Hip Flexor Strain: Causes, Symptoms, and Rehabilitation

Reviewed by the Physiotherapy Team at Waterloo Sports Medicine Centre 

Feeling pain at the front of your hip after running, kicking, or exercising? You may be dealing with a hip flexor strain. This common sports injury can affect athletes and active individuals, but it can also occur from everyday activities involving repetitive hip movements. 

With proper rehabilitation, most people can recover well and safely return to their normal activities. 

What Is a Hip Flexor Strain? 

A hip flexor strain occurs when one or more of the muscles responsible for lifting the thigh toward the body become overstretched or torn. The main hip flexor muscle is the iliopsoas, which is made up of the psoas major and iliacus muscles. Other muscles involved include the rectus femoris, sartorius, and tensor fasciae latae.

The hip flexors play an important role in activities such as: 

• Walking and running 

• Climbing stairs 

• Kicking 

• Jumping 

• Changing direction during sports

When these muscles are injured, pain and weakness can limit movement and athletic performance.

What Causes a Hip Flexor Strain? 

Hip flexor strains commonly occur when the muscles are placed under excessive stress, especially during fast or powerful movements. 

Common causes include: 

• Sudden acceleration or sprinting 

• Kicking movements 

• Jumping or explosive activities 

• Rapid changes in direction 

• Overuse from repetitive hip flexion 

• Inadequate warm-up or muscle fatigue 

• Sudden increases in training intensity 

Athletes involved in sports such as soccer, hockey, football, basketball, and running are particularly susceptible because these activities require repeated high-force hip movements. 

Common Symptoms of a Hip Flexor Strain 

Symptoms depend on the severity of the injury but may include: 

• Pain at the front of the hip or groin 

• Tightness or stiffness in the hip 

• Pain when lifting the knee toward the chest 

• Pain with running, sprinting, or kicking 

• Weakness during hip movements 

• Tenderness when pressing on the injured area 

• Difficulty walking in more severe cases 

A sudden strain may cause sharp pain during activity, while overuse injuries may develop gradually with increasing discomfort. 

Grades of Hip Flexor Strains 

Hip flexor strains are often classified based on severity: 

Grade I (Mild) 

• Small number of muscle fibres are damaged 

• Mild pain and minimal loss of strength 

• Usually heals within a few weeks 

Grade II (Moderate) 

• Partial muscle tear 

• More noticeable pain, weakness, and reduced function 

• May require several weeks of rehabilitation 

Grade III (Severe) 

• Significant muscle tear or complete rupture 

• Major weakness and difficulty with movement

• May require longer rehabilitation and, in rare cases, surgical consultation

  
  

How Can Physiotherapy Help? 

Physiotherapy is an important part of hip flexor strain recovery. Treatment focuses on reducing pain, restoring mobility, rebuilding strength, and preventing future injuries. 

Your physiotherapist may recommend: 

Activity Modification 

Avoiding or adjusting painful activities while maintaining safe movement to support healing. 

Pain and Mobility Management 

Treatment may include gentle mobility exercises, stretching, and hands-on techniques to improve comfort and restore hip movement. 

Progressive Strengthening 

Strengthening the hip flexors and surrounding muscles helps restore function and reduce the risk of reinjury. Exercises may target: 

• Hip flexors 

• Gluteal muscles 

• Core muscles 

• Hip stabilizers 

  
  

Movement Retraining 

Your physiotherapist can assess running, jumping, or sport-specific movements to identify contributing factors and improve movement efficiency. 

Gradual Return-to-Sport Program 

A structured progression from basic movements to higher-level activities helps ensure a safe return to exercise and sport  

How to Prevent Hip Flexor Strains 

You can reduce your risk by: 

• Warming up before exercise 

• Increasing training intensity gradually 

• Maintaining hip and core strength 

• Improving flexibility and mobility 

• Taking adequate recovery time between intense workouts 

• Using proper technique during sport and exercise 

  
  

When Should You See a Physiotherapist? 

Consider booking an assessment if you have: 

• Persistent front-of-hip or groin pain 

• Difficulty walking, running, or exercising 

• Pain that returns every time you increase activity 

• Weakness when lifting your leg 

• Symptoms that are not improving with rest. 

  
  

At Waterloo Sports Medicine Centre in Kitchener-Waterloo, our physiotherapists can assess your hip injury, identify contributing factors, and develop a personalized rehabilitation program to help you recover and return to the activities you enjoy.