Hip Flexor Tendonitis

Hip Flexor Tendonitis Symptoms And Treatment


How do you know if you have a case of hip flexor tendonitis? It you’re sitting down right now, bend and lift your knee. That’s your hip flexor at work. As it contracts, it lifts the upper leg towards the abdomen. If you’re standing up and raise your knee, it’s again the hip flexor at work. If you have a case of hip flexor tendonitis, that very basic movement could be painful, as would running, or climbing up and down a ladder.

Functions Of The Hip Flexor


What we call the hip flexor isn’t a single muscle, but rather a muscle group, with the muscles in the group being attached to the lower or lumber spine, the thighbone, and the pelvis. Flexing or moving your hips and your lower back, as well as lifting your upper leg, brings this muscle group into play. This muscle group also helps you maintain good posture and proper alignment of the spine. Consequently, any problem you might have with these muscles, with the problem under discussion here being tendonitis, can make even the very basic movements involving your hip joints irritating or painful.


Tendonitis And Strain Are Not The Same


Hip flexor tendonitis is not the same as hip flexor strain, although the symptoms can often be quite similar, and at times making it difficult to make a correct diagnosis. Hip flexor strain is caused when the muscles are either not warmed up sufficiently or stretched to abruptly so that one of the hip flexor muscles is torn. Tendonitis is most often due to overuse, and overuse is in turn often due to repetitive use of muscles, such as when running or cycling. The muscles, and especially the tendons, are simply falling victim to wear and tear.

The major players in the hip flexor muscle group are the inner hip muscles, the psoas major muscle, which is attached to the lumbar spine and the pelvis, the smaller psoas minor muscle (not everyone has this muscle, and it doesn’t play a major role), and the iliacus muscle. It is the large psoas muscle that is most susceptible to a hip flexor injury, and it is also the tendons associated with this muscle where tendonitis affecting the hip flexor is most likely to be centered.


The Symptoms


Getting back to the original question as to when you may suspect you have hip flexor tendonitis, the first sign is often pain or tenderness felt in either the front of the upper thigh, in the groin, or sometimes both. As opposed to some muscle injuries, tendonitis tends to become worse with exercise. In other words, once tendonitis has set in, warming up the muscle won’t necessarily help to relieve any pain or discomfort. While the pain may become progressively worse with activity, it tends to subside when resting. Tendonitis occurring in any of the tendons surrounding the hip joint can make life miserable for an athlete, particularly a runner, as it’s usually not possible, nor is it advisable, to try to  “run through” the pain. The pain will only intensify, and mostly it’s the tendons associated with the hip flexor where the problem lies.


While any pain experienced will in most cases initially be confined to the front of the upper thigh or the groin, it may spread down the leg, to the lower back, or be felt in the buttocks. The hip and thigh may begin to feel very stiff. Eventually, the pain may become such that trying to stand upright from a seated position can present a challenge.


The Treatment


As far as treatment is concerned, the best approach involves a combination of rest and gentle exercise. If the hip flexor tendons are inflamed or aggravated, there’s a good chance that the underlying muscle is inflamed or suffering from overuse as well. The muscles have simply been pushed too hard, too quickly, or for too long a time, but may not necessarily have been strained. It’s important to keep the hip flexors active, but not too active, and some rest is needed to get the healing process in gear. You may be told that it is primarily rest that is needed for the tendons to heal, and this is very true, but that should not imply that there should be a total lack of activity. You don’t need to stay in bed to treat a case of hip flexor tendonitis. The key thing is to avoid activity that overtaxes the muscles and tendons. If what you’re doing hurts, either back off, or stop the activity altogether. Doing a set of gentle exercises periodically is a particularly good idea, because it will help determine how well the healing process is progressing, and it’s always a good idea to keep muscles working as long as they aren’t being overtaxed and are being allowed to heal. If the tendonitis is particularly severe, it would be best to start the recovery process with a period of total rest, followed by two or three daily sessions of gentle hip stretching, while slowing working into a daily exercise routine.