Hip & Thigh

What It Is

The hip flexor muscles let you lift your leg and knee up towards your body and bend at the waist (MedlinePlus, 2025). The main hip flexor is the iliopsoas, which is made up of the psoas major and iliacus muscles joined together (Kumazaki et al., 2022). It is possible to strain the muscle or its tendon near the groin, where the front of your thigh meets your hip (MedlinePlus, 2025).

A strain is a stretching or tearing of a muscle or tendon (MedlinePlus, 2025). Tendons are tough bands of tissue that connect muscle to bone. When a tendon becomes inflamed, it is called tendinitis.

Hip flexor strains often happen with sudden movements, such as sprinting, kicking and changing direction while running (MedlinePlus, 2025). The injury is more common in runners, people who practise martial arts, and football, soccer and hockey players (MedlinePlus, 2025; Cleveland Clinic, 2022). Overuse, not warming up, and weak or stiff muscles can also lead to a strain (MedlinePlus, 2025; Cleveland Clinic, 2022).

Hip Flexor Strain Anatomy

The hip is a ball and socket joint connecting the thigh bone (femur) to the pelvis socket. It allows the leg to move. Near the top of the thigh bone are two bony bumps: the greater trochanter on the outside, where several buttock muscles attach to move the leg out to the side (hip abduction), and the lesser trochanter on the inside, where the iliopsoas muscle attaches to bring the leg forwards (hip flexion) (Kumazaki et al., 2022).

The psoas major starts from the lowest vertebra of the upper back (T12) and the vertebrae of the lower back, and joins with the iliacus to attach to the lesser trochanter (Kumazaki et al., 2022). It's a strong muscle with large attachments. It is helped by other muscles, including the rectus femoris, one of the quadriceps muscles at the front of the thigh (Kumazaki et al., 2022).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat a Hip Flexor Strain

Rehabilitation, including massage, stretching and strengthening your hip flexors and the muscles around your hip and back, helps the area heal and can help prevent further injuries (MedlinePlus, 2025). I can guide you through this with hands-on treatment, a stretching and strengthening programme and a gradual return to your activities. See the My Approach tab for how I work.

1. Ice

For the first 2 to 3 days, wrap an ice pack (or a bag of frozen vegetables) in a tea towel and place it over the groin at the front of your hip for up to 20 minutes every 2 to 3 hours (NHS, 2024). Never put ice directly on your skin, as this can cause an ice burn (MedlinePlus, 2025).

2. Anti-Inflammatory Medication

MedlinePlus (2025) says anti-inflammatory painkillers such as ibuprofen or naproxen can reduce pain and swelling, and that paracetamol (called acetaminophen in the US) helps with pain but not swelling. It advises talking to your doctor before using these medicines if you have heart disease, high blood pressure or kidney disease, or have had stomach ulcers or internal bleeding (MedlinePlus, 2025). (This medicine information comes from MedlinePlus, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

3. Exercise

While you rest the hip flexors, I may suggest exercises that don't strain them, such as swimming (MedlinePlus, 2025).

4. Heat

Avoid heat (such as hot baths and heat packs) for the first couple of days, as it can increase swelling (NHS, 2024). Later in the recovery stage, you may find heat over the front of the hip helpful, for example before stretching or warming up.

Tips

Always make sure to warm up before you begin any sprinting or fast-paced activities. Stretching and warming up before exercise is the best way to prevent a hip flexor strain (Cleveland Clinic, 2022).
Check with me or your doctor before going back to running, intense exercise or sport. Returning before the muscle has healed increases the chance of injuring it again (Cleveland Clinic, 2022).
If you are limping or in pain, stop physical activities and come back to see me for more treatment.
Most hip flexor strains heal within a few weeks with home treatment (Cleveland Clinic, 2022).
You may need crutches for a severe strain (MedlinePlus, 2025).

Treatment

My Approach

A hip flexor strain means fibres in the muscle or tendon at the front of your hip have been stretched or torn. My aim is to help them heal well and get you back to running, kicking and sport without straining it again. How I help depends on how bad the strain is.

If it's a mild or moderate strain, and you can walk and lift your leg even if it hurts, I treat it directly. If it's a severe strain or tear (you can't lift your leg, you need crutches, there's a gap you can feel in the muscle, or there's marked weakness), see a doctor first (see When to Get Urgent Help). Once you've been checked, I provide supportive care that follows your doctor's advice; please bring any X-ray or scan reports.

I start by assessing how your hip and low back move, the strength of your hip muscles and how you walk, and I'll ask how it happened.

Early On

I leave the injured spot alone and ease the guarding in your low back, buttock and thigh
Gentle, pain-free tightening of the muscle without moving the hip
I'll show you how to use ice safely at home
Shorter, more frequent visits work best at this stage

As It Heals

Lighter work closer to the injury, and trigger point work in the surrounding muscles
Warm then cool applications in the clinic to help circulation
Gentle stretching for the front of the hip, only to the start of discomfort
Strength building from static holds to lifting and lowering your leg

Back to Full Strength

Cross-fibre work for tight, stuck-down areas, then a gentle stretch and a short cool application
Heavier hip and core strengthening, including gym-based work if you lift
A graded return to running, kicking and changing direction, with taping if it helps, and I'll show you how to tape it yourself

If It's a Severe Strain or Tear

Easing the low back, other leg and shoulders, which work overtime, especially on crutches
Working closer to the injury and rebuilding strength within your doctor's advice

Work near the groin or on the buttock and hip muscles is only with your informed consent and a written consent form, and you can say no at any time.

What to Expect

Typical Course

Typical course: Visits are usually shorter and once or twice a week early on, then weekly, with a reassessment at about 4 to 6 weeks, then spaced out as you manage more on your own. Most mild strains heal within a few weeks; a severe strain or tear usually takes longer, often a few months, and follows your doctor's advice.

What I Focus On

Severity Check

Protect Early

Hip Flexor Release

Graded Hip Strength

Return to Sport

Please read

When to See a Doctor First

When to Get Urgent Help

Call 911 or go to the emergency room at your nearest hospital if there is bleeding in or around the strained muscle, you cannot move your leg, the swelling will not go away or is getting worse, or the injury happened in an accident such as a fall or car crash (Cleveland Clinic, 2022). See your doctor if you do not feel better within a few weeks (MedlinePlus, 2025).

Sources

References

Cleveland Clinic (2022) Hip flexor strain. Available at: https://my.clevelandclinic.org/health/diseases/23978-hip-flexor-strain (Accessed: 7 October 2026).
Kumazaki, T., Takahashi, T., Nakano, T. and Sakai, T. (2022) 'Action and contribution of the iliopsoas and rectus femoris as hip flexor agonists examined with anatomical analysis', Juntendo Medical Journal, 68(4), pp. 352–362. doi: 10.14789/jmj.JMJ22-0009-OA
MedlinePlus (US National Library of Medicine) (2025) Hip flexor strain – aftercare. Available at: https://medlineplus.gov/ency/patientinstructions/000682.htm (Accessed: 7 October 2026).
NHS (2024) Sprains and strains. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooHip Flexor Strain

What It Is

Hip Flexor Strain Anatomy

Self-Care & Treatment

How to Treat a Hip Flexor Strain

1. Ice

2. Anti-Inflammatory Medication

3. Exercise

4. Heat

Tips

My Approach

Early On

As It Heals

Back to Full Strength

If It's a Severe Strain or Tear

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooHip Flexor Strain

What It Is

Hip Flexor Strain Anatomy

Self-Care & Treatment

How to Treat a Hip Flexor Strain

1. Ice

2. Anti-Inflammatory Medication

3. Exercise

4. Heat

Tips

My Approach

Early On

As It Heals

Back to Full Strength

If It's a Severe Strain or Tear

Typical Course

When to See a Doctor First

When to Get Urgent Help

References

Related Conditions

Adductor Tear

Adductor Tendinopathy

Biceps Femoris Tendinopathy

Femoroacetabular Impingement (FAI)

Book a session