What is a hip flexor tear or strain?

A hip flexor tear or strain is an injury to the muscles in the hip. The hip flexors are the group of muscles, including the iliacus and psoas major muscles (iliopsoas) as well as the rectus femoris (part of quadriceps).

The hip flexors help you lift your knee to your body. If these muscles become overused, they can stain or tear.

Types of hip flexor tears

Hip flexor tears are categorized from grade one to grade three, with the majority classified as grade two.

  • Grade 1 tears — minor tears where only a few muscle fibers are damaged.
  • Grade 2 tears — a moderate amount of muscle fiber is damaged, and there is a potential for loss of function in the hip flexor.
  • Grade 3 tears — the muscle fibers are completely torn. If you have suffered a grade 3 tear, you probably can’t walk without a limp.

Causes of a hip flexor tear or strain

A hip flexor strain is typically caused by overuse.

Other causes of hip flexor tears or strains:

  • Extended periods sitting (muscles in the hip stay contracted for a long period of time)
  • Weaknesses in muscles surrounding the hip flexors
  • Acute contraction of the muscles

Risk factors for a hip flexor tear or strain

Certain groups of people are more likely to experience a hip flexor tear or strain including people who have muscle imbalances, people who have weak muscles or are not properly conditioned, and athletes who run, jump and perform high knee kicks.

Sports where this is common include:

  • Soccer
  • Football (kickers)
  • Dancers
  • Cyclists

Symptoms of a hip flexor tear or strain

Sudden hip pain is the most common symptom associated with a hip flexor tear or strain. The pain and other symptoms can range from mild to so intense that it impacts your mobility.

Other symptoms of a hip flexor tear or strain include:

  • Pain when lifting the leg to the chest or stretching the hip muscles.
  • Swelling, bruising or tenderness in the hip or thigh area.
  • Muscles spasms in the thigh or hip that occur when walking or running.

Diagnosis of a hip flexor tear or strain

A hip flexor strain or tear is diagnosed in a full medical exam with your Mercy Health primary care or sports medicine doctor.

Your physician will take your medical history and perform a variety of range of motion tests to determine where the pain is the greatest.

An x-ray may also be ordered to rule out a fractured hip.

Treatment for a hip flexor tear or strain

It is important to rest and seek treatment right away for a suspected hip flexor strain or tear. If left untreated, the condition could worsen and recovery time is extended.

Home remedies including rest, ice, compression, elevation combined with anti-inflammatory medication can alleviate some of the symptoms of a hip flexor tear or strain. Your physician may also recommend using crutches to keep the weight off the hip.

  • Brace — a brace can help compress and stabilize the hip flexor to speed healing.
  • Physical therapy and rehabilitation — if pain persists longer than a couple weeks, your physician may prescribe a physical therapy program to help you increase your flexibility and strength.
  • Platelet rich plasma (PRP) injection — a PRP injection can be used to expedite healing by injecting concentrated growth factor platelets from the patient’s own blood into the hip.

Although most hip flexor strains or tears are treated without surgery, if the muscle has been completely torn, you may require surgery to repair the hip flexor and restore function.

Recovery from a hip flexor or tear

Your physician will recommend avoiding strenuous activity for 10-14 days after the injury. If pain returns after resuming activities, discontinue what you are doing and rest.

To avoid future hip flexor strains or tears, warm up and cool down before and after exercise, wear appropriate protective gear for your sport and make sure you let your body heal before returning to your normal activity levels.

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