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7 doctor-recommended strategies to relieve hip flexor pain at home and when to visit your doctor

Dec 14, 2021, 22:56 IST
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While hip flexor pain is most common in athletes, it can occur in other people, particularly those with tight muscles and tendons. PeopleImages/Getty Images
  • Hip flexor pain can affect your mobility, making it harder to walk or stand up.
  • Mild to moderate hip flexor pain may improve with RICE: Rest, Ice, Compression, and Elevation.
  • If your pain doesn't begin to improve after a week or two, it's time to connect with your doctor.
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Whenever you walk, bend over, or lift something you're activating your hip flexors. Incidentally, when you have hip flexor pain it can make even the most mundane of daily tasks an uncomfortable experience.

Medical term: Hip flexors are a group of muscles and tendons located at the top of your thighs. They attach your femur to the lower spine so you'll usually feel hip flexor pain in the upper groin.

Hip flexor pain is common among certain types of athletes, like sprinters and cyclists, though anyone can experience a strain. The good news is it can be easily treated.

Symptoms

Hip flexor pain is typically felt as soreness or ache in the front of the hip or the groin, says James Suchy, MD, a sports medicine specialist with the Hoag Orthopedic Institute. However, pain can also be sharp depending on the type of injury.

"There can also be a snapping or popping sensation if there is accompanying tightness, " Suchy says.

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Other symptoms of a hip flexor injury include:

  • Pain when lifting the knee to the chest
  • Pain or weakness when walking or climbing stairs
  • Swelling or bruising in the front of the hip or groin

In milder cases, you may only feel this pain with repetitive activity, like walking. However, it's important to rest even with these mild strains since the pain will become progressively worse if it does not heal, Suchy says.

Causes

Hip flexor pain is frequent in athletes because explosive movements, like sprinting, can stretch or tear muscles or tendons supporting the hip, such as the iliopsoas and rectus femoris, Suchy says.

Alyssa Powell/Insider

In most cases, hip flexor pain is due to two different types of injuries:

  • An acute strain, which typically causes sharp pain and occurs when the hip flexor tendons or muscles are stretched or torn.
  • Hip flexor tendonitis, which is inflammation of the hip flexor tendons that causes soreness and achy pain. It is typically caused by repetitive stress or overuse, like running or cycling without rest days.

According to Sridhar Yalamanchili, MSPT, a physical therapist with the Atlantic Spine Center, those most at risk of hip flexor injuries include:

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The risk of hip flexor injury increases among the above athletes if they do not add strength and conditioning workouts to their training.

Treatment

"If it's not severe, most hip flexor pain can be treated at home," says Tobias Barker, MD, Chief Medical Officer of Everside Health. "The acronym typically used for the treatment of muscle strains is RICE: Rest, Ice, Compression, and Elevate."

Important: You should avoid massage when recovering from hip flexor pain. The pressure on the strained muscle or tendon can be aggravating especially within the first few days of the injury, Suchy says.

Here are seven ways to relieve hip flexor pain at home.

1. Rest

"If you suspect a hip flexor injury, rest is a good first response — you shouldn't carry on with your usual athletic activities, or you may risk further injuring tissues in the hip. Rest allows damaged tissues to repair themselves," says Jacob Hascalovici, MD, co-founder and Chief Medical Officer of Clearing.

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If you believe the pain is from a sports injury, you should avoid that particular athletic activity until your hip flexor is healed, says Barker.

However, resting doesn't necessarily mean not moving at all — in fact, being sedentary can lead to muscle stiffness or reduced range of motion, says Hascalovici.

A small 2020 study found that people who are inactive or sit for long periods had reduced hip flexor mobility compared to those who sit for minimal amounts of time or have higher activity levels. Hascalovici recommends easing into an "active rest" period by incorporating low-impact movements like yoga and swimming, along with gentle stretching.

2. Apply ice/heat

Doctors agree that hip flexor strains can benefit from a combination of ice and heat.

While ice may alleviate pain, minimize bruising, and reduce swelling, heat can increase blood flow, relax the muscles, and improve range of motion while preventing muscle tightness, says Hascalovici.

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As soon as you get injured or notice the pain, Barker recommends applying ice to the area for around 20 minutes every four hours or so. Do not apply ice directly to the skin as this can cause frostbite. Instead, wrap an ice pack or plastic storage bag filled with ice in a wet towel or cloth.

Wait until the inflammation has gone down — about 48 hours — before switching to heat wraps or heating pads for 20 minutes at a time.

3. Try compression

"Compression may stabilize the joint and reduce some of the swelling that would otherwise develop," says Barker.

He recommends gently wrapping the hip and pelvis region with an elastic bandage or wearing compression shorts.

4. Elevate the leg

Another tactic to reduce swelling is to elevate your leg, says Barker. This encourages excess fluid that may have collected near the injury to drain away.

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When you're sitting or standing, place a pillow or stack of cushions under the leg attached to the affected hip flexor. Ideally, your foot should be higher than your heart.

If your injury makes elevation difficult or painful, ask a doctor or physical therapist for personalized guidance.

5. Try gentle stretching

Stretching may be helpful for alleviating pain, as well as improving hip flexibility, says Barker.

He recommends holding the following hip flexor stretches for several seconds:

Scientific studies have yet to explore how long-term hip flexor stretching impacts hip flexor pain.

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However, a 2021 review found that hip flexor stretching decreases tightness and increases range of motion. Researchers noted this means it may be useful for reducing pain and preventing future injury.

Important: Remember, if a particular stretch causes pain, stop doing it immediately.

6. Take over-the-counter pain relievers

Two types of over-the-counter medications can help with pain:

  1. Ibuprofen (Advil and Motrin) can help with both pain relief and swelling.
  2. Acetaminophen (Tylenol) is only a pain reliever, says Barker.

Whichever you choose, always follow the dosage instructions.

Also, check with your healthcare provider first before trying these pain relievers if you:

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  • Are taking any prescription medications
  • Have had stomach ulcers in the past
  • Currently have high blood pressure, heart disease, or kidney disease

7. Avoid activities that aggravate the pain

The following types of physical movements can exacerbate hip flexor pain and should be avoided, say Barker and Hascalovici:

  • Bending at the hips
  • Climbing stairs
  • Running, jumping, kicking, or any other activity that puts stress on the damaged hip flexor muscle

"Mild discomfort is a normal part of healing, but anything that causes more severe pain should be avoided until the muscles have enough time to fully heal, which often takes about two to six weeks," says Hascalovici.

Warning: Most hip flexor strains will heal on their own. However, a strain that is not allowed to heal may develop into tendonitis, Yalamanchili says, prolonging the recovery process.

When to connect with a doctor

If the above strategies don't help alleviate some of the pain within a week or two, or the pain gets worse, Hascalovici advises reaching out to your doctor.

According to Barker, medical attention is also necessary if you experience any of the following:

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  • You're unable to walk, which can indicate a complete tear of one or multiple muscles.
  • You can't put weight on the affected leg.
  • There's sudden swelling around the hip.

You notice redness around the hip flexor or have a fever, which could signal an infection.

Insider's takeaway

Hip flexor pain is common among athletes and is usually the result of a strain or chronic inflammation.

Following the standard RICE approach, doing gentle stretching, and taking over-the-counter pain relievers can help with hip flexor pain. However, if your pain is severe, doesn't improve, prevents you from walking, or is accompanied by signs of an infection, you should call your doctor immediately.

"While many hip flexor injuries heal within two months with time, active rest, and home care, some injuries are severe enough to need a professional's attention. If that's the case, you may benefit from sessions with a physical therapist or, in relatively rare cases, surgery to repair muscle tears," says Hascalovici.

You can protect yourself against the risk of hip flexor injuries by warming up and stretching before physical activity.

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