Hip flexor pain: Symptoms, causes, and 9 stretching exercises for treatment

When you bend at the waist or lift your knee towards your chest, about 11 different types of muscles work together to make that happen. 

This group of muscles are called hip flexors, and they play a major role in lower limb movement, allowing us to bend, walk, sit and kick, among other various movements. 

Similar to the other muscles and tendons in our body, the hip flexor can put up with a fair amount of wear and tear. But over time it loses flexibility and gets injured or strained due to overuse or sudden trauma. 

Hip flexor pain ensues, which can range from mild, to moderate, to severe, affecting your mobility and sidelining you from your daily activities and routine. 

To help you beat hip flexor pain fast, here’s a rundown of facts about these hip muscles and some simple at-home treatments guaranteed to be effective for mild to moderate cases.

What are hip flexors and what do they do?

Hip flexors are a group of flexible muscle tissues connecting the top of the femur to the hips, lower back and groin. 

Its major components are the iliopsoas muscles — the joined psoas and iliacus muscles that also serve as the strongest flexors of the hip — and the rectus femoris, which forms part of the quadriceps.

The hip flexor is responsible for keeping us balanced and for various hip movements such as bending (flexion) and extending the leg behind (extension), as well as inward (adduction) and outward (abduction) leg movements.

Being responsible for mobility, these muscles are prone to overuse and over stretching, especially in physically active individuals, leading to hip injuries, strains and other forms of discomfort. 

How does hip flexor pain feel like?

Most often, hip flexor pain persists in the upper groin area, where the thigh meets the pelvic region. 

Depending on which muscle area is affected, hip flexor pain is usually accompanied by several other symptoms, among them tenderness and weakness when walking or climbing stairs, a pulling sensation in the groin, limping, muscle spasms, swelling and bruising on the hip or thigh areas. 

You’ll experience discomfort and decreased range of motion usually while running, kicking, walking and even when sitting down, especially for a long period.

7 common causes of hip flexor pain

1. Arthritis 

When the hip joint cartilage wears down, as in the case of osteoarthritis, the bones rub together with an amount of friction that can cause mild to severe hip pain, along with hip tenderness and a loss of flexibility.

2. Hip flexor strain or tear

Muscles get torn or strained when subjected to sudden movements or are being overstretched, leading to a sharp pain in the pelvic or hip area.

3. Hip flexor tendinopathy

Swelling, pain and tissue breakdown can happen to the tendons in the hip, whether due to overuse, aging or by sudden trauma such as accidents.

4. Hip Impingement 

Hip impingement is caused by abnormal bone growth that forces the bones to rub against each other during movement, leading to groin pain and decreased hip motion.

5. Hip labral tear

The cartilage that lines the hip joint socket, called the labrum, cushions the joint and holds the thigh bone within the hip socket. Repetitive twisting, running and kicking movements of the hip joint may cause labral tears that manifest as a  deep and dull groin pain.

6. Iliopsoas bursitis
An inflammation of the bursa, the sacs in between the hip joint and iliopsoas muscle, can happen to athletes and arthritis patients.

7. Tilted pelvis

Poor posture, childbirth and sitting for prolonged periods may contribute to misaligned pelvis, causing hip tightness and pain.

Hip flexor pain treatment: The RICE method 

For mild to moderate pain, the first step in home care treatment is the RICE (rest, ice, compression and elevation) method. This self-care technique is the standard in alleviating soft tissue injuries. Cost-effective and easy to do, the RICE therapy delivers in most cases, but it can also be done while waiting for your appointment with an orthopedist or physical therapist. 

Home care treatment for hip flexor pains consist of the following steps:

Rest: Taking stress off the affected area of your hip can help prevent the discomfort from getting worse. Do not engage in any strenuous activity like jumping or running to avoid exacerbating your hip muscle condition.  

Ice: This natural pain reliever numbs your pain receptors and reduces swelling. Applying a hip ice pack not only spares you from the side effects of painkillers, it also saves you from paying for expensive medicines.

Do not apply ice for more than 20 minutes. Cover the pack with a thin cloth or towel before using it on the affected area. 

Compress: Applying proper compression amplifies the impact of cold temperature in swelling reduction. Wrap the cold pack with an elastic bandage to fasttrack the flow and circulation of oxygen-rich blood towards the injury site. 

This orthopedist-designed hip ice pack keeps cold for longer while its adjustable straps ensure you’re getting proper compression for faster pain and injury relief.

Elevate: Your hip should be elevated to keep the swelling to a minimum. By keeping it above your heart, you’ll keep fluids away from the injury site.

Along with the RICE method, a stretching and exercise regimen shall complete your home therapy program to ease hip flexor pain.

9 best stretching exercises for hip flexor pain

Done regularly, these movements aim to not only relieve pain but to also strengthen your hip muscles and tendons, helping prevent recurring injuries. 

Kneeling hip flexor stretch

1. Kneel on your right knee.
2. Put your left foot on the floor.
3. Keep your back straight while leaning your hips forward slightly until you feel a stretch at the front of your hip.
4. Hold this position for 15-30 seconds.
5. Repeat three times with each leg.

Seated butterfl

1. Sit on the floor with your feet together in front of you and your knees bent to the side. Keep your back straight, shoulders down and abs tight.
2. Bend forward from the hips until you feel tension.
3. Breathe deeply and hold the position for 30 seconds.
4. Return to the starting position.

Pigeon pose

1. Kneel on all fours on the floor. 
2. Bring your right knee forward and place it behind your right wrist with your ankle near your left hip. 
3. Straighten your left leg behind you and let your upper body fold over your right leg. 
4. As you breathe, sink deeper into the stretch.
5. Repeat on the other leg and as many times as desired.

Glute bridge

1. Lie on your back, keep your feet apart and flat on the floor with your arms straight and with palms flat on the floor.
2. Lift your hips up until your knees, hips and shoulders form a straight line. 
3. Squeeze glutes and keep your abs drawn in. 
4. Pause, then slowly lower yourself back to the starting position.
5. Repeat 10 times for each set. Perform at least two sets per day.

Lunge with spinal twist

1. Stand with your feet together.
2. With your left foot, take a big step forward.
3. Bend your left knee and drop into a lunge, keeping your right leg straight behind you with your toes on the ground.
4. Place your right hand on the floor and twist your upper body to the left as you extend your left arm up.
5. Hold for 30 seconds. 
6. Repeat on the other side.

Skater squat

1. Stand with your feet shoulder-length apart. Clasp your hands in front of your chest.
2. Bend your knees in a squatting position while keeping your back straight and chest up.
3. Straighten your legs to push up to a standing position, shifting weight to the left leg and lifting the right leg to the side, with toes from the right foot aimed forward. 
4. Do 10 repetitions for each set.

Hip flexion

1. Lay flat on your back on the ground and with your legs straight out. 
2. Slowly take your left knee toward your chest.
3. Pull it as close to your chest as possible. Stop when you feel uncomfortable or are in pain.
4. Return to the starting position, and repeat on your right leg.

Reclining angle bound pase

1. Lie on your back.
2. Bring the soles of your feet together. 
3. Allow your knees to open up and move closer to the floor.
4. Hold for 30 seconds. 
5. Repeat as many times as desired.

Forearm plank

1. Using your forearms instead of your hands, assume a push-up position. 
2. While keeping your body straight, lower your hips 
3. Tighten your abs and squeeze your glutes. Breathe deeply and hold the position for 15-30 seconds.
4. Repeat as many times as you like.

Hip stretching safety tips 

Apart from treating hip pain and preventing injury recurrence, stretching exercises also improve blood circulation and promote relaxation, as long as they are done properly.

Some simple guidelines can ensure you’re getting all the benefits of stretching while avoiding your hip pain from getting worse. 

First, prepare your body by taking a light walk. Second, practice proper breathing. Deep breathing helps you relax, while holding your breath causes tension in your muscles. Know when to inhale and exhale while stretching. 

You may be suffering from muscle and tendon tightness, so be wary of overstretching. Start slowly, moving past slight discomfort. Hold the stretch for 10-30 seconds to  ensure that your muscles are suitably flexible. Listen to your body. If it’s starting to hurt, you’re pushing too hard. Stop and reduce stretching intensity if this happens.

Other treatments available for hip flexor problems

You may take non-steroidal anti-inflammatory drugs (NSAIDs) for hip flexor pain. However, keep in mind that these medicines are not recommended for long-term use and do come with side effects. 

If the pain you’re experiencing does not improve after a few days or it worsens, schedule an appointment with a hip specialist. Serious cases of hip flexor problems, like a huge muscle tear, require medical intervention. On rare occasions, surgery might be recommended. 

Conclusion

Weak and tight muscles get easily injured, inflamed or irritated. But these conditions can easily be dealt with even at home. Just remember to keep ice packs handy and include hip flexor stretches and strengthening exercises in your regimen to keep that hip off the surgery table. 

What are your thoughts about hip flexor pain and treatment? Do you have questions about hip ice packs? Let’s start a conversation here.