Why does it occur?

Hip Flexor Strains are caused by an acute injury or gradual overuse to a set of muscles at the front of the hip called the Hip Flexors. The muscles involved are the iliopsoas and/or the rectus femoris.  These muscles are responsible for bringing your knee to your chest (hip flexion). Hip Flexor Strains are most common in kicking athletes such as soccer players, football punters, dancers, cyclists, runners, or martial artists.  The most common causes of this are either the lack of proper warm up prior to activities, or overuse of the muscle from overtraining.

 

Proper warm up is super important and often overlooked, and involves doing an activity to increase your core temperature and muscle elasticity.  This can be jumping jacks or light running for about 10 minutes. Stretching for a period of 5-10 additional minutes may also be helpful in injury prevention.  However, between the two, the warm up is considered more important, so if you only have 10 minutes to spare before your activity, do the warm up!

​

Symptoms:

Patients with a Hip Flexor Strain typically present with pain at the anterior/front of the hip after prolonged overuse or from an acute injury to the area (such as a sudden and painful kick).  Pain is made worse when attempting to bring the knee to the chest or when bending forward at the waist. There may also be increased pain at the front of the hip with running or simply walking. Patients are often tender to palpation at the involved muscles.

​

Diagnostic Testing:

Dr. Lee may typically order an X-ray to assess your hip and/or pelvis to rule out an avulsion fracture, calcifications, or stress fracture.  If Dr. Lee suspects your pain is radiating from your low back, he may also order a lumbar spine x-ray as well.  An MRI may be advised to assess the area further in some cases, especially if a stress fracture is suspected.

​

Treatment Options:

A Hip Flexor Strain is treated primarily with activity modification by backing down on the offending activity such as running, kicking, jumping, or cycling. Icing and NSAIDs such as Advil or Aleve (if not contraindicated) may be advised to reduce inflammation in the area.  Physical Therapy is an important aspect of treatment for a Hip Flexor Strain, and entails a course of stretches and progressive strengthening exercises as well as different modalities to decrease inflammation.

​

Surgical Treatment:

The vast majority of Hip Flexor Strains are treated successfully without the need for surgery. If your pain does not improve after exhausting the non-operative treatments above, surgery may be discussed as an option to repair the tendon(s). 

​

Besides the physical therapy, the most important aspect of this treatment is NOT going back to regular activities too early.  After about 3 weeks, the pain is often significantly improved, so many patients will venture back to sports or activities.  Doing so often causes a re-tear that not only sets the patient back to square one, but actually makes them worse.  Repetitive episodes of re-injury ultimately can lead to a decreased overall outcome.

​

 

 

​

 

*It is important to note that all of the information above is not specific to anyone and is subject to change based on many different factors including but not limited to individual patient, diagnosis, and treatment specific variables. It is provided as an educational service and is not intended to serve as medical advice.  Anyone seeking specific orthopedic advice or assistance should consult Dr. Steven Lee or an orthopedic specialist of your choice.

 

*Dr. Steven Lee is a board certified orthopedic surgeon and is double fellowship trained in the areas of Hand and Upper Extremity Surgery, and Sports Medicine. He has offices in New York City, Scarsdale, and Westbury Long Island.