Hip Flexor Strain and Stretch

What is a hip flexor strain?

A strain is an over stretching or tearing of a muscle or tendon - a fibrous chord that attaches muscle to bone. It differentiates from a sprain in that a sprain is the stretching or tearing of ligaments - a fibrous chord that connects bone to bone.

The hip flexor muscles are muscles that act to flex the femur (thigh bone) toward the lumbo-pelvic complex. The most commonly involved muscle in a hip flexor strain is the iliopsoas.

Whenever the hip flexors contract or are put under stretch, tension is placed through the hip flexor muscle fibers. When this tension is excessive due to too much repetition or high force, the hip flexor muscle fibers may tear. When this occurs, the condition is known as a hip flexor strain.

Patients may develop this condition gradually due to repetitive or prolonged strain on the hip flexor muscles. This may also occur due to repetitive kicking or sprinting excessively. Hip flexor strains are commonly seen in running and kicking sports such as football and soccer.

Patients with this condition usually feel a sudden sharp pain or pulling sensation in the front of the hip or groin at the time of injury. In minor strains, pain may be minimal allowing continued activity. In more severe cases, patients may experience severe pain, muscle spasm, weakness and an inability to continue the activity. Patients with a severe hip flexor strain may also be unable to walk without limping.

After the patient has seen a physician and a hip flexor strain has been confirmed through evaluation and diagnostic testing, the physician should write out a physical therapy referral.

Once a physical therapist has evaluated the patient, rehabilitation will begin in order to decrease pain, regain range of motion and increase strength. The physical therapist will reach these goals by using modalities (electrical stimulation, ice, heat, ultrasound, iontophoresis), stretching, and strengthening exercises.

The following are examples of some exercises the physical therapist would have the patient perform:

Hip Flexor Stretch

Begin in the lunge position, with the leg to be stretched behind you. Keeping your back straight and buttock muscles contracted, gently lunge forwards until you feel a stretch in the front of your hip or as far as you can go without pain. Hold for 15 seconds, 4 times at a mild to moderate stretch pain-free. You can also perform this stretch while leaning into a large swiss ball in front of the leg to be stretched. As strength and flexibility increases, the physical therapist will progress the patient to more exercises that help with balance and promote core strengthening. The following is an example of an exercise that would be performed at this point.


Lie flat on the floor with both hands resting by your sides and with your feet firmly flat on the floor shoulder width apart. You will then slowly contract your abdominal, lower back and gluteus muscles then lift your midsection to make a straight line through your knees - hips - shoulder. Focus on a slow upward and downward movement, ideally 1 rep every 5 - 10 seconds, holding in the upward phase for a few seconds. Once this exercise is perfected, the physical therapist will advance the patient to lifting one leg at a time while maintaining the upward position in order to promote balance.

If you have any questions regarding a possible hip flexor strain or would like to schedule an appointment, please feel free to contact us at (404) 419-7760.