Hip Flexor Strain
A hip flexor strain is a tear in one of the muscles that lift the thigh — most commonly the iliopsoas (iliacus and psoas major) or the rectus femoris (the long head of the quadriceps that crosses the hip). It’s a frequent injury in sports involving explosive sprinting, kicking and rapid changes of direction — AFL, soccer, basketball and athletics.
What’s Actually Strained?
- Iliopsoas: The primary hip flexor. Strains cause deep groin/front of hip pain, worsened by bringing the knee toward the chest against resistance
- Rectus femoris: Part of the quadriceps that also flexes the hip. Commonly strained just below the hip (proximal musculotendinous junction) — causes pain at the front of the hip and thigh
How It Happens
- A sudden explosive sprint start or acceleration
- A powerful kicking action (especially soccer and AFL)
- Overstretching the hip in a lunge or tackle position
- Overuse from repeated sprinting without adequate recovery
Symptoms
- Sharp pain at the front of the hip or groin at the time of injury
- Weakness and pain lifting the leg (e.g., walking up stairs, sprinting)
- Tenderness on palpation of the hip flexors
- Pain with passive stretching of the hip into extension
- Bruising and swelling in more severe cases
Treatment
Acute Phase
- Relative rest and offloading — avoid provocative sprint and kick activities
- Ice for comfort
- Gentle walking to maintain movement
Rehabilitation
- Progressive isometric to eccentric hip flexor loading
- Hip and core strengthening to reduce compensatory loading
- Gradual return to jogging, sprinting and sport-specific movement
Return to Sport
We use pain-free sprinting and kicking as objective markers, alongside strength testing, before clearing return to full training. Most athletes rush this phase — recurrence is common without proper sign-off.
