Hip Strain: Symptoms & Treatment
What is a hip strain?
A hip strain (or hip flexor strain) is when you overstretch or tear one of the muscles that allow you to lift your leg up at the hip joint. This group of muscles is called the “hip flexors.” A strain can happen when you tighten (flex) the thigh quickly and with a lot of force, like when you sprint or kick a ball really hard.
Most people feel pain in the front part of their hip and sometimes in their thighs.
Hip strains usually heal with rest, ice, and pain relievers. Rarely, you’ll need surgery to repair the muscle.
What does a hip strain feel like?
There are several muscles around the hip area that can potentially be strained, including the hip flexor tendons in the front, the abductor tendons on the side of the hip, and the hamstring tendons that attach at the back of the hip in the crease where the thigh meets the buttocks. The location of the pain—groin for hip flexors, side of the hip for the abductors, and buttock area for the hamstrings—determines which hip muscles/tendons have been strained. —Dr. Benjamin Schwartz
Usually, the front of the hip is painful, tender to the touch, and swollen on one side. It may be hard to lift that thigh up, like toward the ceiling or when you get in and out of a car. Your hip flexor muscles in the front of your hip may also feel weak.
Pain and any other symptoms usually start right after the injury happens. It usually worsens over the next 1 to 3 days, and then begins to improve. But they can linger for weeks.
- Pain at the front of hip or thigh.
- Pain is worse when lifting the thigh.
- Leg feels weak when you try to lift or do squats.
Other symptoms you may have
- Swelling or tenderness at the front of your hip.
- Muscle spasms in the thigh or groin area—the muscle suddenly tightens.
What makes you more likely to have it?
- Playing sports that involve kicking or high contact. Especially cycling, dancing, fighting (boxing, taekwondo), soccer, and football.
- Previous hip strain.
- Not warming up before and stretching after playing sports and exercising.
- Using too much weight during lower body weight-lifting exercises.
Hip strain causes
Hip strains are caused by the hip flexor being engaged too forcefully or if the leg is forced into an extreme position. Then the muscles and tendons stretch and may even tear from too much weight being put on the small muscles. It is most likely to happen when playing sports—kicking a soccer ball or football too fast or hard—or exercising.
Some patients develop hip strain even though they don’t remember doing anything that might have specifically hurt the hip. In fact, it is possible to simply wake up one morning with pain in the hip that wasn’t there when you went to bed the night before! —Dr. Schwartz
How do you treat a strained hip?
If you have pain in the hip and thigh area after a fall, or think you may have broken a bone or have experienced other trauma like a really bad sprain, go to the doctor. If you cannot put weight on the leg or are in severe pain, go to urgent care or the emergency room.
If it's less severe, you can first try to treat it yourself. But if you still have pain after a week, see a primary care doctor, orthopedist, or sports medicine doctor.
Muscles and tendons heal on their own. It just takes time. You may need to rest it for 3 to 6 weeks. Even if the pain goes away after a few days or a week, you need to let the torn muscle heal.
- Rest the muscle. Do not do anything that lifts your hip like squatting, sprinting, kicking, lunging or bending down low to lift heavy objects repeatedly for 2 to 3 weeks. If you still have pain, you haven’t rested enough. When pain goes away, gradually return to the activity.
- Walking and very gentle stretching are ok.
- Ice the painful areas for 15 to 30 minutes, four times a day. Do for the first 3 days.
- Taking nonsteroidal anti-inflammatory drugs (NSAIDS)—like Ibuprofen, Naproxen—or acetaminophen (Tylenol) can help with pain. Do not take for more than 10 days. If you have other health issues—like kidney or stomach problems—discuss with your doctor which one is best and for how long.
- Ask your doctor if you need to have physical therapy. Or you can do your own strengthening exercises at home.
- In rare cases, if you have severe pain and weakness, a hip flexor muscle may need surgery to repair it.
If the pain and swelling get better on their own, no follow up is needed. If you have persistent pain for 6 to 12 weeks, see your doctor. This can be your primary care doctor, an orthopedic surgeon, or a sports medicine doctor. You may need physical therapy. Or the pain could possibly be from another issue, like a fracture or mass in the area.
While many patients expect to be pain-free within a few weeks, it can take 4 to 6 months (or beyond) for all of the pain to resolve. Stay patient and realize the recovery may be slow—there is no way to rush it. You want to avoid re-aggravating it as this can reset the clock on the healing process. And even reverse any gains that have been made. —Dr. Schwartz
- When strength-training, don’t lift weights that are too heavy or cause you to use bad form.
- Do not kick objects too forcefully.
- Whenever you feel pain, rest until the pain goes away. If you keep using the muscle, the strain could get worse.
- Always warm up before exercise and stretch after.
Elliot Stein is a second-year internal medicine resident at Vanderbilt University Medical Center, and he intends to sub-specialize in cardiovascular disease. He graduated magna cum laude with an undergraduate degree in molecular and cellular biology from Harvard College in 2013. He obtained his MD and Master of Science in Translational Research (MSTR) from the University of Pennsylvania Perelman School of Medicine in 2019. He stayed at the University of Pennsylvania to complete his internship year 2019-2020 at Pennsylvania Hospital. Elliot also served as an emergency medical technician (EMT) in two countries and three US states before beginning his medical career. He joined Buoy Health in 2018 because of its promise to use new technology to deliver higher quality medical information to anyone regardless of ability to access medical care.