Hip & pelvis
Hip Flexor Strain
A hip flexor strain is an injury to the muscles at the front of the hip, causing pain when lifting the knee, running or standing up after sitting. Common in runners and desk workers.
Common symptoms
- Pulling pain at the front of the hip or deep in the groin crease
- Pain lifting the knee, such as climbing stairs or getting into a car
- Pain when sprinting, kicking or striding out
- Stiffness and ache at the front of the hip after prolonged sitting
- Tenderness when pressing over the front of the hip
- In more severe strains, bruising or a sudden sharp pain during activity
Overview
The hip flexors are a group of muscles at the front of the hip — mainly the iliopsoas and rectus femoris — that lift your knee towards your chest and drive your leg forward when you walk, run or kick. A hip flexor strain is an overstretch or small tear in one of these muscles or its tendon, felt as a pulling pain at the front of the hip or deep in the groin crease.
Strains range from a mild tweak that settles in a week or two, to a more significant tear that takes several weeks to recover. Acute strains usually happen during sprinting, kicking, a sudden change of direction or a slip. More gradual, overuse-type hip flexor pain is common in people who sit all day: the muscle adapts to a shortened position, becomes tight and sensitive, and then complains when asked to work during a run or a gym session.
With the right balance of early rest, progressive loading and attention to hip mobility and strength, most hip flexor strains recover fully, and the recurrence risk can be reduced by addressing why it happened.
Causes and risk factors
- Sprinting, kicking or sudden acceleration without a proper warm-up
- A sharp increase in running speed, hill work or training volume
- Prolonged sitting leaving the hip flexors tight and less tolerant of load
- Weak glutes and core, forcing the hip flexors to overwork
- Previous hip flexor or groin injury
- Fatigue late in a match or long run
- Sports such as football, running, dance and martial arts
How we may be able to help
Groin and front-of-hip pain can come from several structures, so we assess carefully to confirm the hip flexor is the source — testing the muscle with resistance and stretch, checking the hip joint for impingement or arthritis, examining the adductors and lower abdominal wall, and screening the lumbar spine.
Our physiotherapists guide you through the stages of recovery: protecting the muscle early, then restoring length and strength with a graded programme that progresses from gentle isometrics to running- and sport-specific loading. Manual therapy and IASTM to the hip flexor and surrounding tissues can reduce tightness and sensitivity, and dry needling is useful for trigger points in the iliopsoas and rectus femoris.
Our chiropractor can help if lumbar or pelvic stiffness is altering how your hip moves. Kinesiology taping may provide support during the return to running phase. Therapeutic ultrasound is sometimes used as an adjunct to support tendon and muscle recovery in the early weeks.
What you can do at home
- Rest from sprinting and kicking for the first few days; gentle walking is fine
- Ice the front of the hip for 10–15 minutes several times a day in the first 48 hours
- Break up sitting every 30 minutes with a short walk or a gentle standing hip flexor stretch
- Begin gentle hip flexor stretches (half-kneeling lunge) once sharp pain has eased, holding 30 seconds
- Strengthen your glutes and core with bridges and dead bugs to share the load
- Return to running gradually, starting with easy pace on flat ground
When to seek urgent help
If you have any of the following, call us straight away for an urgent same-day appointment — we can examine you and arrange fast-track X-ray or MRI through our imaging partner. If you cannot reach us, go to A&E. For loss of bladder or bowel control, numbness around the groin, chest pain, a sudden severe headache or rapidly worsening weakness, call 999 or go to A&E immediately:
- Sudden severe groin pain with a 'pop', inability to bear weight or a visible lump — possible complete tear or avulsion, seek urgent medical review
- In teenagers, sudden hip or groin pain during sport may be a growth-plate injury — needs prompt assessment
- Groin pain with fever, feeling unwell, or a hot swollen area
- Numbness or weakness spreading down the leg
Frequently asked questions
Should I stretch a hip flexor strain?
Not in the first few days, when aggressive stretching can aggravate the tear. Once sharp pain has settled, gentle stretching helps restore length. Strengthening is just as important, and we will show you how to combine the two.
Can I keep running?
Depends on severity. Mild strains may allow easy running on the flat once walking is comfortable; moderate strains need a short break. We guide a return-to-running plan so you do not re-injure it.
Why do I get this from sitting at a desk?
Sitting keeps the hip flexors in a shortened position for hours. Over time they become tight and sensitive, so when you suddenly ask them to work hard — in a run or a workout — they strain. Regular movement breaks and hip strengthening reduce this.
Do I need a scan?
Rarely for a typical strain. Imaging is considered if there was a loud pop, significant weakness, or if a teenager is involved, where a bony avulsion needs to be excluded. We can arrange a private GP referral in those cases.
This page is general information, not a diagnosis. A clinician will assess you before recommending any treatment. Outcomes vary from person to person. Written with reference to NHS and other peer-reviewed guidance.
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