Overview of Hip Flexor Muscles and Injuries (2023)

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 and bend forward at the hip. This includes the iliacus, pectineus, psoas major, rectus femoris, and sartorius muscles that work together to enable hip flexion.

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

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

Overview of Hip Flexor Muscles and Injuries (1)

Hip Flexor Anatomy and Function

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

In the case of the hip flexor muscles, they draw together the upper leg and torso at the hip joint. These muscles get a workout whenever doing movements like climbing stairs, running, or riding a bicycle.​ If the muscles are flexed while sitting, they aren't working.

A sedentary lifestyle can lead to weak and tight hip flexors. Tight hip flexor muscles can lead to a limited range of motion, poor posture, lower back or hip pain, and injuries.

The muscles that make up the hip flexors include:

  • Psoas major: This deep muscle connects your spine to your leg. It runs from your lower back to the front of your hip and attaches to the top of your thigh bone (femur).
  • Iliacus: This is a flat, triangular muscle situated deep within your pelvis. It attaches your pelvis to your femur. Its primary action is to flex and rotate your thigh.
  • Rectus femoris: This is one of the four quadriceps muscles that attach your pelvis to the tendon of your knee. It enables squatting and lunging.
  • Pectineus: This is a flat muscle situated at the top of your inner thigh, often called your groin muscle. It is primarily responsible for hip flexion but also rotates your thigh and pulls your legs together (adduction).
  • Sartorius: This 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.

Causes of Hip Flexor Pain

Hip flexion pain can be due to an injury or postural issues that contribute to muscle tightness.


You can strain or tear your hip flexors when you make sudden movements such as changing directions while running or kicking.

Sports and activities where this is likely to occur include:

  • Running
  • Soccer
  • Football
  • Hockey
  • Martial arts
  • Dancing
  • Gymnastics

You're more likely to get a hip flexor injury if you've had one in the past, you don't warm up properly, or your muscles are weak from overuse.

You can also strain a hip flexor when you slip and have a bad fall.

Postural Issues

Postural issues contribute to hip flexor weakness, pain, and injury. According to the National Exercise Trainers Association, a large proportion of the population has dysfunctional hip flexors due to poor posture, faulty biomechanics, and sitting too much.

Prolonged sitting puts the hips in a constant state of supported flexion. This can cause the muscles to shorten and become chronically tight. When this happens, the lower back compensates by overarching, leading to low back pain.

Thereafter, if you engage in strenuous activity or simply take a wrong step, the shortened hip flexor muscles can become strained or sprained. The change in gait can also cause knee, ankle, and foot pain.

(Video) Hip flexor strain: Mechanism of injury, diagnosis and treatment

Hip Flexor Injury Symptoms

The chief symptom of a strained or torn hip flexor is pain where your hip meets your thigh. The symptoms can vary and may involve:

  • Mild to stabbing pains
  • Pulling sensations in the hip when rising
  • Bruising
  • Swelling
  • Muscle spasms

With a complete tear, it may be difficult to even walk.

What Is a Frozen Hip?

Diagnosing Hip Flexor Problems

Muscle injuries are commonly graded so the appropriate treatments can be prescribed and your healthcare provider has a better sense of your prognosis (likely outcome).

Grade 1 (Mild)

A grade 1 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 2 (Moderate)

A grade 2 injury is a larger tear that causes moderate pain when you move. Swelling, tenderness, and limping are common. You may have a 5% to 50% loss of function. You cannot go back to sports activities until the tear is completely healed.

Grade 3 (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 will also have lost more than 50% of your muscle function. These injuries are less common and may need surgery to repair.

Hip Flexor Treatment

As long as it's not severe, you should be able to treat your hip flexor strain at home with pain relievers and the PRICE protocol.

The PRICE protocol is an acronym for protection, rest, ice application, compression, and elevation. It involves:

  • Protection: This includes protecting your hip with a walking stick or crutches and avoiding any activities that cause pain.
  • Rest: This means staying off your hip as much as possible for the first few days.
  • Ice application: An ice pack can help relieve pain and swelling. Apply immediately after the injury for 20 minutes, and repeat every three to four hours for the next two to three days.
  • Compression: If there is significant swelling, wrap the injured area with a compression bandage or wear compression shorts.
  • Elevation: Raise your leg above your heart as often as possible to help relieve pain and inflammation.

You can use over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) or Aleve (naproxen) to reduce pain and swelling. Tylenol (acetaminophen) works for pain relief but doesn't treat inflammation and swelling.

With the appropriate treatment, recovery from mild to moderate hip flexor strain can take anywhere from one to three weeks. Severe grade 3 strains can take up to eight weeks and may require surgery.

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.

(Video) Everything You Need to Know About Treating Hip Flexor and Iliopsoas Injuries

Preventing Hip Flexor Problems

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

  • Always warm up before engaging in any exercise or strenuous physical activity.
  • Make sure you do a proper cool down after exercising.
  • Work on strengthening yourcore musclesand glutes (buttock muscles). These muscles work together to balance and stabilize your body. When one of these muscles is weak or tight, it can cause injury to another.
  • Before you go back to your regular exercise or sports, be sure that your injury has fully healed. Your healthcare provider or physical therapist can help you make the determination.

Hip Flexor Exercises

Keep your muscles in shape by stretching and exercising regularly. Exercises that help stretch and strengthen your hip flexors include:

  • Pigeon pose: This is a floor stretch in which one leg is extended behind you while the other is splayed open in front of you with the knee pointed outward and the heel tucked toward your groin. Holding this position gradually stretches the hip flexor and groin.
  • Seated butterfly stretch: This is a floor stretch in which you are seated on your sit bones with the soles of your feet placed together and your knees pointed outward. Gently pressing your knees toward the ground stretches the hip flexors and groin.
  • Straight leg raises: This is a strengthening exercise you do lying on your back. Keeping your head and back on the ground, slowly lift your straightened legs together to a 45-degree angle. Hold for several seconds, and lower your legs to the ground with control.
  • Squats: This can be done by sliding your back down a wall until you are in a squatted position with your knees positioned above your hips. If you are strong enough, you can squat up and down from a standing position, holding a wall or the back of a chair for balance.
  • Lunges: This is done from a standing position by taking one step forward and lowering yourself until your front knee is at a 90-degree angle. Your knee should not be behind your foot. You can alternate between your right and left foot, holding the back of a chair for balance.

Don't push too hard or move too quickly. These stretches and exercises shouldn't hurt.

Frequently Asked Questions

  • 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 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 hip. 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. Stop if stretching your hip flexor increases your 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. National Exercise Trainers Association. Tight hip flexors can cause lower back pain, knee pain and foot pain.

  3. 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

  4. Mount Sinai. Hip flexor strain - aftercare.

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.

    (Video) Hip Flexor Injuries: The Right Strength Exercises | Tim Keeley | Physio REHAB

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

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(Video) Injury Spotlight - Hip Flexor Strain


Which muscle is involved in a hip flexor injury? ›

A hip flexor tear or strain is an injury to the muscles in the hip. The hip flexors are the group of muscles, including the iliacus and psoas major muscles (iliopsoas) as well as the rectus femoris (part of quadriceps).

What 4 muscles are responsible for hip flexion? ›

The hip flexors consist of 5 key muscles that contribute to hip flexion: iliacus, psoas, pectineus, rectus femoris, and sartorius.

How are hip flexors injured? ›

Sudden movements, such as sprinting, kicking, and changing direction while running or moving, can stretch and tear the hip flexors. Runners, people who do martial arts, and football, soccer, and hockey players are more likely to have this type of injury.

How long does a pulled hip flexor take to heal? ›

The recovery time for a hip flexor strain will depend on the severity of the injury. It typically requires one to three weeks of rest and treatment to recover from mild conditions fully. On the other hand, more severe cases can take around four to six weeks or longer.

What are the 3 hip flexor muscles? ›

Your hip flexors are a group of muscles along the front of your upper thigh. They include the iliacus, psoas major, rectus femoris and sartorius.

Where does a hip flexor injury hurt? ›

The most common symptom of a hip flexor tear or strain is pain located at the front of the hip. You may experience hip pain as you walk or run. Other symptoms associated with hip flexor tears or strains include: Sharp pain in the hip or pelvis after trauma.

How do you test for hip flexor injury? ›

While holding one knee close to your chest, slowly straighten your other leg and let it hang off the edge. You passed the test if your back and the back of your lowered thigh is flat against the bed, and your hanging knee is bent at a 90-degree angle off the surface.

What exercises should you avoid with a hip flexor strain? ›

Avoid exercises involving repetitive hip flexion, the motion involving bringing your hip or leg up toward your chest. If doing squats, keep them shallow and hold off on lunges entirely, until you receive a diagnosis from your doctor. Do not work through pain. When walking or running, pay attention to pain.

What causes weak hip flexors? ›

Underuse of the muscles or sitting down for extended periods can cause weak hip flexors. Conditions such as and osteoarthritis can also cause weakness in this muscle group.

How do you fix a hip flexor problem? ›

Hip flexor stretch (edge of table)
  1. Lie flat on your back on a table or flat bench, with your knees and lower legs hanging off the edge of the table.
  2. Grab your good leg at the knee, and pull that knee back toward your chest. ...
  3. Hold the stretch for at least 15 to 30 seconds.
  4. Repeat 2 to 4 times.

Is a hip flexor injury serious? ›

Hip flexor strains are most often caused by “overdoing it.” While not usually serious, this injury can be quite painful if left untreated. Understanding what a hip flexor strain is and its symptoms can help you get the right treatment for this common orthopedic condition.

Does walking help hip flexor pain? ›

' Walking is good for the hip flexors, but to run far more efficiently (and, crucially, without pain), strategically opening and also strengthening your hip flexors needs to be part of your running routine.

What is the fastest way to heal a hip flexor? ›

Most people can recover by resting their muscle and using at-home treatments like ice and over-the-counter medicine. If you're feeling pain for a few weeks after your injury or have severe symptoms, see a healthcare provider.

What does a hip flexor injury feel like? ›

Symptoms of hip flexor strain

sudden, sharp pain in the hip or pelvis after trauma to the area. pain when lifting the leg. cramping, stiffness, and weakness in the muscles of the upper leg area. swelling.

What is the most common hip flexor pain? ›

Hip flexor pain are muscle strains and minor ligament sprains can be caused by overuse. These less serious acute injuries generally heal in a short period of time with minimal treatment. However, chronic or recurring hip flexor pain may be a sign of a more serious injury.

What is the most important hip flexor muscle? ›

Other muscles assist with flexing the hip, but the iliopsoas is the primary and major hip flexor or hip flexor muscle. Because of the hip flexor muscles' position, they can become tight with repetitive sitting activity such as working at a computer.

What is the strongest hip flexor muscle? ›

The iliopsoas muscle is the strongest hip flexor and assists in external rotation of the femur, playing an important role in maintaining the strength and integrity of the hip joint. It is essential for correct standing or sitting lumbar posture, and during walking and running.

Which muscle is a hip flexor quizlet? ›

What are the hip flexion muscles? Iliopsoas, rectus femoris, sartorius, tensor fasciae latae.

What muscles are in the groin hip flexor? ›

Hip Flexor Muscles Anatomy

The hip flexor is not one singular muscle but a group of muscles, including the psoas major, iliacus, rectus femoris, pectineus, and sartorius. (The rectus femoris is also considered a quadricep muscle.) These muscles attach to various points on the spine, pelvis, and femur (thigh bone).


1. What Are the Causes & Signs/Symptoms of Hip Flexor Injuries?
(Airrosti Rehab Centers)
2. Muscles of the Hip and Thigh - Human Anatomy | Kenhub
(Kenhub - Learn Human Anatomy)
3. How to tell if you injured your hip flexor
(Beyond the Scalpel with Dr. Paull)
4. Hip Flexor Injury Overview
(Derrick Condor)
5. Hip Flexor Pain When Squatting? (HOW TO FIX!)
(Squat University)
6. Get Rid of Hip Flexor Pain in Seconds #Shorts
(SpineCare Decompression and Chiropractic Center)


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