Hip Flexor Pain Diagnosis and Treatment

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If you are experiencing Hip Flexor pain, this article should help you figure out what type of injury you have and what your next steps should be.  If this is your first time dealing with pain in this region, I encourage you to take a few minutes to first learn about Hip Flexor anatomy, as it’s more complicated than you might think.

As discussed before, in a previous article, if you have a Hip Flexor injury, there are three causes of Hip Flexor pain, all of them as a result of different kinds of injuries.  The specific type of pain that you feel will be indicative of the cause of the pain.

Pulled Hip Flexor (Muscle Strain)

A muscle strain is often indicated by pain that occurs while lifting the leg. If you have a pulled muscle you may know it already based on the activity you were doing when it first started hurting; usually it will be hurt during some sort of explosive movement or when you move your muscles to the limit of their comfortable range of motion.  If you distinctly remember an over-stretching sensation like this, you probably have a Hip Flexor strain.

Hip Flexor Pain Diagnosis knee to chest test

In order to test if you have pulled your Hip Flexor, try standing on the opposite foot, then lifting your leg as high as possible(knee to chest), if you feel any pain at any stage stop immediately.

Once you have established that there is pain in the Hip Flexors while performing the knee to chest movement, it is almost certain that you have a pulled Hip Flexor. Please scroll down to the severity section to learn what this means.

Severity of Injury

If you have a pull the first thing you need to do is determine the severity of the injury.  There are three degrees of strains, refer to the below sections to learn what each means.  Afterwards, if you feel confident of this diagnosis for your pain scroll down to the treatment section to find out where you should go from here.

First Degree

If you can move your leg to your chest without much discomfort, you most likely have a first degree strain; this is the best kind you could have. A first degree strain means you have a minor or partial tear to one or more of the muscles in the area and probably don’t have a lot of pain.

Second Degree

If you had a lot of trouble moving your leg to your chest and had to stop part way through, you probably have a second degree pull. A second degree pull is a much more severe partial tear to one of the muscles, it can cause significant amount of pain and needs to be taken care of extremely cautiously in order not to fully tear the injured area.

Third Degree

If you can barely move your leg at all why are you reading this article!!! Go see your doctor right away and try not to move your leg if you can avoid it. A Third degree strain is a full tear of your muscle causing severe pain and requires a much longer time to heal, please get your doctor’s opinion on this before you do anything else.


If you have a nagging ache throughout the day, and it hurts when you move your leg or stretch your Hip Flexors, you may have Hip Flexor Tendonitis.

Hip Flexor tendonitis occurs usually with athletes as an overuse injury. Whenever a repetitive movement is performed, such as running or cycling, there is a lot of force being placed on the Hip Flexors. Often this will lead to inflammation of the tendon attaching the muscles to the bone and will cause pain every time it touches other internal structures.

Contusions (Bruises)

A bruised Hip Flexor is an umbrella term describing an injury to one or more of the several muscles that the Hip Flexors contain. If your pain started after a blunt trauma to this area, it is most likely the result of bruising.

It can be hard to tell the difference between a bruised and pulled Hip Flexor, because you will often experience pain when lifting the leg either way. The difference is that in a stationary position, a bruised muscle will be very sensitive if you touch it and typically only hurts one specific area.

To diagnose this, stand up and slowly apply pressure to the different parts of the Hip Flexor discussed earlier; if the pain felt while applying pressure is similar in intensity to the pain felt while lifting your leg, you probably only have a contusion, which might sound bad but in most cases is great news!  Bruised Hip Flexors only require a few days of rest and you’ll be ready to go, although maybe a bit sore.

Treatment & Next Steps

So far we have identified three different types of injuries that could be causing your discomfort.  Hopefully you have an idea of what specifically is the problem for you.  The next step is to determine a treatment plan in order to relieve and heal any trauma.

The treatment suggested are best practices for minor injuries.  If you have a significant amount of pain you should always go see a healthcare professional in person to be examined.

Strain Treatment: I have written a full series on hip flexor strain treatment that I suggest you read.  There are multiple stages to the healing process, starting with the RICE procedure, followed by rest, rehab, and then strengthening to prevent future recurrences.

Treating Tendonitis: Refer to the treatment section of the article on tendonitis that I wrote for detailed plans.  Essentially what you need to do is rest and ice the inflamed tendon until the inflammation disappears and then build up your strength and slowly re-integrate whatever activity caused the injury in the first place.

Treating Contusions: For the most part, minor bruising will heal by itself within a week.  However, to speed up healing, apply a moderate amount of heat to the area 2-3 times a day with a heat pack or warm towel, this will stimulate blood flow and kick start your healing system.

Hip Flexor Pain Summary

Hopefully you have identified the cause of your Hip Flexor pain you are experiencing, if you are not confident in your ability to assess the degree of injury following the above instruction, please see a qualified doctor who can give you a professional opinion, it can never hurt, but may help a lot.

Ready to Get Rid of Your Pain?

The only way to speed up your recovery is by using heating and cooling technology.

Low temperatures quicken the inflammation process, while heat will improve bloodflow to your hip flexor.

By stimulating blood flow in the injured area, you speed up:

  • how fast damaged tissue and waste are removed
  • the rate that nutrients are delivered to build healthy tissue
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