Clinics in Bedford
Open Mon-Fri 9-5pm

Hip Flexor Pain

To understand hip flexor pain it is important to understand the anatomy. A group of flexible muscle tissue located in the pelvic region and top of your thigh is called hip flexors. Hip flexors allow you to bend and move your knees and hips easily. The iliopsoas muscle, also known as the psoas major and iliacus muscle, is referred to as the hip flexor. The other two muscles that sometimes qualify as hip flexors are the rectus femoris (part of quadriceps) and sartorius muscles. The hip flexors connect your femur to the hips, lower back, and groin region.

Overstretching and overuse of flexor muscles and hip joints can cause pain in front of the hip that can limit your activity and mobility. The people who are at more risk of hip flexor injuries include:

  • Weak muscles
  • Dancers
  • kickers
  • cyclists
  • Soccer player
  • Martial artist

Grades of hip flexor pain

It usually occurs due to muscle stretching. We can classify this condition into three grades based upon their severity.

Grade I: It is a stage with minor cuts in which very few muscle fibres are damaged. In this condition hip functions normally but with minor pain.

Grade II: In grade 2, many fibres of muscles are damaged. This causes a moderate loss of hip flexor function while walking or standing for a long time.

Grade III: This is the stage where the hip is no longer available to bear the body weight as the muscles are entirely damaged. It is accompanied by a sharp pain in the affected area.


The main symptom of a hip flexor is characteristic pain in the pelvic region. Hip flexor pain symptoms vary based on how much tissue has been affected. Some symptoms of hip flexor pain are:

  • Acute pain in the hips and pelvic
  • Cramping in upper leg muscles
  • Sore feel in the upper leg.
  • Difficulty in jumping, kicking and sprinting.
  • Pain when walking on stairs.

Occasionally, people with hip flexor pain experience referred symptoms in their buttocks and upper thigh. The location of your pain can indicate where you are experiencing tension. For example, someone who experiences pain below their knee may have tension in their iliotibial band (ITB), while someone with pain above their knee may have adductors issues.

Sport is the most common cause of hip flexor pain. Some non-sport-related issues include walking habits, poor postures, and arthritis.


Hip flexor pain is felt in the hip and pelvic region, and some movements like kicking, moving the knee towards the chest, and pivoting at high speeds make this pain worse. The main hip flexors are three muscles that run from your lower back to your thigh bone: The iliopsoas, rectus femoris, and tensor fasciae latae.

In medical terms, it’s called anterior (front) hip musculature. These muscles connect to multiple joints of your body and help you bend forward at your waist and lift your knees toward your chest. They also raise your legs when you walk or run, but that’s not as common these days. When they’re tight and inflexible, they can cause pain in several parts of your body.

The underlying causes of hip flexor pain are

  • Hip flexor strain
  • Iliopsoas bursitis
  • Hip flexor tendinopathy
  • Hip impingement
  • Osteoarthritis
  • Hip labral tear


Before you can prevent pain in the hip flexors, you need to know what caused it in the first place. Hip flexor problems are often related to muscle weakness and tightness in your hips. If you’re on your feet for long periods (for example, if you work in retail or as a delivery driver), you may not be properly warming up before standing—and over time, that can lead to muscle imbalances and tightness.

Hip flexors don’t tend to get as much attention as larger muscles such as quads or hamstrings, but they play an essential role in stabilizing your pelvis and lower back. So if one isn’t working correctly, it could contribute to posture problems and other problems further down your body.

Some people have loose hip flexors and therefore don’t experience any pain. If you’re one of those fortunate people, you probably won’t be too concerned about preventing hip flexor pain. However, if you do suffer from it, here are some tips on treating and preventing it: Pain in your hip flexors can often cause you to walk with an altered gait, leading to other areas of discomfort throughout your body.

So although your original injury may be in your pelvic region, it will soon spread out into other regions, for example, your lower back. This can sometimes make these injuries more complicated to treat, so prevention is better than cure!

Treatment of hip flexor pain


Some of the structures in and around the hip flexors have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that help to heal these structures.

Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is needed to heal them and provide pain relief.

As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.

Beating your hip flexors may be hard at first, but with the help of regular exercise, you can strengthen and loosen them. Start by doing a set of 50 for each leg (100 in total) every day and increase by 1 set every few days. The best exercise to do are step-ups, where you climb up something like three stairs then step down, bringing one foot forward at a time; 10 steps on each leg will do. Hip flexor stretches can help improve your muscle spasms and groin pain. This not only helps get back the lost range of motion but can also be a significant factor in limiting back pain.

To start with, you may need some help holding onto something if you have a bad balance or use an elastic band around your knees as support. You could also use ankle weights to start but don’t be too harsh when starting as it could damage your muscles more than help them. 

The following are some simple tips you can use to treat hip flexor pain in hip muscles:

  • Rest
  • Exercise (mild workouts)
  • Pain killers for quick pain relief (ibuprofen, acetaminophen)
  • Home remedies
  • Surgery (In severe cases)


When you feel pain in your hip flexors, moving and doing your usual activities can be challenging. To understand why hip flexor pain happens, you must first understand what a hip flexor is. Hip flexor muscles are a group of muscles—the iliacus, psoas muscle, and rectus femoris—that run from your inner pelvis to just below your knee and aid in lifting your knee toward your chest. When these muscles are tight or overworked, they may pinch one of two nearby nerves (the pudendal nerve or sciatic nerve), resulting in pain symptoms that vary by age group. Consult your healthcare professional or an orthopedic for immediate medical intervention. Your doctor may recommend seeing a physical therapist or a sports medicine expert if you’re an athlete.

Frequently Asked Questions

Should I stretch my hip flexor if it hurts?

Stretching the hip flexor before a workout or stannous activity is beneficial. Moreover,  when the hip flexor feels tight, then stretching assists you in improving your mobility.

Does walking help hip flexor pain?

With flexor pain, physical activities are not entirely avoided. A gentle walking for about 3 minutes before doing stretching can help to reduce the risk for hip flexor stress. But you should limit this walk; too much intense workout negatively influences the body.

Are squats good for hip flexor?

Yes, squats are good for hip flexors. Squats move in and out of the contraction and play a vital role in raising the endurability of the hip flexor. Furthermore, squats and lunges perform the same job as psoas by contracting the muscles and the hip flexor itself.

Can sitting cause hip flexor pain?

Sitting for a very long period can be a causing factor in hip flexor pain. Sitting in a constant position for many hours may result in the hips flexors and other muscles stiffening up, which can cause compression, reduce the ability to move, and produce pain in the buttocks.

What causes weak hip flexor?

Inadequate use of the muscles and sitting in a constant position for an extended period are the contributing factors to weak hip flexors. Conditions such as cerebral palsy, osteoarthritis, and lateral transpose surgery can also lead to weak hip flexors.

What are the signs and symptoms of a hip flexor strain?

Signs and symptoms of hip flexor strain include:

  • Difficulty in climbing stairs up and down
  • Severe pain, swelling, bruising, and spasms
  • Difficulty coming up from a squat or getting out of a chair
  • Mild pain and pulling in the front of the hip
  • Intense pain and cramping

How long does it take for a hip flexor strain to heal?

Recovery time for a minor hip flexor strain is about two or three weeks. Further considerable tears can take about six weeks. Extreme and intense hip injuries can take eight weeks to recover. It depends on working closely with a therapist and following their recommendations.


  1. Hip flexor pain. (n.d.). Sports Health. Retrieved January 15, 2022, from https://www.sports-health.com/treatment/hip-injury-treatment/how-treat-hip-flexor-pain
  2. Hip flexor pain. (n.d.). Newyorkorthopedics. Retrieved January 15, 2022, from https://newyorkorthopedics.com/2019/12/12/what-is-a-hip-flexor-strain-and-how-is-it-treated
  3. Bell, A. (2021). Hip flexor strain: Symptoms, recovery time, treatment, and more. Medical News Today. Retrieved January 15, 2022, from https://www.medicalnewstoday.com/articles/320655
  4. Orenstein, B. W., Orenstein, B. W., Theobald, M., Suszynski, M., Vann, M. R., & Editors, E. H. (2013). Understanding hip flexor pain symptoms & stretching exercises that can help. EverydayHealth.com. Retrieved January 15, 2022, from https://www.everydayhealth.com/hip-pain/understanding-hip-flexor-pain.aspx 
  5. Heger, E., Strong, R., & Thurman, J. (2021, December 14). 7 doctor-recommended strategies to relieve hip flexor pain at home and when to visit your doctor. Insider. Retrieved January 15, 2022, from https://www.insider.com/hip-flexor-pain#:~:text=In%20most%20cases%2C%20hip%20flexor,causes%20soreness%20and%20achy%20pain.


Read more: