Hip flexor pain can be more than just a minor inconvenience — it can disrupt your daily life, leaving you frustrated and unsure of where to turn for relief.
Whether it’s caused by overuse, injury or inflammation, the impact on your mobility is real. But there’s good news. By understanding the root causes of your pain and exploring targeted solutions — from physical therapy to, in rare cases, surgery — you can regain control of your body and your life.
As an orthopedic and geriatric physical therapist at Creighton University Health Sciences Campus in Phoenix, I’m sharing some common causes, symptoms and effective treatments for hip flexor pain.
Hip flexor pain can be caused by chronic tendon issues or tendonitis (when a tendon, the tissue that connects muscles to bones, becomes inflamed and swollen), bursitis (a painful condition that occurs when a bursa, a fluid-filled sac that cushions joints, becomes inflamed) or by muscle strain.
Overuse of the tendon can lead to some of these problems. Other conditions that can mimic hip flexor pain include:
• Femoroacetabular impingement — when one or both bones of the hip joint are irregularly shaped, causing them to rub against one another.
• Hernia — a bulge that occurs when an organ or tissue pushes through a weak spot in the abdominal wall or other muscle.
• Labral tear — a tear in the cartilage that lines the hip socket and helps keep the hip joint stable.
• Osteoarthritis — a degenerative joint disease that causes the cartilage in the joints to break down over time.
Hip flexor pain can cause problems with many activities. Hip flexors help us lift our legs —for example, into a car or bed — so hip flexor issues can affect these activities. Depending on the severity, even walking can be painful.
Our hip flexors also work a lot when we run, so this can be significantly affected. If our hip flexors are tight, weak or painful, there can be potential compensations at the hip and spine.
Major concerns with anterior hip pain include a fracture or dislocation. If the hip pain was precipitated by a fall, particularly in someone who has low bone density, they should notify their physician.
Other medical diagnoses can cause anterior hip pain, but they are rare. One example is avascular necrosis, also known as osteonecrosis, a disease that occurs when a bone’s blood supply is cut off, causing bone tissue to die and the bone to collapse.
When looking at treatment options, physical therapy is a great place to start. A physical therapist will assess the joints, ligaments and muscles on the first visit to determine what structures are involved and where to start with treatments.
They will also look at how you move and walk to look for other compensations. Possible interventions for a hip flexor strain include stretching, soft tissue mobilization, joint mobilizations and strengthening.
Hip flexor issues rarely require surgery, and most can be addressed through physical therapy.
Maintaining strength and flexibility in the trunk and lower extremities can go a long way in preventing hip flexor pain. Be smart about the volume of exercises and ramp up slowly to avoid overuse issues. This would include things like running and sprinting.
Unfortunately, it can be common for tendon issues to recur. This may be due to muscle imbalances, compensations or early/excessive volume of training. This is where a physical therapist can help.
Hip flexor pain can be frustrating and disruptive, but understanding its causes and addressing the symptoms early can make a significant difference in your recovery. If you’re experiencing persistent hip pain or aren’t sure where to start, consult a health care provider or a physical therapist to develop a personalized plan for your needs.
Editor’s note: Dr. Stefany Shaibi PT, DPT, EdD, OCS (emeritus), GCS (emeritus) is an associate professor in the Department of Physical Therapy at Creighton University Health Sciences Campus in Phoenix. Please send your comments to AzOpinions@iniusa.org. We are committed to publishing a wide variety of reader opinions, as long as they meet our Civility Guidelines.
Share with others
