Hip Flexor Strain
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What is a hip flexor strain?
A hip flexor strain is an injury to one of your hip flexors, the muscles where your thigh meets your hip. They’re a type of muscle strain — a tear in your muscle tissue. They’re one of the most common injuries, especially among athletes.
Strains are classified with three grades to indicate how severe they are. Most people can recover by resting their muscle and using at-home treatments like ice and over-the-counter medicine. If you’re feeling pain for a few weeks after your injury or have severe symptoms, see a healthcare provider.
Muscle strains vs. pulled muscles
There’s no difference between a strained muscled and a pulled muscle. People use the terms interchangeably. The same is true for a strained muscle and a torn muscle. They’re the same injury with the same symptoms and treatments.
Hip flexor strains and other injuries
There are lots of common injuries that cause muscle pain similar to hip flexor strains, including:
- Pinched nerves.
- Herniated disks.
- Blood clots.
- Other muscle strains — like groin strains and quadriceps strains.
- Femoroacetabular impingement (also called hip impingement).
Talk to a provider if you experience any sudden, sharp pain in your body, especially if it happens during physical activity like a workout or playing sports.
Who do hip flexor strains affect?
Hip flexor strains can affect anyone. They’re common in athletes and people who are especially active.
Even if you don’t play sports or workout often, you can still strain your hip flexor, especially if you suddenly exert yourself much harder than usual.
How common are hip flexor strains?
Hip flexor strains are a common sports injury. Any athlete can injure their hip flexor, but the most common sports that cause hip flexor strains include:
- Martial arts.
How do hip flexor strains affect my body?
Your hip flexors run across the bottom of your abdomen and down the top of your hips. Like all of your muscles, your hip flexors are made of thousands of small fibers woven together. These fibers stretching and pressing together is what allows your body to move when you squeeze a muscle.
When you overuse a muscle, the strands of muscle fiber are stretched beyond their limit and tear apart. If you’ve ever tried to use an old bungee cord to hold something in place you’ve seen this happen. New bungee cords — and healthy muscle fibers — have plenty of give and stretch. But if you use them for too long or suddenly jerk on them too hard, the elastic fibers in the bungee cord will start to pull apart. It’s the same way in your muscles. Strains are what happen when some of the thousands of fibers in your muscles are pulled beyond their limit and tear.
In addition to being painful, a hip flexor strain might make it hard to walk or move without pain. Your hip and leg might feel weak or unstable. They might also cause other symptoms like bruising.
Symptoms and Causes
What are hip flexor strain symptoms?
Symptoms of a hip flexor strain include:
- A feeling of tightness or pulling in your hip.
- Trouble walking or moving without limping.
- Weakness in your lower abdomen or hip.
- Bruising or discoloration.
- Muscle spasms.
What causes hip flexor strains?
Hip flexor strains happen when you tear the fibers of your hip flexor muscles. Causes of hip flexor strains include:
- Overuse: Repeating the same motion — whether at work or during an activity like playing sports — can lead to overuse syndrome.
- Not stretching or warming up before exercise: Stretching before exercise gradually increases how much stress you put on your muscles.
- A lack of flexibility: If you’re not very flexible, your muscles (and the fibers in them) are tighter, which makes them more susceptible to strains.
- Traumas: Traumas like falls and car accidents can cause hip flexor strains too, especially if you suddenly tense your muscles to brace for an impact or during a fall.
Diagnosis and Tests
How are hip flexor strains diagnosed?
A healthcare provider will diagnose a hip flexor strain with a physical exam. Make sure to tell them what you were doing when you first noticed your symptoms. Because hip flexor strains come from physical activities, it’s important they know what led to yours.
Your provider will classify the hip flexor strain with a grade, depending on its severity:
- Grade 1 (mild).
- Grade 2 (moderate).
- Grade 3 (severe).
What tests will be done to diagnose a hip flexor strain?
If you have a more severe strain, your provider might use some imaging tests to diagnose your hip flexor strain:
- Ultrasound: Your provider will use an ultrasound to check for tears or fluid buildup around your hip flexor muscle.
- MRI: An MRI will help your provider check for blood clots or internal bleeding.
These tests will also help them see if your injury damaged any other tissues like your tendons or ligaments.
Management and Treatment
How are hip flexor strains treated?
You can treat most hip flexor strains at home using the RICE method:
- Rest: Stop the physical activity that caused your strain to avoid further damaging your muscle.
- Ice: Apply an ice pack or cold compress for 10 to 15 minutes every hour for the first day after your injury. After one day, you can apply ice every three to four hours. Don’t apply ice directly to your skin (wrap the ice pack in a towel or washcloth).
- Compression: Compression helps reduce blood flow to your injured muscle and reduces swelling. Apply a compression bandage or wrap around your hip. You can also wear compression shorts or pants to help keep pressure on your strained muscle.
- Elevation: If possible, lift your hips and lower body above the level of your heart. Support your leg with pillows, blankets or cushions.
Hip flexor strain surgery
It’s rare to need surgery for a hip flexor strain. If you have a severe strain (grade 3), you might need surgery to repair your torn muscle. If the strain was severe enough to pull tendons or ligaments off of your bones, you’ll need surgery to re-attach them. Your provider will tell you which kind of surgery you’ll need and what you can expect.
What medications are used to treat hip flexor strains?
Your provider might recommend over-the-counter NSAIDs to reduce pain and swelling while you’re recovering.
Don’t use NSAIDs for more than 10 days in a row without talking to your provider.
Your provider will tell you which medications to take based on your specific symptoms.
How soon will I feel better?
Depending on how severe your original hip flexor strain is, you should feel better in a week or two. Talk to your provider before resuming any intense physical activities or exercises — especially anything that puts stress on your hips and legs.
Can I run with a hip flexor strain?
You shouldn’t run, work out or do intense exercise while you’re recovering from a hip flexor strain. If you start working out or playing sports again before your hip flexor is healed, there’s an increased chance you’ll re-injure it and hurt your muscle worse than the original strain.
How can I prevent hip flexor strains?
The best way to prevent hip flexor strains is to stretch and warm up before exercising. Increasing your overall flexibility will also protect your muscles from future injuries. The more flexible you are, the more room your muscle fibers have to stretch before they begin to tear.
It’s similar to how certain fabrics have more give than others. Your favorite pair of jeans has plenty of flexibility to it because you’ve stretched it out over years. On the other hand, you might have to wear a brand-new pair a few times before they feel comfortable. Your muscles are the same. The more you work them out and gradually stretch them, the more flexibility and give they have when you move.
Outlook / Prognosis
What can I expect if I have a hip flexor strain?
You should expect to make a full recovery from a hip flexor strain. You should regain all your strength and ability to move after it heals. Make sure to warm up before exercising or playing sports, and give your body time to rest and recover after intense activity.
Some people with severe hip flexor strains have long-term symptoms like weakness in their torn muscle, but this is rare.
How long does a hip flexor strain last?
How long a hip flexor strain lasts depends on how badly you strained your muscle. Most hip flexor strains heal in a few weeks with at-home treatments.
Will I need to miss work or school with a hip flexor strain?
If you can do your job or schoolwork without putting stress on your strained hip flexor, you shouldn’t need to miss work or school.
Talk to your provider about which activities you should avoid while you’re recovering. Check with your provider before resuming any intense activity or exercising.
When should I see a healthcare provider?
Visit a healthcare provider right away if you’re experiencing severe symptoms like intense pain. If you’re still feeling pain after a few weeks of at-home treatments, talk to your provider.
When should I go to ER?
Go to the emergency room right away if you experience any of the following symptoms:
- Bleeding in or around your strained muscle.
- You can’t move your leg.
- Swelling that won’t go away or is getting worse.
Go to the emergency room if you’ve experienced a trauma.
What questions should I ask my doctor?
- Do I have a hip flexor strain or another injury?
- Which grade of strain do I have?
- How long will I need to rest?
- Are there any activities I should avoid while I’m recovering?
A note from Cleveland Clinic
Hip flexor strains are a frustrating injury. They’re usually caused by doing something you love, like playing your favorite sport. Even though it can be annoying to stay off the field, ice or court for a few weeks, it’s important to give your body the time it needs to heal. If you rush your recovery, you might re-injure your hip flexor or other muscles.
Don’t be afraid to reach out to your provider with questions. Just because an injury is common doesn’t mean your situation isn’t unique.
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