Hip Flexor Strain and Hip Soft Tissue Injuries

A hip flexor strain is a stretch or tear of the muscles at the front of the hip, the muscles that lift your knee toward your chest and help you walk, run and climb stairs. It is one of the most common hip soft tissue injuries, especially in active people and athletes, and it usually causes pain at the front of the hip or groin. Most hip strains are mild and heal with rest and simple care, though more severe strains take longer and benefit from a specialist's guidance.

If pain at the front of your hip or groin came on after activity and is not settling, it helps to know what is going on. The board-certified and fellowship-trained hip specialists at Resurgens Orthopaedics diagnose and treat hip strains and other soft tissue injuries at locations across metro Atlanta.

What Is a Hip Flexor Strain?

The hip flexors are a group of muscles at the front of the hip that bend the hip and raise the knee. The main hip flexors include the iliopsoas, which is made up of the psoas major and iliacus, and the rectus femoris, a muscle of the quadriceps that crosses the front of the hip. A hip flexor strain happens when one of these muscles or its tendon is overstretched or torn. It is sometimes called a pulled hip flexor or a hip flexor tear, and it can range from a mild overstretch to a complete tear.

The hip flexors are not the only soft tissue around the hip that can strain. A groin strain affects the inner-thigh muscles that pull the leg inward, and a hamstring strain can occur where those muscles attach at the back of the pelvis. These injuries are treated in a similar way, and a specialist can tell which muscle group is involved.

Hip Strain Grades

Hip strains are usually described in three grades based on how much of the muscle is injured. Knowing the grade helps guide treatment and recovery:

Grade 1, a mild strain with only a few muscle fibers stretched or torn, causing minor pain and little loss of strength
Grade 2, a moderate strain with more fibers torn, causing more noticeable pain, swelling and weakness
Grade 3, a severe strain with a complete tear of the muscle or tendon, causing significant pain and difficulty using the leg

What Causes a Hip Flexor Strain?

Hip flexor strains usually happen during activity, though tightness and weakness can set the stage for one. Common causes and risk factors include:

Sudden, explosive movements such as sprinting, kicking or jumping
Quick changes in direction, common in soccer, martial arts and dance
Overuse from repetitive hip motion without enough recovery
Tight or weak hip flexors, often from long periods of sitting
Not warming up enough before exercise or sport

Hip Flexor Strain Symptoms

Symptoms depend on how severe the strain is, but they usually center on the front of the hip. Common signs include:

Pain or tenderness at the front of the hip or groin
A sudden, sharp pain or a pulling sensation at the time of injury
Pain that worsens when lifting the knee, climbing stairs or sprinting
Muscle spasms, cramping or tightness in the upper thigh
Swelling and, with more severe strains, bruising or weakness in the leg

Please Note: Most mild hip strains improve with rest and at-home care. If the pain is severe, you cannot put weight on the leg or the pain is not improving after a couple of weeks of rest, it is worth having a hip specialist evaluate it to rule out a more serious tear.

How a Hip Strain Is Diagnosed

A hip specialist can usually diagnose a hip flexor strain with a physical examination and a few questions about how the injury happened. Your physician will check where it hurts, test the strength and movement of the hip and feel for tenderness along the muscle. For a more severe strain, or if the diagnosis is not clear, imaging such as an ultrasound or MRI can show the soft tissue and confirm how much of the muscle is involved, while an X-ray can rule out a bone injury.

Hip Flexor Strain Treatment

The good news is that most hip flexor strains heal without surgery. Treatment focuses on letting the muscle recover, then gradually rebuilding its strength and flexibility.

At-Home and Non-Surgical Care

Early care for a hip strain follows the familiar rest, ice, compression and elevation approach, often shortened to RICE:

Rest and a break from the activity that caused the strain
Ice to the area to ease pain and swelling in the first days
Compression and elevation to help control swelling
Over-the-counter anti-inflammatory medication for pain and inflammation

As the pain settles, a gradual return to activity and physical therapy helps restore strength and flexibility and lowers the chance of straining the muscle again. Your physician or physical therapist can guide which stretches and exercises are safe and when to add them, so you come back at the right pace.

When More Treatment Is Needed

Most strains do not need surgery. In the uncommon case of a complete tear, or a strain that pulls a piece of bone away where the muscle attaches, your physician will discuss whether a procedure is needed and what recovery would involve. Your Resurgens specialist will tailor the plan to the severity of your injury and your activity goals.

Schedule an Appointment for Hip Pain

If hip or groin pain from an injury is not improving with rest, a hip specialist can confirm what is going on and help you recover safely. Book an appointment online today with a Resurgens hip specialist or call us at (404) 847-9999.

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