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Hip Flexor Strain: A Guide to Understanding and Healing

a/professor andrew dutton hip flexor strain
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Injuries are inevitable in sports and in any active lifestyle, and a hip flexor strain is among the common ones around. Depending on the activity you like to engage in, some of these injuries can cause significant damage, while the others just seem like negligible pain.

But what sets apart a full recovery and the worsening of symptoms is how soon you can get help for it. Make yourself familiar with what to expect about this hip problem in this blog.

Your hip flexors

a/professor andrew dutton hip flexor illustration

Walking, bending, kicking, or shaking your hips would not be possible if not for your flexor muscles doing the job. Hip flexors are actually a group of muscles near the top of your thighs. It is composed of the iliacus, psoas major muscles (iliopsoas) and rectus femoris and they are key players in lower body movement.

Your rectus femoris is a big and powerful muscle that runs diagonal to your thigh and is responsible for controlling the hip and knee joints. It is also the most frequently injured muscle among this group accounting for almost half of hip flexor injuries.

The iliacus muscle is one of the key muscles that help to maintain proper body posture. This muscle can shorten with overuse, and it’s common in individuals who handle a desk job each day and in those who engage in lots of exercises without stretching. As the iliacus shortens, it can start to cause dysfunction and injuries in the hip and pelvic regions of the body.

The psoas muscle is responsible for flexing the hip joint and lifting the upper leg towards the body. A common example of the movement that this muscle creates is walking.

What is a hip flexor strain?

a/professor andrew quoc dutton hip flexor illustration

How you injure yourself is an indicator of which structure you have strained. An acute Rectus Femoris strain is commonly associated with sprinting and kicking, while iliacus and psoas injuries are more likely to occur with a change of direction movements.

A hip flexor strain can be mildly uncomfortable or serious that it will be hard for you to walk accompanied by muscle spasms and a lot of pain.

What are the causes of a hip flexor strain?

A hip flexor strain is a common injury among athletes because it can be sustained with sudden movements such as kicking, sprinting, and sudden change in direction while in motion. Football, hockey, running, and martial arts are more likely to create this type of injury. However, there are also aggravating factors that can lead to hip flexor strain include, such as:
  • Weak muscles surrounding the hip flexors
  • Not warming up/ poorly conditioned muscles
  • Stiff muscles
  • Trauma or falls
  • Overuse
  • Extended periods of sitting
  • Acute contraction of the muscles
a/professor andrew dutton list of common sports

What are the symptoms?

A hip flexor strain can be felt in the front area where your thigh meets the hip. Depending on the extent of damage sustained, a hip flexor strain may be felt either as mild pain or a sharp and cramping one that can make it hard for you to walk without limping. The reason behind it is that the top of the thigh muscle may budge, making it hard for you to walk, indicating a tear which is less common.

You may also experience a pulling sensation in the front of the hip. It may even get difficult getting out of a chair or coming up from a squat. This is often accompanied by spasms, swelling, and bruising down the front of your thigh a few days after injury. An examination of the hip and pelvis typically reveals tenderness over the groin area. There may also be tightness of the hip flexors and weakness of your buttocks and hamstring muscles.

a/professor andrew quoc dutton hip flexor strain symptom checklist

How is a hip flexor strain diagnosed?

A full medical examination can be done to diagnose a hip flexor strain. Your physician will take your medical history and perform a variety of range-of-motion tests to determine where the pain is heavily concentrated. An x-ray may also be done to rule out a fractured hip

What are the different ways to provide relief from a hip flexor strain?

To relieve any symptom for the days or weeks after an injury, you can do the following:
(1) Rest your hips and stop any activity that causes pain.
(2) Apply cold compress on the area for 20 minutes every 3 to 4 hours for 2 to 3 days. Make sure to wrap the ice in a clean cloth first before applying it directly to your skin. It’s important to rest your hips and stop any activity that causes pain.
(3) Analgesics and anti-inflammatory medications may be prescribed to reduce the pain and swelling
(4) Seek treatment right away. If a hip flexor is left untreated, the condition could worsen, and recovery time may take longer.
(5) Your doctor will prescribe medications to address the pain and swelling. It’s important that you follow your doctor’s instructions in taking medications and NEVER take more than the recommended amount.

Besides home remedies, the doctor may also recommend that you use crutches to keep the weight off the affected hip. Specialised hip braces also provide therapeutic compression and help stabilise the hip flexor to speed up healing.

Physical therapy and rehabilitation can also help if the pain persists longer than a couple of weeks. This will help increase your flexibility and strength. To augment the healing process and provide symptom relief, Platelet Rich Plasma (PRP) injections can also be administered. It is a concentrated portion of the patient’s own blood containing growth factors that has regenerative properties.

Hip flexor strains or tears can be treated without surgery. But if a hip muscle has been torn completely, a patient may require surgery to repair the hip flexor and restore function.

What are the activity restrictions once you get a hip flexor strain?

As one of the consequences of overuse, you can improve a hip flexor strain by avoiding strenuous activity for at least 10-14 days after injury. If the pain still persists once you’ve resumed activities, it is better that you focus on just resting your hip muscles first.

While you rest the area, some doctors may recommend that you gradually introduce light exercises, like swimming, to avoid straining the hip flexors.

For severe strain, regular sessions with a physical therapist (PT) can help to stretch and strengthen the hip flexor muscles, and others that surround and support the area. A therapist can also properly guide you on how to increase your activity level so you can return to your usual activities.

Proper warming-up and cooling down before and after exercise is important to avoid future hip flexor strains. Wearing the appropriate protective gear for the sport you engage in prevents this type of injury and other serious damage. Should you ever experience a hip flexor strain, you have to let your body recover first before returning to your normal activity levels. Failure to modify your activities may lead to further injury.

What happens if hip flexor pain is left untreated?

If left untreated, a hip flexor strain can trigger the onset or progression of hip osteoarthritis leading to reduced or loss of mobility.

In a hip flexor strain, delayed treatment can lengthen recovery time. Hip flexor tears or strains can generally be treated with conservative therapy or physical therapy. In rare cases, surgery may be necessary to repair any ruptured tissue. Therefore, act on the symptoms and get help as soon as possible.

Get into a no-obligation consultation with A/Professor Andrew Dutton today. You can book an appointment here, or call (+65) 6836 8000.

Read: Patient’s Guide When Seeking Orthopaedic Care in Singapore

A/Professor Andrew Quoc Dutton Orthopaedic & Sports Clinic Insurance

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About A/Professor Andrew Quoc Dutton

A/Professor Dutton, also known as, has been in clinical practice since 1996 after graduating from Marist College, Canberra and the University of New South Wales, Sydney, Australia. A/Professor Dutton has worked at the Prince of Wales Hospital, Sydney, and the St. George Hospital, Sydney, before completing his orthopaedic surgery training in Singapore. He is currently an associate professor of orthopaedic surgery at the National University of Singapore (NUS).

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