How to Manage a Hip Flexor Strain (Tips & Rehab Exercises)

So, you overdid things in the gym or on the field and now you’ve got hip pain.  Or, perhaps you’ve been spending many days in a row now sitting behind a desk or on the couch without moving around a lot and now your hips hurt.  Depending on how bad your symptoms are, you may have a strained hip.

Thankfully, managing your hip flexor strain can usually be done right at home.  With certain rehab exercises, stretches, and maybe even a simple lifestyle change or two, you should be back to normal in no time.  Here’s our easy guide to managing your hip flexor strain.

Understanding Your Hip Flexors and Hip Flexor Strains

Before we get into how you can manage your hip flexor strain, you must have at least a basic understanding of this important muscle group.  Unfortunately, because the hip flexors are a smaller group of muscles, they’re often overlooked by larger muscle groups. 

Yet, a strain in this small muscle group is enough to keep you out of the gym for weeks and leave you in serious pain.  Therefore, start by getting to know your hip flexors a little better!

Anatomy of Your Hip Flexors

All of the muscles in your hips are grouped based on the types of movements they help initiate.  Therefore, the hip flexors are the muscles in the hips that help initiate hip flexion.  Flexing the hips allows you to raise your legs forward.  The movement is initiated from the hip joint by the hip flexor muscles.  Not only do your hip flexors help raise your legs forward, but also allow you to:

• Bend your knees up to your hips
• Lift your knees towards your chest
• Maintain balance in your posterior pelvic muscles

Several muscles make up your hip flexor muscle group including the:

• Psoas major and psoas minor (also called the iliopsoas)
• Iliacus
• Pectineus
• Rectus femoris

The iliopsoas is the largest and most important of the hip flexor muscles.  It does most of the initiation of movement from the hips while the other four muscles assist it.  It attaches to the lower back, also known as the lumbar spine, then runs through the pelvis and eventually attaches at its other end to the top of the femur.

The hip flexor muscles have a tight relationship with the quadriceps because the rectus femoris is technically also part of the quads and because the quads extend from the hips to the knees.  So, taking care of your hip flexors will also have an impact on your quads and vice versa.

What is a Hip Flexor Strain?

A hip flexor strain is a type of hip flexor injury categorized by hip flexor pain near the front of the hips by the groin.  The pain comes from inflammation or tearing of the hip flexor muscles and/or tendons within the hip flexors.

If left untreated, the strain can turn into tendonitis, which is more severe inflammation or tearing of the hip flexor muscles that often leads to degeneration.  As soon as you start to experience frontal hip pain, even if it's mild, make sure to address it to prevent it from developing into tendonitis. 

What Causes Hip Flexor Strains?

You don’t need to do a whole lot to strain your hip flexors.  In fact, you don’t need to do anything at all to strain them!  Most hip flexor strains are caused by sitting for long periods and having an overall very sedentary lifestyle.  And, when you sit with poor posture, you’re even more likely to strain your hip flexors.  When you regularly sit down for extended periods, your hip flexors not only weaken but also tighten up.  Both weak and tight hip flexors are common causes of strains.

Other times, hip flexor strains are caused by overstretching and overuse.  Overuse injuries usually occur in athletes who play sports where a lot of kicking or lifting from the knees is involved.  For example, soccer players, dancers, and track and field athletes are usually some of the most prone to hip flexor strains related to overuse.

Common Signs That Your Hip Flexors are Strained

The most common sign that your hip flexors are strained is generalized hip pain.  Some additional signs that you may be dealing with a hip flexor strain include:

• Sharp pain
• Hip, pelvis, or lower back pain
• Pain while extending the leg backward
• Stiffness after sitting
• Tenderness while walking upstairs or kicking

If you have any one of these symptoms, you could be dealing with a hip flexor strain.  And, if you’re an athlete who kicks a lot or someone who finds themself sitting behind a desk for much of the day, then the odds of you having a strain are even higher.

Sadly, x-rays cannot show whether or not you have a strained muscle.  However, they can show if fluids are accumulating around a muscle, which is a common sign of inflammation and a potential indicator of a strain.  Therefore, you might not be able to get a formal diagnosis for your strain and may just have to go off whether or not you’re experiencing one or more of these symptoms.

Different Degrees of Hip Flexor Strains

If you are struggling with a hip flexor strain, then hopefully it’s one of a lesser degree.  Strains of lower degrees are overall less painful, more manageable, and simpler fixes.  However, if you’re experiencing debilitating pain, you, unfortunately, could be dealing with a higher degree of strain.

There are three key degrees of strains:

• 1st degree:  Small tears in only a few tendon or muscle fibers with only moderate pain
• 2nd degree:  Multiple tears in tendon or muscle fibers with some loss of hip flexor function
• 3rd degree:  Completely torn tendons or muscles with almost entire loss of hip flexor function

Hopefully, if you do have a strain, you’re only dealing with a 1st or 2nd-degree one.  The higher the degree the strain is, the more likely you’ll need to see a doctor.

Best Rehab Exercises For a Hip Flexor Strain

Once you’ve got a better understanding of your hip flexor strain, it’s time to move on to learning how to manage it.  And, the best way to do that is to do the right exercises and stretches.  These movements will help strengthen your hip flexor muscles while stretching them out to help manage the pain and prevent further injuring them. 

Before getting started, make sure you’ve got all the necessary health information you need so that you’re not overdoing it and accidentally making your injury worse. Also, if you want to help prevent hip flexor strains in the first place, then make these exercises and stretches a part of your regular warm-up routine!

Best Strengthening Exercises For Hip Flexor Strains

Strengthening your hip flexors with these exercises is extremely important for anyone who has weak muscles thanks to spending long hours sitting around.  And, if you want to prevent hip flexor injuries in the first place, then making sure that the muscles are strong to begin with is super important!

1. Lunges:  Start standing up straight with your feet hip-width apart and hands on your hips.  When you’re ready, step your right foot forward and bend your knee so that your right leg is at an almost 90-degree angle and your left knee hovers just above the floor.  Press back up and return your right foot to the starting position next to your left foot.  Switch to stepping your left foot forward and keep alternating between legs.  You should feel your glutes, hamstrings, and quads fire up throughout the movement.

2. Pelvic tilts:  Pelvic tilts are a very small movement that barely looks like an exercise at all.  Start by laying on your back in a neutral spine on a soft, flat surface.  Bring your feet in towards your glutes so your knees bend.  Your neutral spine actually has a slight curve to it near the lower back; the goal with pelvic tilts is to flatten that curve. Exhale and press your low back into the floor then inhale and return to neutral.  Imagine that there’s a little blueberry under your lower back and you’re trying to squish it.  Keep alternating slowly between the neutral spine and squishing the blueberry.

3. Marching:  Probably the simplest of all the hip flexor exercises is marching.  You can do it in place or simply by going for a march instead of a walk.  Just be sure to get the full range of motion by lifting your knee high enough so your leg creates a 90-degree angle.

4. Straight leg raises:  Start by laying down on a soft, flat surface and getting into a neutral spine position.  Pull both your feet in towards your glutes so your knees bend.  Extend your right leg out straight while keeping your left leg pulled in. When you’re ready, exhale and raise your right leg straight up into the air while keeping your back straight.  Only lift your leg as high as it will go without curving your back.  Inhale and drop the right leg back down.  Lift and lower the right leg 10 times then switch to the left leg.

5. Just stand up: Standing still isn’t necessarily an exercise, but it will do absolute wonders for your hip strain.  The next time you’re tempted to sit down while eating dinner, watching TV, or checking your email, do it standing up instead.  Sitting looks innocent, but it can take a major toll on your entire body including the hip flexors.  Studies show that people who spend more time sitting are not only at a greater risk for hip injuries, but also several other diseases and premature aging. The bottom line, just stand up!

Best Hip Flexor Stretches For Strains

Stretching your hip flexor muscles helps make them more flexible.  The more flexible they are, the greater range of motion they have and the less likely you are to injure them.  And, if you’re an athlete, having flexible hip flexors will also allow you to kick higher, run faster, and overall improve your athletic performance.

1. Kneeling lunges:  Kneeling lunges are very similar to the regular exercise lunge.  But, rather than firing your hip flexors muscles up, they stretch them out.  Start by standing up straight with your feet hip-width apart.  Take a step forward with your right foot just like you would with a regular lunge.  Then, drop your left knee down to the ground so that you’re in a lunge position but kneeling.  Shift your weight into the heel of your right foot to stretch out those hip flexors.  Try to hold the position for at least 1 minute then switch to the other side.

2. Butterflys:  Sit up straight on your glutes on a soft surface.  Press the bottoms of your feet together so that your knees fall outside of your hips.  Hold your feet with your hands and try to lower your chest forward and get your knees as close to the ground as possible.  If you’re doing this right, your legs will look like the wings of a butterfly.

3. Hip flexor stretch with resistance band:  Grab a resistance band and lay down on your back on a flat surface.  Wrap the resistance band around the bottom of your right foot and hold one end of the band in each hand.  Keeping your back flat and hips square, pull your foot up into the air straight towards your chest.  Not only is this going to stretch your hip flexors but it’ll also target your hamstrings.  Hold the stretch for 1 minute, then lower the right leg and switch to the left.

Additional Treatments For Strained Hip Flexors

In addition to doing rehab exercises and stretches, you can also give these treatments a try to help heal your hip flexor strain:

1. Spend more time standing:  We’ll say it again here because it’s that important: If you believe that your hip flexor strain is the result of sitting for extended periods, then the solution is simply to start standing up more.  Spend all day behind a desk?  Invest in a standing desk!  Or, the next time you go to turn on your tv, walk in place to avoid planting yourself on the couch.  Whatever method you choose, the whole point is to simply spend less time sitting.

2. Take some time off from activities:  If you believe that your hip flexor strain is due to overuse, then give yourself some recovery time by taking time off from strenuous activities.  While you’re resting, spend some time making sure that you’ve got good posture and not making the injury any worse.  When you’re feeling better and it’s time to get back to activities, you can give a hip flexor wrap a try.

3. Ice ice ice:  Last but not least, try icing the front of your hip or wherever you’re feeling the most pain.  Ice helps to calm inflammation which can reduce some of the pain.

If you’re suffering from a very severe strain, then you may need to have surgery.  While it is rare, it’s possible if it’s bad enough.  But, before you jump to conclusions, be sure to get solid medical advice from a healthcare professional. 

If your strain is bad but not bad enough for surgery, then you’ll probably want to pay a visit to a physical therapist or sports medicine doctor.  Physical therapy would be the best way to help repair a bad tear and alleviate the pain.

The Bottom Line on Hip Flexor Rehab

Whether you’re an elite athlete or a perpetual sitter, a hip flexor strain can strike at you!  If you’re already there, then make sure to do all of our top exercises and stretches to manage that strain. 

And, if you don’t currently have a strain, then do them anyway in order to prevent a strain from developing in the first place.  The best thing about a hip flexor strain (if there is one) is that you can probably solve it on your own.  So get to it so you can get back into the gym!

Bonus tip:  When you’re doing your hip flexor exercises, be sure to get the full range of motion to get the maximum benefit of each movement!