What Is Hip Flexor Pain?

Hip flexor pain describes discomfort at the front of the hip or upper thigh. It often affects people who run, play field sports, lift weights or spend long periods sitting. If you experience ongoing hip pain or groin pain, the hip flexor muscles are frequently involved.

The hip flexor muscles, mainly the iliopsoas group, help lift your knee and stabilise the hip during walking, running and stair climbing. When these muscles become overloaded, tight or strained, pain and movement restriction can develop. If symptoms continue, a physiotherapy assessment can help identify contributing factors and support effective hip flexor pain treatment and recovery.

Common Causes

Several issues can lead to hip flexor pain. These include:

• Muscle strain: Often linked with sprinting, kicking or sudden changes in direction.
• Training load spikes: Increasing distance, speed or volume too quickly.
• Prolonged sitting: Hip flexors tighten over time, increasing tension around the iliopsoas.
• Reduced hip or core strength: Can increase demand on the hip flexor in walking or sport.
• Biomechanical factors: Pelvic position and movement habits may influence symptoms.

To learn more about related soft tissue injuries, see:

• • Muscle Injuries
  • Groin Pain

 

Symptoms You May Notice

Hip flexor pain may present with:

• A sharp, tight or aching sensation at the front of the hip.
• Pain when lifting the knee, sprinting, kicking or climbing stairs.
• Reduced stride length during running.
• Difficulty moving after sitting for long periods.
• Tenderness when pressing over the upper thigh or groin.

If symptoms begin affecting your daily activity, it is sensible to seek assessment from a physiotherapist.

How Physiotherapists Assess Hip Flexor Pain

A physiotherapist will examine:

• Hip flexor strength and flexibility.
• Movement patterns during walking, running or sport tasks.
• Tenderness across the iliopsoas, rectus femoris or adductor region.
• Load tolerance when lifting the knee.
• Contribution from the lumbar spine, pelvis or hip joint.

Imaging such as ultrasound or MRI is used only when symptoms persist or another condition needs to be ruled out.

Physiotherapy Treatment Options

Physiotherapy focuses on reducing symptoms, improving movement and addressing load-related factors. Treatment may include:

1. Exercise-Based Rehabilitation

Your physiotherapist may prescribe exercises that aim to:

• Improve hip flexor and core strength.
• Increase hip extension flexibility.
• Restore balanced muscle activation during walking or sport.
• Support a safe return to running or training.

Progressive loading is an important part of managing tendon and muscle conditions.

2. Manual Therapy

Hands-on treatment may help reduce irritation and improve comfort. This could include soft tissue techniques or joint mobilisation around the hip and pelvis. These treatments aim to support mobility while your exercise program restores long-term capacity.

3. Activity Guidance

Small adjustments to training load, running technique, warm-up routines or sitting habits often help reduce strain on the hip flexor. Your physiotherapist will guide you on safe progression and how to modify activities without losing fitness.

When to Seek Treatment

You should consider physiotherapy for hip flexor pain when:

• Pain lasts longer than a few days.
• Symptoms return repeatedly during sport.
• Stiffness or tightness limits your stride length.
• Climbing stairs or lifting your knee becomes difficult.

Early guidance can shorten recovery time and reduce the risk of recurrent issues.

Hip Flexor Pain – People Also Ask

What does hip flexor pain feel like?
It often feels sharp, tight or aching at the front of the hip or upper thigh. Pain may increase when lifting the knee or after sitting for long periods.

Should I walk if my hip flexor is sore?
Gentle walking may be suitable if symptoms remain mild. If pain increases or changes the way you move, reduce load until assessed by a physiotherapist.

How long do hip flexor strains take to heal?
Mild strains may settle within two to six weeks. Higher-demand sports or more significant injuries can take longer depending on training goals.

Related Articles

• Hip Pain
• Hip & Groin Pain Guide
• Hip Adductor Tendinopathy
• Groin Strain
• When Should You Worry About Hip or Groin Pain?

References

• Christopher ZK, Hassebrock JD, Anastasi MB, Economopoulos KJ. Hip flexor injuries in the athlete. Clin Sports Med. 2021;40(2):301–310. Available from: https://pubmed.ncbi.nlm.nih.gov/33673888/
• Juan J, et al. Hip flexor muscle activation during common rehabilitation and strength exercises. J Clin Med. 2024;13(21):6617. Available from: https://www.mdpi.com/2077-0383/13/21/6617
• Ehresman BA, Lehecka BJ, Hiser D, Koster L, Wietharn J. Improved hip flexibility and gluteal function following a daily lunge-and-reach stretching intervention. Int J Sports Phys Ther. 2025;20(6):814–823. Available from: https://pubmed.ncbi.nlm.nih.gov/40469644/
• Bonello C, King MG, Crossley KM, et al. The association between hip/groin pain and hip strength in football players: an exploratory analysis of the FORCe cohort. J Sci Med Sport. 2023;26(12). Available from: https://www.sciencedirect.com/science/article/pii/S1440244023001792
• Bizzini M. The athletic hip: joint status and muscle strength among the key elements in the return to sport process. Front Sports Act Living. 2025. Available from: https://www.frontiersin.org/journals/sports-and-active-living/articles/10.3389/fspor.2025.1690282/full

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