Hip Flexor Strain

A hip flexor strain causes pain at the front of the hip. The hip flexors are a group of muscles which work to lift the thigh upwards. They also assist in lifting the trunk when in a laying position. The two main muscles in this group are the Iliopsoas and the Rectus Femoris.

Symptoms of a Hip Flexor Strain

  • Pain at the front of the hip.
  • Pain develops suddenly.
  • Pain is made worse by raising the thigh against resistance.
  • Stretching these muscles may causes pain.
  • It may be tender to touch the area at the front of the hip, although Iliopsoas is very deep so difficult to feel. Tenderness is more likely to indicate a Rectus Femoris injury.
  • Swelling and bruising may occur in severe cases.

Causes of Hip Flexor Strain 

A strain is a muscle tear. These range in severity from minor (grade one, where only a few fibres are torn), to a full rupture (grade three). Whilst a Rectus Femoris tear is not an uncommon injury, damage is more often located in the belly of the muscle, or towards the attachment at the knee. It is less frequent for the upper portions to be torn, resulting in pain at the front of hip.

The Iliopsoas muscle is located higher up, within the pelvis and is more frequently the muscle involved when one of the hip flexors is torn. However, this is not a common injury.

Injuries most frequently occur as a result of a strenuous hip flexing motion, such as when kicking a ball. It may also occur from over-stretching the muscle, which would involve a backward movement of the thigh.


Treatment should involve:

  • Rest from aggravating movements and activities until pain free.
  • Apply ice regularly.
  • Once pain free to do so, start gentle hip flexor stretches.
  • Strengthening may begin after 2-7 days depending on severity and pain levels.
  • Isometric contractions should be used first - the muscles are contracted against resistance, without movement!
  • These can be progressed provided they are pain-free.