Hip flexors are muscles that many people don’t spend much time thinking about. They’re located on the front side of your hip and help your hip bend. They’re the muscles we use each time we kick or run. These muscles are fairly susceptible to injury when they are engaged suddenly without a proper warm-up. They are also injured through repeated strenuous activity, or even too much inactivity. Hip flexor tears can be quite painful and greatly limit your hip’s range of motion.

At Epic Healthcare & Physical Medicine we treat many people with hip flexor injuries. Our physical therapists know just how to help you through your injury while minimizing pain and reducing recovery time. This type of injury does very well with physical therapy and shockwave therapy, so our team will have you up and moving in no time.

Types of Injuries to Hip Flexors

Hip flexor muscles are stressed from contracting and stretching during hip movement. Too much stress can lead to a muscle tear. These flexor tears present with pain and loss of function depending on the severity of the hip flexor injury. A complete rupture of your hip flexors can be disabling.

A flexor tear is graded on a scale of one to three.

  • Grade 1: a mild or small tear accompanied by mild pain and minimal loss of function
  • Grade 2: a moderate tear affecting a large number of muscle fibers and accompanied by moderate pain and loss of function
  • Grade 3: a total rupture (completely torn) of all muscle fibers and accompanied by intense pain and severe loss of function

Most hip flexor injuries fall under the grade 2 category.

The strain that leads to tears is most often caused by a sudden contraction in your hip flexors. This type of movement is typical when kicking or sprinting. The injury occurs most commonly when you didn’t warm-up properly before exerting yourself. The tears can also be a result of overuse as seen in sports that rely on this muscle group frequently, such as soccer.

You can also be a victim of hip flexor strain due to muscle weakness or tightness, inadequate or inappropriate training, insufficient warm up prior to exertion, stiffness, bad posture, inadequate core stability, and fatigue.

Hip flexor strains and injuries are accompanied by sudden pain in the front of the hip that worsens when the thigh is raised. Some people also experience significant bruising, swelling, or tenderness.

Diagnosis and Treatment of Hip Flexor Injuries

Flexor injuries are diagnosed with a basic exam. However, your physician may request additional diagnostic tests to rule out other conditions. These tests may include:

  • X-ray
  • MRI Scan – Magnetic Resonance Imaging
  • Ultrasound
  • CT Scan

Once diagnosed with a hip flexor injury, it’s important that you let the muscle group rest. Avoid any sports and activities that aggravate the condition or worsen your symptoms. If you don’t rest the muscles and allow them to heal, then you risk extending your recovery time. To help with pain and swelling your health care provider may recommend applying an ice pack to your hip flexor area for 30 minutes approximately every 4 hours. Depending on the severity of the injury, your doctor may prescribe the use of crutches during the initial recovery stages.

Once the muscle has had time to rest and begin repairing itself, your doctor may refer you to a physical therapist. Physical therapy is an excellent way to treat hip flexor injuries and reduce recovery time. Your physical therapist will use a variety of techniques to help the area heal and strengthen the muscles such as:

  • Soft tissue massage
  • Ice and heat treatments
  • Trigger point therapy
  • Shockwave therapy

Ongoing Treatment for Hip Flexors

As your flexor injury continues to heal, then your physical rehabilitation plan may expand to include hip joint mobilization therapy focusing on the hip and lower back. Hip flexor stretches and progressive exercises are also very useful for strengthening the hip flexor and surrounding muscles and tendons and increasing flexibility.

If you injured yourself through your normal, everyday activity, then your physical therapist can also give you advice on how to prevent future injury. Athletes are typically provided with a special sports medicine plan that safely expedites their return to the sport that caused the injury.

Recovery time for minor tears to hip flexors takes around two or three weeks. More significant tears can take up to six weeks. Severe hip injuries and tears can take closer to eight weeks to heal. These times are based on working closely with your physical therapist and following their instructions. It’s very important that you don’t overexert yourself during the recovery period. Doing so may add a few weeks to your healing time.

Working with a trained physical therapist can quickly get you back to doing what you love, but only if you follow the hip flexor treatment plan.

Call Epic Healthcare & Physical Medicine at (972) 355-0083 for more information on using physical therapy and shockwave therapy to treat injuries to hip flexors.

Frequently Asked Questions

Can I still run with a tightened or pulled hip flexor?

Rest is the first step in treating hip flexor pain. If you’ve injured your hip flexor or have hip pain, then it’s a good idea to rest until you’re able to go throughout the day with no hip pain. Then you can begin running again. If you don’t rest the area, then there’s a chance you may injure it worse than it already is. Not to mention, tight hip flexors can result in poor running form which may lead to other injuries in the feet, ankle, knee, leg, or back.

Could there be any long-term effects from a hip flexor strain?

If left untreated, flexor strains may trigger the onset or the progression of hip osteoarthritis which leads to reduced mobility. After the initial rest period, it’s a good idea for patients to work with a physical therapist to treat the flexor injury and reduce the risk of problems with the flexor muscles in the future.

How can I tell if I have a hip flexor strain?

The most common symptom indicating you have suffered hip flexor tears or strains is a noticeable pain in the front of your hip. For some, the pain is persistent, but others may only notice the hip flexor pain when they walk or run. If the injury was a result of trauma, then you may experience a sharp pain in the hip or pelvic area.

Is it bursitis or tendonitis?

Bursitis and tendonitis are two other conditions that can also cause hip pain.

Bursitis occurs when the bursa is irritated and inflamed. Bursa are the small fluid-filled sacs around a joint. Hip pain caused by bursitis is typically intense to start then it ebbs to a widespread ache. Trochanteric bursitis is the inflammation of the bursa located on the outer part of the hip joint. This area is known as the greater trochanter. Symptoms associated with bursitis include pain on the outside of the hip, thigh, or buttock that worsens with activities such as walking up stairs or getting out of a car.

Tendonitis occurs when the tendons in the hip become inflamed or irritated. This may also commonly be called hip flexor tendonitis or iliopsoas tendonitis.

What can be done to reduce the chances of developing trochanteric bursitis?

There are a few things you can do to reduce the chances of developing trochanteric bursitis. These include:

  • Losing weight if needed
  • Avoid repetitive activities that stress the hips
  • Properly fitted shoe inserts
  • Improve strength and flexibility in hip muscles
  • Use a walking cane when needed
What is greater trochanteric pain syndrome?

Greater trochanteric pain syndrome is a type of pain on the outer hip related to the greater trochanter area. It occurs at the top of the femur or thigh bone at the widest part of the hip. It’s often caused by overuse or stress on the hip joint from exercise or standing for long periods. Pain can persist for anywhere from several weeks to a few years if untreated. However, shockwave therapy for greater trochanteric pain syndrome has shown promising results as an effective treatment when it comes to remodeling and regeneration the tissues in the hip. This is because shockwave therapy shows regeneration benefits in damaged soft tissues.

What is shockwave therapy?

Shockwave therapy is used in orthopedics, sports medicine, physiotherapy, and more to accelerate the body’s healing process. It uses shock waves to stimulate metabolism as well as blood flow and blood circulation which in turn provides significant improvement for regeneration and pain relief.

How does extracorporeal shockwave therapy work?

Extracorporeal shock wave therapy or ESWT works by emitting high-energy pulses to the injured area using an applicator that is attached to the shockwave therapy machine. The shockwaves improve circulation while stimulating new blood and nerve cells. Extracorporeal shock wave therapy is a noninvasive treatment for soft tissue injuries and musculoskeletal conditions.

Is shockwave therapy an effective treatment for hip flexor injuries?

Yes. Shockwave therapy can effectively treat hip flexor injuries and lateral hip pain. Shockwave therapy shows regeneration benefits in soft tissues. Therefore, it helps improve regeneration in hip tissues. Clinical studies analyzing the comparison of extracorporeal shockwave treatment versus natural healing provide evidence that the clinical outcomes show improved bone remodeling and regeneration of soft tissue than they did without the shockwave treatment.

How long does shock wave treatment take?

Each shockwave treatment takes approximately 5 to 10 minutes. Treatments take place over several weeks depending on the condition or injury being treated and how well your body responds to shock wave therapy.

What types of pain can be treated with shockwave therapy?

Shockwave treatment has been shown to help with pain and healing in a variety of conditions and areas including:

  • Knee pain
  • Plantar fasciitis
  • Heel pain
  • Shoulder pain
  • Lateral hip pain

And so much more. This useful tool is helping people work through the recovery process faster for lasting results.