PT Tip of the Month Archive

Hip Flexor Muscle Strain

The two main muscles that are known as your hip flexors are called iliacus and psoas major. Their function is to bring your knee up toward your chest. A hip flexor strain is when those muscles are stretched or torn, usually during activities such as kicking or sprinting. During these activities, there is either a quick demand on the muscle or a quick change in direction. Like other muscle strains, a grade can be assigned to a hip flexor strain depending on the severity: mild (grade I), moderate (grade II), and complete (grade III). Grade I muscle strains means there is a micro tear in the muscle. Grade II muscle strains correlate with a partial tear in the muscle. Grade III muscle strains means there is a complete rupture of the muscle. People with complete ruptures experience severe pain, which prevents them from participating in sporting activity.




The iliacus muscle arises from the inside of the hip bone (iliac fossa). The psoas major originates from the sides of the lumbar vertebrae (L1-L5). Together, these two muscles insert into a bony prominence on the femur bone, called the lesser trochanter.

Who gets hip flexor strains?

Athletes who perform repetitive bending of the knees and hips, perform high kicking, or perform forceful kicking, are common recipients of hip flexor strains. These athletes include: sprinters, runners, bicyclists, martial artists, basketball players, football players, baseball players, and soccer players.


Symptoms depend on the severity of the muscle strain. Symptoms include: pain over the front hip or groin area (over the injured muscle), swelling, tenderness on site of the injury, bruising, hip flexor weakness, difficulty, and worsened pain when moving the hip. A person with a grade I muscle strain may experience tightness or pain in the front of the hip, but minimal to no swelling in that area. A person with a grade II muscle strain may feel a sharp pain in the front of their hip and thigh, which will limit their ability to use that muscle properly. A person with a grade III muscle strain will have severe pain with contraction of the muscle. Noticeable swelling will also be present.


During the acute phase, RICE (rest, ice, compression, elevation), relative rest, and activity modification is recommended. This includes engaging in cross-training activities, such as swimming, instead of biking or running. After this phase, your skilled physical therapist can assess if there are muscle strength imbalances in your core, hips, or thighs that may have contributed to your injury. He/she will also assess if there are any muscle length deficits causing altered biomechanics during activity. Physical therapy may include the use of soft tissue mobilization, stretching, strengthening, and other manual techniques in order to restore proper strength and flexibility. As you progress through therapy, the goal will be to return you to your prior level of activity safely. If you feel you are experiencing signs and symptoms of a hip flexor strain and would like to be scheduled for a physical therapy evaluation, please contact 617-232-PAIN (7246) for our Brookline office and 617-325-PAIN (7246) for our West Roxbury office.

33 Pond Avenue, Suite 107B Brookline, MA 02445 Tel: (617) 232-PAIN (7246) Fax: (617) 232-5196
1208B VFW Parkway, Suite 202 West Roxbury, MA 02132 Tel: (617) 325-PAIN (7246) Fax: (617) 325-7282