Preventing and Treating A Hip Flexor Strain (2024)
A hip flexor strain is extremely common among runners and cyclists and is often caused by tight hip muscles and overuse of the muscle fibers. This can lead to a hip flexor tear in the muscle fibers that connect the hip bone to the thigh bone.
It is important to know how to prevent this injury from happening and what treatment options are available if it does occur.
As always, you should seek the advice of a healthcare professional or physical therapist if you have persistent pain or discomfort anywhere in your body.
What Are Your Hip Flexors?
The hip flexors are a group of muscle fibers located on the upper thigh at the front of the hip joint, responsible for flexing the hip joint and bringing the thigh towards the torso (like when you pull your leg forward during running). These muscles include the psoas major, iliacus, rectus femoris, sartorius, and the tensor fasciae latae.
The hip flexors are essential for activities such as walking, running, jumping, and climbing stairs. They can become tight and overused with prolonged sitting and can also be strained during intense physical activity or with improper form during exercise.
Hip Flexor Strain Symptoms
One of the primary symptoms of a hip flexor strain is pain or discomfort in the front of the hip or groin area. The pain might be sharp or aching, and it can range from mild to severe depending on the extent of the strain. The pain can also extend down the front of the thigh.
The affected muscle fiber area might become tender to the touch, indicating inflammation and sensitivity in the hip flexor muscles and tendons. Pressing on the area may exacerbate the discomfort.
Hip flexor strains can lead to a decreased range of motion in the hip joint. Activities that require lifting the knee, such as walking, climbing stairs, or bringing the knee toward the chest, might become challenging and painful.
Causes of Hip Flexor Strain
A desk job along with overuse and even genetics can exacerbate hip flexor issues.
Sedentary Lifestyle
A sedentary lifestyle can be a common source of hip flexor strain, as it reduces the body’s ability to use its muscles efficiently. Do you sit at a desk all day? Your hip flexors are relaxed when sitting and over time they will begin to shrink slightly. Sitting causes muscles to become tight, which is the perfect recipe for strains to occur.
Standing desks are better, but have you tried standing all day? Some people have found success following short intense Tabata workouts a few times per week.
Poor Running Form
Hip flexor strains are most common among runners who pull their legs forward more than necessary while running, especially heel-strikers. When you pull the leg forward, you’re engaging the hip flexor, and with a heel strike, you’re sending a jolt of concussive energy back up the leg all the way to the hip flexor area. This can quickly cause inflammation, especially among beginner runners training for a 5k or half marathon.
Also, make sure your running shoes and running insoles are working as expected.
Overuse
Repetitive motions such as running or cycling can put a lot of strain on the muscle group and lead to discomfort and inflammation if done without proper stretching and warm-up. This is the same as running too hard and not practicing proper pacing techniques (check out our running pace chart).
Even something as simple as sitting in an awkward position for too long can result in stiffness or soreness in the hips. It is important that you take steps to prevent this type of injury by avoiding repetitive stress and maintaining good posture throughout your day-to-day activities.
Muscle Imbalances
One of the key factors that can contribute to hip flexor pain is muscle imbalances. Muscle imbalances occur when one muscle group is stronger or tighter than its opposing muscle group, which can cause uneven stress and strain on the joints and muscles. In runners, muscle imbalances can often develop due to the repetitive nature of the sport, as well as poor posture or biomechanics.
The hip flexors are a group of muscles that work together to lift the leg and bend the hip. They are often overused in runners, which can lead to tightness and strain. When these hip flexors are overused, they often become dominant over the opposing muscle group, the hip extensors, which are responsible for extending the hip and lifting the leg behind you. This muscle imbalance can lead to uneven stress on the hip joint and result in hip flexor pain.
Additionally, weak glute muscles can also contribute to hip flexor pain in runners. The glute muscles are the largest and strongest muscles in the body, and they play a key role in stabilizing the pelvis and supporting the hips during running. When the glute muscles are weak, the hip flexors may compensate by working harder, which can also lead to tightness and strain.
Everyone has some degree of muscle imbalance. A good sports medicine professional can help determine exactly what you need to work on if you need more clarification.
How to Fix a Hip Flexor Strain
Stretching, Foam Rolling, improvement to your running form, Kinesiology tape, and achieving muscle balance are all excellent ways to fix a hip flexor strain. I’ve been to physical therapy in the past for this pain, but nearly all of my recovery has been at home with these exercises. Let’s go over these home remedies in my preferred order.
Stretching Exercises
Nearly all hip flexor strains can be resolved with adequate stretching before and after exercise combined with a structured foam rolling session at home.
Stretching can be done in a variety of ways to help improve flexibility and reduce pain.
Standing Quad Stretch
Stand with your feet hip-width apart and then lift one foot off the ground, bending the knee and bringing the heel towards your glutes.
Use your hand to hold the ankle or foot, gently pulling it towards the buttocks until a stretch is felt in the front of the thigh. It’s important to maintain good posture during the stretch, keeping the torso upright and avoiding leaning forward or backward. It’s okay to have the opposite hand on a wall to stabilize yourself.
This stretch can alleviate tightness in the quadriceps muscles. Use it in your warm-up and cool-down routine.
Hip Flexor Stretch
Begin in a lunge position with knees bent and one knee on the ground. The other foot should be flat on the floor in front of you.
Slowly shift your weight forward, pressing the pelvis forward until a stretch is felt in the front of the hip of the leg that has the knee on the ground. It’s important to maintain good posture during the stretch, keeping the back straight and avoiding arching it.
This stretch can help to improve flexibility and reduce tightness in the hip flexor muscles. Use it in your warm-up and cool-down routine.
These exercises should be done slowly and gently, focusing on deep breathing as you move through the stretches. Make sure to take breaks throughout the day to prevent straining the muscle fibers further. If necessary, use ice or heat packs before starting any stretching routine. With regular stretching and proper care, you can easily prevent hip flexor strain and enjoy a more active lifestyle without any pain or discomfort.
Be sure to use your favorite triathlon watch to time these stretches and do them for about 30 seconds max.
Use a Foam Roller
Foam rolling is a self-massage technique that can help relieve muscle tension and soreness, increase flexibility, and improve circulation. I personally use this daily, and it has cured my hip flexor pain many, many times.
Foam Roll the Hip Flexor Area
Using a foam roller on the hip flexors can help release tension and improve flexibility in these muscles. To foam roll the hip flexors, lie face down with the foam roller positioned under your hip flexors. Slowly roll up and down over the affected area, applying gentle pressure. You can also tilt your body slightly to one side to target one hip flexor at a time.
Using a foam roller can help reduce muscle tension and improve flexibility in the hip flexors, which can help alleviate issues in this area.
Foam Roll the IT Band Area
The IT band, or iliotibial band, is a long, thick band of fascia that runs along the outside of the thigh, from the hip to the knee. Tightness in the IT band can lead to a variety of issues, including hip flexor pain in runners and cyclists. Fortunately, foam rolling the IT band area can be an effective way to alleviate a strained hip flexor and improve overall mobility.
Foam rolling the IT band can help release tension and improve flexibility in the surrounding muscles, including the hip flexors. To foam roll the IT band, lie on your side with the foam roller positioned under the outside of your thigh. Use your arms to support your body weight, and then slowly roll up and down over the affected area. You can also turn your leg slightly inward or outward to target different areas of the IT band.
Improve Your Running Form
Improving your running form can help reduce the strain on your hip flexors and prevent further injury. Most beginning runners tend to land on their heels and roll to their toes, but that is highly inefficient and opens up the risk of injuries.
The biggest improvement you can make in form is to land on your midfoot. Landing on your midfoot like the photo above or forefoot can help reduce the impact on your body, which can reduce the strain on your hip flexors. It’s also a much faster way of running and you’ll move farther with less energy. Bonus!
Kinesiology Tape
Kinesiology tape, also known as KT tape, is a thin, stretchy, and adhesive tape that can be used to support muscles and joints during physical activity. It has become increasingly popular among athletes, including runners, for its ability to help alleviate pain and improve muscle function. I have personally used it many times to help with a hip flexor strain during a race.
When applied correctly, the tape can help improve circulation, reduce inflammation, and support the hip flexors during movement. This can be especially helpful for runners who are experiencing pain or discomfort in the hip flexors.
To apply KT tape to the hip flexors, start by cleaning the area and ensuring that the skin is dry. Cut a strip of tape long enough to cover the hip flexors, and then apply the tape with slight tension over the affected area. You can also apply additional strips of tape in a fan-like pattern to provide more support.
Watch the video for a good example.
Strengthen Surrounding Muscles
Sore hip flexors can be the result of muscle imbalances. Your glutes, hamstrings, quads, and hip flexors all work together to do their job, and slight imbalances in any of them can cause problems.
Personally, my glutes are my weak link, but I try to strengthen all the areas in the hip region with some of the exercises below.
Bodyweight Squats
Stand with your feet shoulder width apart in front of you and slowly go down until your thighs are parallel with the floor, then come back up while squeezing your glutes together for 1 second at the top.
Do 3×25 of these every other day.
Single Leg Step Up
These are simple but effective. Keep the step between 6-12 inches maximum.
I recommend doing this S-L-O-W rather than explosive.
With one foot on an elevated surface (like a bench, box, or step), push up through that heel to lift yourself up onto it (stepping up), then return back down.
You can also throw in a “knee up” with the leg not on the box so the thigh is parallel with the floor, but be careful about that. It will directly work the hip flexors so perform with caution and go S-L-O-W.
If there is any irritation in the hip flexor area, leave the “knee up” portion for another day. Do 3×15 of these every other day.
Finally, don’t forget to rest and recover from your workouts. It goes a long way in keeping your body healthy.
Hip Flexor Strain Exercises to Avoid
When you have a hip flexor strain, you need to avoid overworking the area until the inflammation has decreased and healing is underway. A sharp pain from any exercise or activity should be avoided. Here are some common exercises that may set you back in your recovery.
Heavy Squats
Any squatting motion will work the hip flexors, and adding weight to this motion can be harmful to the recovery process if done too quickly.
It’s better to perform bodyweight squats without additional weight until your hip flexors are sufficiently healed.
Flutter Kicks
This is when you lie on your back and flutter kick your legs about 12 inches off the floor.
I don’t perform these because your legs are a fairly heavy “weight” and these hit your hip flexors pretty hard. Personally, I find these to be more harmful than beneficial to an injured hip flexor, so I avoid them until my injury is healed.
Frequently Asked Questions
Conclusion
As the old adage goes, an ounce of prevention is worth a pound of cure—so make sure that when it comes to your hips, you’re taking all necessary precautions! And if you do experience pain or discomfort that isn’t healing quickly, it’s essential to seek treatment from a qualified professional.
Heal up quick, sign up for a bucket list marathon or one of the best half marathons in the US, and have fun!
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