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What is a Hip Flexor Strain?

A hip flexor strain is an overuse injury to the flexor muscles of your hip and can range from a minor stretch injury to a complete tear of the muscle fibers or tendons. 
The hip flexors are several muscles that allow the flexion movement (bending) of your hip and include the following:

  • Psoas major muscle
  • Iliacus muscle
  • Rectus femoris muscle
  • Pectineus muscle
  • Sartorius muscle

The severity of a hip flexor strain can grade as follows:

  • Grade 1 tear: A few muscle fibers are damaged
  • Grade 2 tear: Damage to significant muscle fibers with moderate loss of muscle function
  • Grade 3 tear: The muscles are torn or ruptured completely and you usually can’t walk without a limp

Causes

The common causes of a hip flexor strain include:

  • A fall or a slip
  • A sudden blow to the hip flexor muscles
  • Too much exercise in a short time
  • Activities involving repetitive movements such as cycling, jumping, dancing, martial arts, and football

Symptoms

You may experience a tearing or popping sound when the injury occurs. Common symptoms include:

  • Pain while stretching your leg or bending towards your torso
  • Muscle spasms at the thigh or hip
  • Tenderness, swelling and bruising around the hip

Diagnosis

Diagnosis of a hip flexor strain includes a review of your symptoms and medical history. A physical examination will be performed by your doctor to check the affected hip for pain, swelling, and inflammation. X-ray’s, CT-scan or MRI scanning may be ordered. 

Treatment

Your doctor may suggest the following treatment options:

  • Rest: Rest your hip by refraining from the activities that may cause further injury. 
  • Ice packs: Use of ice packs may be suggested to reduce inflammation.
  • Compression: Wrapping your hip with an elastic bandage or compression stocking can help minimize the swelling and support your hip.
  • Elevation: Elevating your leg above heart level will also help reduce swelling and pain. 
  • Pain medications: A combination of non-steroidal anti-inflammatory drugs (NSAIDs) and opioids may be used to manage pain.
  • Exercise: Physical therapy exercises will be taught to enhance your flexibility, range of motion and strength.

Grade 3 injuries may require surgery to repair the torn muscles and tendons. 

  • Indiana University Health
  • International Cartilage Regeneration & Joint Preservation Society (ICRS)
  • Osteoarthritis Research Society International
  • American Orthopaedic Society for Sports Medicine
  • Arthroscopy Association of North America
  • American Academy of Orthopaedic Surgeons