and medical experts
Maureen Lu, PT, DPT
Jonathan Lee, MD, MBA
Dylan Peterson, PT, DPT
Hip flexor pain: a Hinge Health perspective
Hip flexor pain — specifically hip flexor strain — is most commonly associated with athletes. Still, the vast majority of us who spend most of our days seated are also susceptible to experiencing it due to tense muscles. “A strong muscle is a supple muscle, so if muscles — and the fibers in them — are more flexible, they’re less likely to become strained,” explains Dr. Lu.
That’s why being sedentary is the last thing you want to do when treating (or trying to prevent) hip flexor pain. Instead, taking action (literally) with hip exercises that improve strength and mobility in your hips is the key to improving your hip pain and getting back to living your life. As our Hinge Health care team says, movement is medicine.
Hip flexor pain causes
Hip flexor pain can have several causes, with hip flexor strain being the most common. A hip flexor strain occurs when one or more of the muscles in the hip flexor group (such as the iliopsoas or rectus femoris) are overstretched or torn. This can happen due to sudden movements, overuse, or repetitive activities like running, kicking, or lunging, leading to discomfort or pain in the front of the hip.
Other potential causes of hip flexor pain include:
Tendonitis, or inflammation of the tendons in the hip flexor muscles, often due to overuse.
Hip impingement, also known as femoroacetabular impingement (FAI). This is a condition where extra bone grows along one or both bones that form the hip joint, leading to pain and limited range of motion.
Hip labral tear. Damage to the labrum, the cartilage that surrounds the hip joint, can cause pain in the front of the hip.
Osteoarthritis. Changes to the hip joint are normal with age. Sometimes, these changes contribute to stiffness, pain, and discomfort.
Tight hip flexors. Prolonged sitting or lack of stretching can cause the hip flexor muscles to become tight, leading to discomfort or pain.
What is a hip flexor strain?
Hip flexor strain happens when you stretch or tear some of the thousands of fibers in your hip flexor muscles. As scary as that may sound, it’s important to keep in mind that the micro-tearing that occurs with mild to moderate strains is also what happens when we strengthen our muscles (think: the muscle soreness you sometimes feel after doing a new or challenging workout). It’s all part of how our muscles adapt to stress.
That adaptation happens on a continuum. If you slowly challenge your muscles and gradually increase the range of motion, load, and speed, micro-tearing can lead to muscle building, explains Dr. Lu. On the opposite end of the continuum, increasing the stress on a muscle really quickly — say, by doing a very challenging workout that your body wasn’t ready for — can result in muscle strain and hip flexor pain.
Just remember: Your body has the amazing ability to adapt. Doing hip strengthening and flexibility exercises can help you recover from a strain, and it can also make you more resilient to pain and injury in the future. “What our hip flexors can tolerate in terms of load, speed, and motion can be greatly increased over time,” says Dr. Lu. In other words, you can increase the load your muscles can handle so that challenging your body, or moving in new ways, results in muscle building as opposed to muscle strain.
What does hip flexor strain feel like?
The chief symptom of hip flexor strain is noticeable pain at the front of the hip where it meets your thigh. The pain may be persistent, or you may only notice it when you walk, run, or make certain movements, such as kicking or moving your knee or thigh toward your chest. Other potential symptoms may include:
Cramping and muscle spasms.
Difficulty getting out of your chair or up from the ground. This is especially true if you’re getting up quickly because that action requires your hip flexors to elongate from a compressed position quickly, says Dr. Lu.
Difficulty climbing stairs or walking up or down sloped surfaces.
Lower back pain. “One of the main hip flexors, the psoas, is directly connected to your lower back, so it’s not unusual to experience lumbar pain with hip flexor pain,” says Dr. Lu.
Swelling, inflammation, and bruising.
Instability or weakness in your hip and leg.
What causes hip flexor strain?
There are many ways you can stretch or injure the fibers of your hip flexor muscles. Some common causes of hip flexor strain include:
Overuse. Overdoing it at work or during physical activity can strain your hip flexors and lead to an overuse injury. This essentially means doing more than your body is ready for, or doing something for longer than your body can handle at that moment. Among athletes, hip flexor pain often affects cyclists, runners, football players, and dancers.
Lack of flexibility. Sometimes, too little activity or spending extended periods of time in one position can cause your muscles to adapt to be less elastic, which makes them more susceptible to strains. “After weeks, months, and years of being less active — say, due to joint pain or limited mobility — it’s a lot easier for something to trigger a hip flexor strain,” says Dr. Lu.
Trauma. An acute injury, like a fall or car accident, can strain your hip flexors, especially if you suddenly tense your muscles to brace for impact.
Exercises to relieve hip flexor pain
Want expert care? Check if you're covered for our free program →- Hip Flexor Stretch
- External Hip Rotation
- Dead Bug
- Standing Marches
The above exercises from Hinge Health are commonly used to stretch and strengthen the hip flexor muscles. You can also check out more moves that will help you open tight hips, a very common problem that can lead to hip flexor strain, so you can get back to your normal routine – hip, hip, hooray! (Sorry, we had to.)
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
Treatment options for hip flexor strains
Most hip flexor strains can be treated with simple measures, such as the following:
Physical therapy. Physical therapy helps treat hip flexor strain by reducing pain, improving mobility, and strengthening the muscles around the hip. A physical therapist will guide you through targeted stretches and exercises to gently stretch the injured muscles and gradually rebuild strength. They may also guide you through other techniques to promote healing and reduce inflammation, helping to restore normal function and prevent future strains. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.
Adjust your activity. After an injury, it’s important to work on restoring movement and strength as soon as possible. So while it’s okay to back off from activities that make your symptoms much worse, you should absolutely continue doing other activities that you can tolerate, says Dr. Lu. “Nudging into that pain is a perfectly safe thing to do,” she adds.
Ice and heat. Both ice and heat can be helpful for hip flexor pain. Right after an injury or pain flare, it’s usually better to use ice. Ice eases pain and swelling by constricting blood vessels and decreasing circulation to the area. After this period, when the area tends to feel tight but not painful, it often helps to switch to heat, says Dr. Lu. This loosens up muscle fibers and helps you recover your range of motion.
Over-the-counter pain medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for hip flexor pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.
How to prevent hip flexor strains
To help keep hip flexors humming along, take a cue from their name. They’re called flexors because their function is to flex the hip. And the more flexible they are when doing that job, the more room your muscle fibers have to stretch before they strain — and the better protected you’ll be from potential injury.
To keep your hip flexors flexible, try to warm up before exercise, even if you’re walking or doing something less intense than you normally do. Remember, every time you take a step, you’re using your hip flexor muscles.
Another smart move is to avoid sitting for long periods. “Hip flexor pain often starts as hip flexor tightness that goes unchecked,” explains Dr. Lu. “Consistently taking short standing or stretching breaks throughout the day can save you from injury a lot of times by keeping your hip flexors supple.”
PT tip: Tuck it in
When you do hip flexor stretches, try to tuck your pelvis underneath you, advises Dr. Lu. “Maintaining that tuck will help flatten your lower back, which can help you to really feel the stretch.”
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
Looking for pain relief? Check if your employer or health plan covers our program
References
Heger, E. & Strong, R. (2021, December 14). 7 doctor-recommended strategies to relieve hip flexor pain at home and when to visit your doctor. Insider. https://www.insider.com/guides/health/treatments/hip-flexor-pain
Alaia, M. J. (2020, July). Hip Strains. Ortho Info—American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/hip-strains/
Eckard, T. G., Padua, D. A., Dompier, T. P., Dalton, S. L., Thorborg, K., & Kerr, Z. Y. (2017). Epidemiology of Hip Flexor and Hip Adductor Strains in National Collegiate Athletic Association Athletes, 2009/2010-2014/2015. The American Journal of Sports Medicine, 45(12), 2713–2722. doi:10.1177/0363546517716179
How Long Does a Strained Hip Flexor Take to Heal. (2022, August 25). American Hip Institute & Orthopedic Specialists. https://www.americanhipinstitute.com/blog/how-long-does-a-strained-hip-flexor-take-to-heal-32964.html