Hip Flexor Pain

Hip flexor pain anterior hip resisted knee lift assessment

Hip flexor pain assessment

Hip flexor pain often causes pain or tightness at the front of the hip, upper thigh or groin. It may affect running, kicking, stairs, gym work or standing after sitting.

The hip flexors include the iliopsoas and rectus femoris muscles. They lift your knee and help control your hip during walking, running and sport. If symptoms persist, a physiotherapy assessment may help identify the cause and guide safe recovery.

Quick Summary

Hip flexor pain usually sits at the front of the hip or groin.
It may worsen with sprinting, kicking, stairs or lifting the knee.
Common causes include overload, strain, stiffness and weakness.
Other hip and groin conditions can feel similar.
Physiotherapy may help guide load, strength and return to sport.

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What Is Hip Flexor Pain?

Hip flexor pain describes discomfort from the muscles or tendons at the front of the hip. The iliopsoas is the main hip flexor group. It runs from the lower spine and pelvis to the upper thigh bone.

These muscles work hard when you lift your knee, run uphill, sprint, kick, climb stairs or stand after sitting. When load rises faster than the muscle or tendon can tolerate, pain may develop.

Hip flexor pain can overlap with other forms of groin pain and hip pain. This is why a clear assessment matters.

What Does Hip Flexor Pain Feel Like?

Hip flexor pain may feel sharp, tight, pinching or achy. Many people notice symptoms at the front of the hip, deep in the groin or high in the upper thigh.

Pain when lifting the knee.
Pain with sprinting, kicking or hill running.
Tightness after sitting for a long time.
Shorter stride length when running.
Pain climbing stairs or getting out of a low chair.
Tenderness near the front of the hip or upper thigh.

If pain changes your walking, running or sport pattern, reduce the load and seek advice.

Could It Be Something Else?

Front hip and groin pain can come from several structures. Hip flexor pain is one possibility, but similar symptoms may occur with:

Common Causes of Hip Flexor Pain

Hip flexor pain often develops when the front of the hip is asked to do more than it can currently tolerate.

Muscle strain: This often follows sprinting, kicking or sudden change of direction.
Training load spikes: Faster running, longer sessions or extra hills may overload the hip flexors.
Prolonged sitting: Sitting can increase stiffness around the front of the hip.
Reduced hip or core strength: The hip flexors may work harder when the pelvis and trunk lack control.
Running or sport demands: Repeated high-knee drive, kicking or cutting can irritate the area.
Related hip or groin conditions: Hip joint or adductor problems may mimic hip flexor pain.

Runners may also find our running injuries guide useful if symptoms flare during training.

How Physiotherapists Assess Hip Flexor Pain

A physiotherapist will assess the hip, groin, pelvis and lower back. This helps identify whether the pain is mainly from the hip flexor or another nearby structure.

Hip flexor strength and pain during a resisted knee lift.
Hip range of motion and extension flexibility.
Tenderness around the iliopsoas, rectus femoris and adductor region.
Walking, running, squat or step movement patterns.
Single-leg control and pelvic position.
Possible contribution from the lumbar spine or hip joint.

Imaging, such as ultrasound or MRI, is not always needed. It may help when symptoms persist, trauma is involved, or another condition needs to be ruled out.

Physiotherapy Treatment for Hip Flexor Pain

Physiotherapy treatment for hip flexor pain aims to calm symptoms, restore movement and rebuild load tolerance. Your plan should match your pain level, activity goals and sport demands.

Exercise-Based Rehabilitation

Exercise is usually the main part of recovery. Your physiotherapist may start with low-load drills, then build strength and sport-specific control.

Hip flexor isometric holds for early pain control.
Core and pelvic control exercises.
Gluteal and adductor strengthening.
Hip extension mobility drills.
Gradual return to running, kicking or gym work.

Hip flexor pain anterior hip banded knee drive rehab

Controlled hip flexor loading

Manual Therapy

Hands-on treatment may help reduce guarding and improve comfort. This may include soft tissue techniques or joint mobilisation around the hip and pelvis.

Manual therapy should support, not replace, a clear strength and load plan.

Activity and Load Guidance

Small changes can reduce stress on the hip flexor while you recover. These may include shorter running sessions, less speed work, modified gym exercises, better warm-ups or breaks from long sitting.

Can You Keep Training?

You may be able to keep moving if symptoms stay mild and settle after activity. Use pain as a guide, but also watch for next-day stiffness or loss of stride length.

Usually okay: gentle walking, easy cycling or low-load strength if pain stays mild.
Modify: hills, sprinting, kicking, deep lunges or heavy hip flexion work.
Pause and seek advice: limping, sharp pain, night pain, worsening symptoms or repeated flare-ups.

Return to Running and Sport

A safe return depends on pain, strength and how your hip responds to load. Avoid using time alone as your guide.

Stage	Main Goal	Examples
Early	Settle pain and restore easy movement	Walking, gentle mobility, light isometrics
Build	Improve hip, trunk and groin strength	Bridges, step-ups, controlled hip flexion drills
Run	Rebuild running tolerance	Walk-run intervals, flat running, gradual pace work
Sport	Return to speed, kicking and direction change	Acceleration drills, cutting, kicking and game-specific loading

Hip flexor pain anterior hip step-up knee drive return to running

Return-to-running hip control

When Should You Seek Help?

Consider physiotherapy if hip flexor pain does not settle quickly, keeps returning, or limits sport, work or daily movement.

Pain lasts longer than a few days.
Symptoms return each time you run or train.
You limp or shorten your stride.
Stairs, kicking or lifting the knee feel difficult.
You notice groin pain, clicking, catching or deep hip pinching.
You are unsure whether to keep training.

Seek urgent medical care if you have severe pain after trauma, fever, unexplained weight loss, night pain, inability to weight-bear, or new bladder, bowel or nerve symptoms.

Hip Flexor Pain FAQs

What causes hip flexor pain?

Hip flexor pain may occur after a muscle strain, a sudden rise in training load, prolonged sitting, reduced hip strength or repeated sprinting and kicking. It can also overlap with hip joint or groin conditions.

What does hip flexor pain feel like?

It often feels sharp, tight or achy at the front of the hip, upper thigh or groin. Pain may increase when lifting the knee, sprinting, kicking, climbing stairs or standing after sitting.

Should I walk with hip flexor pain?

Gentle walking may be suitable if symptoms stay mild and your walking pattern remains normal. If pain increases, causes limping or worsens later that day, reduce load and seek physiotherapy advice.

How long does hip flexor pain take to recover?

Recovery depends on the cause and severity. Mild strains may settle within two to six weeks. Higher-load sport injuries or repeated flare-ups can take longer and may need a staged return-to-training plan.

Can hip flexor pain cause groin pain?

Yes. The iliopsoas and nearby hip flexor structures can refer pain into the front of the hip or groin. However, adductor injury, FAIS, labral injury and osteitis pubis can also cause groin pain.

What To Do Next

If hip flexor pain is limiting running, sport, stairs or daily movement, a physiotherapy assessment may help identify the main driver and guide your next steps.

Your physiotherapist can help you decide what to keep doing, what to modify, and how to rebuild strength without repeated flare-ups.

Products That May Support Your Recovery

Some people use recovery products to support comfort, mobility or home exercise. Your physiotherapist can help you choose what suits your symptoms and goals.

Groin Products

These groin products are commonly used by our physiotherapists to improve groin pain, strength, balance, proprioception, endurance and flexibility, plus assist home exercise programs.