Hip flexors may sound like a buzzword as of late, popping up in every health and fitness article you read, but the recognition for this group of muscles is long overdue. Along with the other core muscles, the hip flexors are key muscles in stabilizing the pelvis and spine. Keeping them nice and loose allows you to move and exercise without the risk of injuring your lower back1Fletcher, J. (2018). Hip flexor exercises: Stretches to strengthen. Medical News Today. Retrieved 27 December 2021, from https://www.medicalnewstoday.com/articles/320489.. They’re also powerful muscles used in explosive movements, such as jumping and running. But most of us don’t even know what hip flexors are or how they may be the invisible trigger to a vast array of physical, emotional and mental health concerns you’re experiencing. On the bright side, focusing on strengthening and stretching your hip flexors can eliminate a wide range of symptoms that seemingly have no link to your hips.
What are Hip Flexors?
Your hip flexors are a group of muscles that are found toward the front of the hip. They help you flex and move your leg and knee towards your body in what is known as a flexion movement. A flexion refers to a bending movement that reduces the angle between two body parts. For example, think of bending at a joint.
The muscles that make up the hip flexors are:
- Psoas major: a deep muscle that connects your spine to your leg, running from your lower back through your pelvis to the front of your hip, attaching to the top of your thigh bone (femur)
- Iliacus: a flat muscle that is found deep in the pelvis, linked from the pelvis to the thigh bone (femur)
- Rectus femoris: a quadriceps muscle that attaches your pelvis to the knee-tendon
- Pectineus (groin muscle): a flat muscle that is at the top of your inner thigh
- Sartorius: a long thin muscle that runs down the thigh from your pelvis to your knee.
Types of Hip Flexor Injuries and Symptoms
With your hip flexors being a group of core muscles, you can only imagine how many symptoms and potential injuries can happen when a hip flexor becomes strained or torn. Typically, pain of a potential strain or tear will be felt in the area at the front of your hip where it meets your thigh. The pain may be combined with any of the following:
- Pain and pulling, particularly when coming up from a squat or standing up from sitting
- Cramping and sharp pain
- Swelling
- Bruising
- Muscle spasms
- Difficulty walking
- Limping
Treatment of Hip Flexor Injuries
Common hip flexor injuries can range from a tear or strain, to hip flexor tendonitis (inflammation) and Psoas syndrome. Assuming your injury is not severe, you should be able to work it out at home with a little bit of protection, rest, ice, compression and elevation, and some pain relief medication. This method is commonly referred to as the PRICE method and is as simple as:
- Protecting your injury from getting worse by using a brace or support
- Resting your hip as much as possible within the first couple of days
- Using ice to reduce swelling (20 minutes every three to four hours)
- Wrapping the injured area or wearing compression shorts to reduce swelling
- Elevating your leg to be higher than your heart as much as possible to reduce inflammation and swelling
If over-the-counter medications aren’t helping with your pain and swelling or your symptoms are getting worse or not improving within a couple of weeks, it’s time to visit the doctor. This may be an indication that you’ve suffered a more severe injury than initially thought.
Additionally, it’s important to seek medical care if you have any underlying health conditions, such as kidney disease, heart disease or high blood pressure, or have experienced ulcers or internal bleeding in the past.
Exercises to Help Hip Flexor Injuries
A common form of treatment for hip flexor injuries, in combination with the prior, is the use of exercises. These can often be done at home on your own. However, in some severe cases, you may need to see a physical therapist who will work with you to gradually and safely strengthen and stretch your muscles.
In addition to stretching exercises, there are also soft tissue release techniques and trigger point therapy that serve as alternative therapies for healing and relieving pain. Soft tissue release is an advanced form of massage that specifically targets the damaged muscle fibers, and trigger point therapy focuses on individual trigger points that are compressed and causing pain.
Most times, repeat trips to a physical therapist, getting an expensive massage or alternative therapy aren’t mandatory for your healing. Doing regular stretches can help keep your hip flexors loose to prevent and heal injuries.
The most common stretches that help repair and reduce the risk of a hip flexor injury are:
Seated Butterfly
- In a seated position, put your feet together in front of you and your knees bent to the side
- With your back straight, shoulders down, and abs tight, slowly bend forward from the hips until you feel tension
- Hold the position for 30 seconds
- Return to the starting position
Lunge
- In a standing position with your body straight, shoulders back, chin up, and your abs tightened, step forward with one leg
- Lower your hips until both knees are bent at about a 90-degree angle, making sure that your front knee is directly above your ankle
- Squeezing the glute of the back leg, drive the knee back into the ground as you allow the hip to sink down and forward
- Return to the starting position and repeat with your other leg
Forearm Plank
- From a forearm push-up position, lower your hips while keeping your body straight from head to toe
- Tighten your abs and squeeze your glutes as you hold the position for 15 to 30 seconds
- Release, pause, and repeat.
Standing Stretch
- From a standing position, bend your right knee and bring your right heel up toward your butt
- Hold your right foot with the right hand, gently pulling so your knee is pointed towards the floor
- Hold for 30 seconds
- Repeat on your other leg
Active Stretch
- Standing on your left foot with the toes slightly turned inward, put your right foot on the seat of a chair in front of you
- Hold your arms out straight in front of you at chest level, slowly raising them straight up into the air as you squeeze your butt and gently push your pelvis forward
- Return to the starting position and repeat on the other leg
Your hip flexors are one of the most important muscles you’ll certainly want to take good care of to keep your body in tip-top shape. A combination of tightness and weakness causes most hip flexor injuries, so it’s important to loosen your hip flexor and strengthen it to prevent future injuries. Unfortunately, some injuries can also occur without any obvious symptoms or stem from direct trauma to your hip, and it’s important to see a doctor for a professional evaluation to determine the severity of your injury.
