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Best Exercises for Hip Flexor Pain: Should You Stretch or Strengthen?

What Are The Best Exercises for Hip Flexor Pain?

If you have hip flexor pain, you may wonder what exercises are best to relieve it.

Should you stretch or should you strengthen your hip flexors?

The answer is that it depends on the type of hip flexor pain that you have. 

Watch the video below to learn which exercises are best for your type of hip flexor pain.

7 Simple Tips To Get Rid Of Hip Pain by Dr. Dave Candy, More 4 Life Physical Therapy, St. Louis, MO

Understanding Hip Flexor Pain

Hip flexor pain can be caused by either stiff (shortened) hip flexors or strained (lengthened) hip flexors, most commonly the iliopsoas muscle.

iliopsoas hip flexors

Figuring out which problem is causing your hip flexor pain is important because the treatments for each cause is different.

Stiff, short hip flexors are more common and are often due to prolonged sitting.

True hip flexor strains are less common.  These often occur due to sudden forceful exertions during sporting activities such as kicking a soccer ball.

However, lengthened hip flexors can be due to other problems such as overusing your hamstrings and under using your glutes.

When to Stretch Your Hip Flexors

If your hip flexors are short or stiff, stretching exercises are the proper treatment.  However, having "short" hip flexors is different than your muscles just subjectively feeling "tight".

To test you hip flexor length, you can do a test called the Thomas test.

How to do the hip flexor length test (Thomas test)

To do the test, lie at the edge of a bed with one knee pulled up to your chest and the other leg hanging off the edge of the bed.

Thomas test

Make sure to keep your knee pulled all the way up to your chest to keep your lower back flat on the bed. 

Interpreting the test:

  • If the back of your thigh falls all the way down to the bed, this would be considered a normal test.
  • If you thigh does not touch the table (as shown in the picture above), this would be considered a positive test for short hip flexors.

If the test is positive, stretching your hip flexors is a good idea.  See the exercise section below to learn different ways to stretch your hip flexors.

When to Strengthen Your Hip Flexors

If your hip flexor pain is due to lengthened hip flexors, you'll want to strengthen your hip flexors.  If you've had an acute hip flexor strain, you may need to wait until the pain subsides a bit before starting to strengthen your hip flexors.

In addition, whether you have short or lengthened hip flexors, strengthening your glutes is often indicated for either problem.

See the strengthening exercise section below to learn hip flexor and glute strengthening exercises.

Best Exercises for Hip Flexor Pain

Here are some targeted exercises for addressing hip flexor pain. We'll start with stretching exercises and then move to strengthening exercises.

Stretching Exercises for Hip Flexor Pain

Thomas test hip flexor stretch

You can stretch your hip flexors in the same position you used to text their length.  Hold one knee toward your chest and allow the other leg to fall of the side of the bed.

Thomas test hip flexor stretch

You should feel a stretch in the hip and thigh of the leg that is hanging down.  Hold the stretch for 1 minute.

Kneeling hip flexor stretch

This is one of my favorite ways to stretch the hip flexors.  To do this, you'll kneel on the knee of the leg you're stretching with the other leg out in front as if doing a lunge.

Do a pelvic tilt to flatten your back. Squeeze your glutes and push your pelvis forward slightly until you feel a stretch in the front of your hip and thigh.

stretching exercise for hip flexor pain (kneeling)

Make sure not to allow your lower back to arch.

kneeling hip flexor stretch (incorrect)

Hold this stretch for 1 minute.

Modified kneeling hip flexor stretch

If you can't kneel on your knee due to knee pain, you can do a modified version of the kneeling hip flexor stretch sitting on the side of a chair as shown below.

modified stretching exercise for hip flexor pain

Hang one leg off the side of the chair with the knee bent as if kneeling on the knee, but your knee won't touch the ground.

Hold the stretch for 1 minute.

Strengthening Exercises for Hip Flexor Pain

Seated hip flexor isometric strengthening exercise

Sit in a chair and lift your leg using your hands as high as you can comfortably.

Next try to let go with your hands an hold your leg in that position using your hip flexor muscles.

seated hip flexor exercise

If your hip flexors aren't strong enough to keep your leg from dropping, you can use your hands to assist as needed.

Hold for 10 seconds, then slowly lower your leg.  Repeat for 10 repetitions.

Glute bridge exercise

If you recall from above, it's a good idea to strengthen your glutes regardless of if you have stiff or lengthened hip flexors.

Bridges both help strengthen your glutes as well as to stretch your hip flexors without overstretching them.

To do a bridge, lie on your back with your knees bent.

Do a slight pelvic tilt and then slightly lift your bottom up off the bed or floor.  Don't allow your lower back to arch.

bridge exercise

Hold this position for 10 seconds and repeat 10 times.

Prone bent leg lift exercise

The last exercise is also to strengthen your glutes.  For this one, you'll lie on your belly with one knee bent.

Prone leg lift exercise

Lift your knee up from the bed or floor thinking about using your glute muscles to lift.

Hold for 10 seconds and repeat 10 times.

When to See a Professional For Hip Flexor Pain

If your hip flexor pain doesn’t improve with exercises or worsens over time, consult a physical therapist or other healthcare provider.

If you live in the St. Louis area and need 1-on-1 help to get rid of hip hip flexor pain, we'd be happy to help you here at More 4 Life. Just tap the button below to request an appointment.

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