Hip Flexor Muscles and Injuries

Tight hip flexor muscles can lead to limited range of motion, pain, and injury

The hip flexor muscles are a group of muscles situated near the top of your thighs that allow you to lift your knee toward your chest, squat, and bend forward at the hip. The five key hip flexor muscles include the iliacus, pectineus, psoas major, rectus femoris, and sartorius, which work together to enable hip flexion.

When these muscles are involved in explosive leg movements or placed under extreme stress while jumping or running, they can be injured. This can lead to a hip flexor strain in which one or more of the hip flexor muscles becomes stretched or torn.

This article explains how the hip flexor muscles work and common causes of hip flexor pain, stiffness, or tightness. It also explains how to treat hip flexor injuries or prevent them with stretches and strengthening exercises.

man doing hip flexor stretch on beach
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Hip Flexor Anatomy and Function

Flexion refers to a bending movement that decreases the angle between two body parts. When a flexor muscle contracts, it draws two bones together, typically bending at a joint.

In the case of the hip flexors, they draw together the bones of the leg and the bones of the hip or spine at the hip joint. If the hip is already flexed, such as when you are sitting, these muscles aren't working.

A sedentary lifestyle can lead to weak and tight hip flexors, which are always in a shortened position. Tight hip flexors can lead to a limited range of motion, poor posture, lower back or hip pain, and even injuries.

Your hip flexors get a workout when you are standing and doing movements such as raising your leg to climb stairs, run, or ride a bicycle.​

Hip Flexor Muscles

The muscles that make up the hip flexors include:

  • Psoas major: The psoas muscle is a deep muscle that connects your spine to your leg. In fact, it's the only muscle that does so. It runs from your lower back through your pelvis, passing to the front of your hip, where it attaches to the top of your femur, which is your thigh bone.
  • Iliacus: The iliacus is a flat, triangular muscle that lies deep within your pelvis. It attaches from your pelvis to your thigh bone (femur). Its primary action is to flex and rotate your thigh.
  • Rectus femoris: This muscle is one of the four quadriceps muscles attaching your pelvis to the patellar tendon of your knee. Squats and lunges exercise the rectus femoris.
  • Pectineus: The pectineus muscle is a flat, quadrangular muscle that lies at the top of your inner thigh, often referred to as your groin muscle. It's primarily responsible for hip flexion but also rotates your thigh and adducts, which means it pulls your legs together when the muscles contract.
  • Sartorius: The sartorius muscle is a long thin muscle that runs down the length of your thigh from your pelvis to your knee. It's the longest muscle in the human body and helps flex the knee and leg.

Hip Flexor Injury Symptoms

The chief symptom of a strained or torn hip flexor is pain in the area at the front of your hip where it meets your thigh. Your experience can vary and may involve:

  • Mild pain and pulling
  • Cramping and sharp pain and/or severe pain
  • Bruising
  • Swelling
  • Muscle spasms (in the case of a complete tear)

You may feel pain or a pulling sensation when you come up from a squat or when you stand up after sitting.

With a complete tear, which isn't as common as a strain, it may be hard to walk.

Causes of Hip Flexor Pain

You can strain or tear one or more of your hip flexors when you make sudden movements such as changing directions while running or kicking. Sports and athletic activities where this is likely to occur include running, football, soccer, martial arts, dancing, and hockey. In everyday life, you can strain a hip flexor when you slip and fall.

You're more likely to get a hip flexor injury if you've had one in the past, you don't warm up properly before engaging in athletic activity, your muscles are already tight or stiff, or your muscles are weak from being overused.

If, while exercising, you try to do too much at once in too short an amount of time, you can also put yourself at risk for a hip flexor injury.

Diagnosing Hip Flexor Problems

Muscle injury grading systems and classifications are currently being revamped and studied to be more comprehensive so they can include more precise diagnostics. However, the traditional grading system is often still used.

Grade I (Mild)

A grade I injury is a small tear in your muscle that's mildly painful and may cause some minor swelling and tenderness. You're able to continue doing your regular activities, including sports. It may take a couple of weeks to recover fully.

Grade II (Moderate)

A grade II injury is a larger tear in your muscle that makes it difficult to move and causes a moderate amount of pain, especially when you move the affected muscle, swelling, and tenderness. You may have 5% to 50% loss of function, and you may be limping.

You can't go back to sporting activities until the tear is completely healed. These injuries can take anywhere from a couple of weeks to a few months to heal, depending on how bad they are.

Grade III (Severe)

A complete tear in your muscle causes severe pain and swelling. You can't bear weight on that leg, making it difficult to walk. You've also lost more than 50% of your muscle function. These injuries are less common and may need surgery to repair the torn muscle. They can take several months or more to heal completely.

Hip Flexor Treatment

As long as it's not severe, you should be able to treat your hip flexor strain or tear at home using the PRICE (protection, rest, ice, compression, elevation) protocol and pain relievers. Here's what to do:

  • Protection: Protect your injury to keep it from getting worse or injured again. For example, you can use a walking support to take pressure off the hip.
  • Rest: Stay off your hip as much as possible for the first few days and avoid any activities that cause pain.
  • Ice: Using ice or a reusable ice pack can help relieve pain and reduce muscle swelling. Apply immediately after you get the injury for 20 minutes and repeat every three to four hours for the next two to three days.
  • Compression: If you're worried about swelling or find that it's increasing, try wrapping the injured area lightly with a bandage or wearing compression shorts.
  • Elevation: Put your leg up so it's higher than your heart as often as possible. This helps reduce swelling and inflammation. (Note that this may be harder to achieve with a hip injury; ask your healthcare provider or physical therapist for hip-specific protocols.)

You can use over-the-counter remedies such as Motrin or Advil (ibuprofen) or Aleve (naproxen) to help with pain and swelling. Tylenol (acetaminophen) works for pain relief but doesn't treat inflammation and swelling.

If you have heart disease, high blood pressure, kidney disease, or if you've had ulcers or internal bleeding, check with your healthcare provider before taking any of these medications.

When to See a Healthcare Provider

If your symptoms don't improve within a couple of weeks or you start having a hard time moving your leg and/or hip, it's time to see your healthcare provider. Your injury could be more severe than you originally thought. It may require other treatments, or it may be unrelated to the hip flexors entirely.

Physical Therapy

You may be given exercises to do at home, including hip flexor stretches. If your strain is severe or it isn't getting better, you may need to see a physical therapist who will help you work on gradually strengthening and stretching your muscles. Complete tears may require you to use crutches until you're healed and to seek surgery to reconnect the muscle.

You can also consider soft tissue release techniques and trigger point therapy. These are both alternative therapies that help treat and relieve pain. A soft tissue release is an advanced form of massage therapy that targets specific muscle fibers that have become damaged or tangled up and helps stretch and strengthen them.

Trigger point therapy focuses on trigger points, which are areas that cause pain when they're compressed. However, when pressure is put on these trigger points, it can actually relieve pain. This can be done with dry needling, chiropractic care, or massage.

Preventing Hip Flexor Problems

To prevent hip flexor injuries, keep these tips in mind:

  • Always warm up before engaging in any exercise or physical activity, even if it's just practice.
  • Make sure you do a cool down after activity. Slowly stretch each muscle group and hold the stretch for a few seconds.
  • Keep your muscles in good shape by regularly exercising. Exercises that help stretch and strengthen your hip flexors include pigeon pose, bridges, lunges, seated butterfly stretch, straight leg raises, and squats. Don't push too hard; these shouldn't hurt.
  • Work on strengthening your core muscles and glutes. These muscles work together to give you balance and stability and to help you move through the activities involved in daily living, as well as exercise and sports. When one set of these muscles is weak or tight, it can cause injury or pain in another, so make sure you pay equal attention to each.
  • Before you go back to your regular exercise or sports, be sure that your injury has fully healed and that the muscles are back to the same strength and flexibility you had before the injury (or better). Not taking enough time to heal can lead to reinjuring yourself, which can set you back even further.

Frequently Asked Questions

  • What is the primary hip flexor?

    The pectineus is the primary muscle in charge of flexing the hip. Other hip flexors include the psoas major, iliacus, rectus femoris, and sartorius, each of which has its own unique role.

  • What are symptoms of tight or weak hip flexors?

    Symptoms of tight or weak hip flexors include a limited range of motion, lower back and hip pain, and poor posture.

  • Where are the hip flexors located?

    The hip flexors are primarily located in and around the pelvis. The muscles originate at the spine or pelvis and attach to the thigh bone. Some muscles, like the rectus femoris, reach all the way down to the knee joint.

  • Where is hip flexor pain felt?

    Hip flexor pain is typically felt where the thigh meets the pelvis in the upper groin. The pain can be felt closer to the inner thigh, across the front of the thighs, or in the front of the up. Tight hip flexors are commonly caused by sitting for long periods.

  • Should I stretch my hip flexor if it hurts?

    It depends. Stretching your hip flexors before and after physical activity or anytime they feel tight can help relieve pain and improve the range of motion. But use your judgment. In general, a stretch should feel good or mildly sore. If stretching your hip flexor increases your pain, don’t force it. 

    It is possible to over-stretch your hip flexors and make the pain worse. If you have been trying to relieve hip flexor pain through stretches without success, take a break from stretching for a few days to see if that improves it. 

  • How do you relieve hip flexor pain?

    Sore hip flexors can be relieved with moist heat, ice, and over-the-counter NSAID pain relievers like Advil (ibuprofen) or Aleve (naproxen). Hip flexor exercises and stretches can also be helpful for easing tight hip flexors and relieving pain. 

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. MedlinePlus. Hip Flexor Strain—Aftercare.

  2. Grassi A, Quaglia A, Canata GL, Zaffagnini S. An update on the grading of muscle injuries: a narrative review from clinical to comprehensive systems. Joints. 2016;4(1):39-46. doi:10.11138/jts/2016.4.1.039

  3. Mount Sinai. Hip flexor strain - aftercare.

  4. Harvard Medical School, Harvard Health Publishing. The Real-World Benefits of Strengthening Your Core.

Additional Reading
  • GRASSI A, QUAGLIA A, CANATA GL, ZAFFAGNINI S. An Update on the Grading of Muscle Injuries: a Narrative Review From Clinical to Comprehensive Systems. Joints. 2016;4(1):39-46. doi:10.11138/jts/2016.4.1.039.

  • Massagetique. Soft Tissue Release.

  • Ortho Info. Hip Strains. American Academy of Orthopaedic Surgeons.

By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.