How to fix hip flexor strain

Hip flexor pain can usually be treated quickly with non-surgical, low-risk treatments. In fact, one study found that 80% of college athletes who reported strained hip flexors were able to return to play in less than one week.1 The most effective treatments are typically rest and self-care.

See Understanding Hip Flexor Pain

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Making simple changes or including self-care treatments can make daily life with hip flexor pain manageable.

Self-care for hip flexor pain may include:

• Avoiding bending at the hip, such as when reaching into a stove or picking up a child, in order to rest the affected area.
• Avoiding activities that put stress on the hip, including any sports that involve running, kicking, or turning. A person may want to consider limiting going up or down stairs or walking long distances; however, activities should not be completely avoided.
• Applying ice or heat to the affected area of the hip or groin. This can be done with ice cubes or frozen vegetables (in plastic bags) wrapped in a towel, or a hot water bottle.
• Compressing the affected hip with an elastic bandage to reduce any swelling. The elastic bandage can be wrapped around the hip and pelvis. Compression should be moderately tight without causing any additional pain.
• Elevating the affected leg when possible to reduce any possible swelling.
• Taking over-the-counter pain medication, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may help with hip flexor pain. Be careful when taking over-the-counter pain relief as they may come with side effects and are not recommended for long-term use.

See Groin Strain and Injury

Not all of these remedies will work for everyone. People are encouraged to try out each one to determine what works best.

While many cases of hip flexor pain can be relieved with at-home treatments, sometimes pain persists. In these cases, medical attention may be necessary.

When to See a Doctor

In many cases, hip flexor pain can be resolved with home treatment within a few weeks. If pain persists for more than 4 to 6 weeks, contact a doctor. A doctor can make a diagnosis and recommend appropriate treatment.

See Causes of Hip Flexor Pain

A person should seek immediate medical attention if they experience:

• Severe pain or sharp and shooting hip or groin pain
• The inability to walk or bear weight on the affected hip
• Sudden swelling in the hip or groin
• Protruding bones or deformities, especially after falling or a car accident
• Signs of an infection, such as a fever, redness, and the chills

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These are signs of serious injuries that need immediate medical attention.

Watch: Hip Pain Diagnosis Video

Hip flexor tears are categorized from grade one to grade three, with the majority classified as grade two.

• Grade 1 tears — minor tears where only a few muscle fibers are damaged.
• Grade 2 tears — a moderate amount of muscle fiber is damaged, and there is a potential for loss of function in the hip flexor.
• Grade 3 tears — the muscle fibers are completely torn. If you have suffered a grade 3 tear, you probably can’t walk without a limp.

Causes of a hip flexor tear or strain

A hip flexor strain is typically caused by overuse.

Other causes of hip flexor tears or strains:

• Extended periods sitting (muscles in the hip stay contracted for a long period of time)
• Weaknesses in muscles surrounding the hip flexors
• Acute contraction of the muscles

Risk factors for a hip flexor tear or strain

Certain groups of people are more likely to experience a hip flexor tear or strain including people who have muscle imbalances, people who have weak muscles or are not properly conditioned, and athletes who run, jump and perform high knee kicks.

Sports where this is common include:

• Soccer
• Football (kickers)
• Dancers
• Cyclists

Symptoms of a hip flexor tear or strain

Sudden hip pain is the most common symptom associated with a hip flexor tear or strain. The pain and other symptoms can range from mild to so intense that it impacts your mobility.

Other symptoms of a hip flexor tear or strain include:

• Pain when lifting the leg to the chest or stretching the hip muscles.
• Swelling, bruising or tenderness in the hip or thigh area.
• Muscles spasms in the thigh or hip that occur when walking or running.

Diagnosis of a hip flexor tear or strain

A hip flexor strain or tear is diagnosed in a full medical exam with your Mercy Health primary care or sports medicine doctor.

Your physician will take your medical history and perform a variety of range of motion tests to determine where the pain is the greatest.

An x-ray may also be ordered to rule out a fractured hip.

Treatment for a hip flexor tear or strain

It is important to rest and seek treatment right away for a suspected hip flexor strain or tear. If left untreated, the condition could worsen and recovery time is extended.

Home remedies including rest, ice, compression, elevation combined with anti-inflammatory medication can alleviate some of the symptoms of a hip flexor tear or strain. Your physician may also recommend using crutches to keep the weight off the hip.

• Brace — a brace can help compress and stabilize the hip flexor to speed healing.
• Physical therapy and rehabilitation — if pain persists longer than a couple weeks, your physician may prescribe a physical therapy program to help you increase your flexibility and strength.
• Platelet rich plasma (PRP) injection — a PRP injection can be used to expedite healing by injecting concentrated growth factor platelets from the patient’s own blood into the hip.

Although most hip flexor strains or tears are treated without surgery, if the muscle has been completely torn, you may require surgery to repair the hip flexor and restore function.

Recovery from a hip flexor or tear

Your physician will recommend avoiding strenuous activity for 10-14 days after the injury. If pain returns after resuming activities, discontinue what you are doing and rest.

To avoid future hip flexor strains or tears, warm up and cool down before and after exercise, wear appropriate protective gear for your sport and make sure you let your body heal before returning to your normal activity levels.

Hip flexor strains are most often caused by “overdoing it.” While not usually serious, this injury can be quite painful if left untreated. Understanding what a hip flexor strain is and its symptoms can help you get the right treatment for this common orthopedic condition.

What Are Hip Flexors?

Hip flexors are the flexible muscle tissues located near the top of your thigh and pelvic region. They allow you to flex your hips and bend your knees. Overuse or overstretching of these muscles may result in a hip flexor strain, which can significantly limit your activity and mobility.

This orthopedic injury typically occurs when the hip flexor muscles and tendons are used too much, causing stretching or tearing. Some people are more prone to hip flexor strains than others due to their activity type and level. Active individuals who may be at a higher risk for this condition include:

• Cyclists
• Dancers
• Football players (especially kickers)
• Martial artists
• Soccer players

Hip flexor strains typically occur when the muscles are stretched or torn. This condition is classified into three grades depending on its severity:

• Grade I tear: A minor tear in which a few fibers are damaged. The hip still functions normally.
• Grade II tear: Several muscle fibers are damaged. There is a moderate loss of hip flexor function causing the hip to occasionally give out while standing or walking.
• Grade III: The muscle is completely torn. The hip can no longer bear weight.

Most hip strain injuries begin as a microscopic tear that gradually increases in size with repetitive hip movement. Addressing a minor tear early on is the best way to prevent the condition from worsening.

Symptoms of Hip Flexor Strain

The primary symptom of a hip flexor strain is pain where your thigh meets your hip. However, there are several other symptoms associated with this orthopedic condition:

• Sharp pain in the hip or pelvis
• Cramping in the upper leg muscles
• The upper leg feels tender or sore
• Tugging sensation in the front of the groin
• Difficulty kicking, jumping or sprinting
• Tightness or stiffness after being stationary
• Pain or tenderness when walking up the stairs

While sports are one of the more common causes of hip flexor strains, other factors can contribute to this injury. Overuse, poor posture or walking habits, and arthritis are among some of the non-sports related causes.

A hip specialist will be able to confirm your diagnosis with an exam. They will discuss your symptoms as well as the activity that may have caused your hip pain and create a treatment plan for you.

Hip Flexor Strain Treatment

Most hip flexor injuries can be treated at home and don’t require prescription medications or invasive procedures. Your doctor may suggest applying ice to the affected area in 10- to 15-minute increments. They will also recommend you avoid activities that will overuse your hip flexors. Additionally, gentle stretching exercises can help reduce muscle tension and decrease the likelihood of future injury.

If your injury is the result of a larger muscle tear, your hip specialist may recommend physical therapy. Occasionally, surgery to repair the ruptured muscle may be recommended—however, this is very rare.

Recovery time often depends on the severity of the injury. Mild strains may take a few weeks to heal while severe strains, on the other hand, can take up to six weeks or more to recover fully. Failing to rest appropriately typically results in greater pain and worsening of the injury.

Nagging hip pain can bring your day to a grinding halt. Knowing what a hip flexor strain is and how our “Centers of Excellence” can help you regain mobility in your hip once again can get you on the road to recovery faster. Make an appointment today with one of our NY Orthopedics locations in New York City to start your healing journey.