Hip Flexor Strain

What Is It?

The hip flexors — mainly the iliopsoas and the upper rectus femoris — lift the thigh toward the chest. Strains occur with explosive hip flexion or forced hyperextension.

A strain means muscle fibers were overstretched. We grade strains I–III: Grade I — mild, microscopic fiber injury; Grade II — moderate, a partial tear with strength loss; Grade III — severe, complete disruption.

How It Happens

Sprinting starts, kicking, or the leg being forced backward (e.g., a blocked kick). Common in soccer, sprinting, and dance.

What It Feels Like

Pain in the front of the hip or deep groin with lifting the knee, striding out, or standing from a deep squat; discomfort with prolonged sitting.

How Long Recovery Takes

• Grade I: 1–3 weeks
• Grade II: 3–6 weeks
• Grade III: 2–3 months

Treatment

Almost all muscle strains heal without surgery. For the first 72 hours: relative rest, ice 15–20 minutes several times daily, compression, and gentle motion — complete rest slows healing. Then a progressive program: pain-free motion → isometrics → strengthening → eccentric loading (strengthening the muscle while it lengthens — the phase that prevents re-injury) → sport-specific work.

Restore pain-free hip extension first, then progressive hip-flexion strengthening (marches, resisted flexion) and hip-extension mobility work.

Returning to Sport

Return when strength is at least 90% of the other side, motion is full and pain-free, and you can perform your sport’s movements at full speed without hesitation. Returning before the muscle is re-strengthened is the main cause of re-injury.

Preventing the Next One

Hip mobility work, glute strengthening to balance the front of the hip, and progressive sprint buildup.

When to Call Us

In adolescents, sudden pain at the front of the pelvis during sprinting can be an avulsion fracture (the tendon pulling off a growth area) — X-rays and prompt review are needed.