Complete Guide to Hip Flexor Tendonitis

Posted by: Doug Cahill

When we think of tendonitis we think of getting old and aging getting the best of us. This doesn’t mean that we are not vulnerable to tendonitis, more specifically hip flexor tendonitis earlier on in our lives when we are more or less healthy. This article should cover most of the information about hip flexor tendonitis.

Background: What is It?

Hip Flexor Tendonitis is pain caused by tendon inflammation, which is typically caused in the hip flexor region by repetitive movement of major muscles.  It is an extremely common Hip Flexor injury since many activities have a high rate of repetition.  Since tendons attach muscles to bones, they are always tied together, that is why if there is tendon damage, it is usually the result of muscle damage.  Hip flexor tendonitis is also often called Iliopsoas tendonitis due to the fact that the Iliopsoas is often the affected muscle.  To learn exactly what the Iliopsoas is composed of and where it is, refer back to the hip flexor anatomy page.

How is Hip Flexor Tendonitis Caused?hip flexor tendonitis

As alluded to earlier, hip flexor tendonitis is caused through overuse of a particular muscle, which in turn inflames the associated tendon.  If you are young and have hip flexor tendonitis, chances are good that you are an athlete, as running/cycling and all kinds of activities require repetitive movements and actions using the hip flexors.

In a nutshell, hip flexor tendonitis is an overuse injury, which is hurt by trying to do ‘too much too fast’.  This is why it often affects athletes who try to increase their training volume, but do so too much or without a sufficient base fitness level.

How do you Diagnose Hip Flexor Tendonitis?

Because of the type of injury it shares many symptoms with a hip flexor strain, which are commonly exhibited through pain while lifting your leg, and inflammation, tendonitis can be hard to diagnose.  One difference that many people experience is that when they perform a hip flexor stretch, the ones with hip flexor tendonitis often experience MORE pain, rather than relief;  while this is not a reliable test, as hip flexor strains can also have this symptom, it is more often than not indicative of tendonitis.

So while none of the above are conclusive there are a few more things you should do to determine if you have hip flexor tendonitis.  Firstly, when did you start feeling pain?  Did you get hurt performing an explosive movement or pushing your body outside your natural movement limits?  If so you probably have a hip flexor strain, in which case read more to confirm your diagnosis about your hip flexor pain.  If you cannot trace your pain back to a single movement, and it has gradually just increased through exercise, then you most likely DO in fact have hip flexor tendonitis.

Finally, if all of the above makes you think there is a significant chance you have hip flexor tendonitis, please see a doctor, this is an injury that is very difficult to diagnose through the internet, but doctors can run the appropriate tests to confirm your injury.

How is Tendonitis treated?

There are a few immediate things you should do if you suspect you have hip flexor tendonitis:

1)      Stop all activity IMMEDIATELY; this is an injury that cannot heal without rest.

2)      If you feel pain stretching, stop performing stretching, this will only aggravate the injury

3)      Ice the area, this should help bring down some inflammation

Once the diagnosis has been made by a physician, there are a few possible courses of action.

Standard Recovery

The priority of a standard recovery will be to bring down your hip flexor inflammation, which can be done using ice, anti-inflammatory medication, and/or cortisone injections.  The inflammation and damage will heal in time, which will then allow you to SLOWLY begin activity following a structured strength rehab program.

Iliopsoas Release

As mentioned at the start of this article, the Iliopsoas is often the source of the problem.  In many cases, the injury can be caused by overuse, which leads to a really tight Iliopsoas, which in turns causes the actual damage.  The Iliopsoas is a hard muscle to work with, which is why it is best to go see a licensed massage therapist who can perform deep tissue massage to release the muscle.  I have known several people personally who have had this injury cured after a few sessions of massage.


In some extremely rare cases, the tendon may be damaged beyond normal repair, if you are able to read this article and are not thriving around in pain, you probably do not need surgery.

Hip Flexor Tendonitis Summary

To summarize what you should do if you suspect you have hip flexor tendonitis:

  • Rest, stop ALL activity before you make the damage worse
  • Go see a doctor to confirm the diagnosis and get advice

If there is anything you want more detail on or feel wasn’t covered about hip flexor tendonitis, please leave a comment below.  Our homepage will help you navigate the site to learn more about your hip flexors.