About hip flexor strain and iliopsoas tendinopathy
The hip flexors are the muscles that lift your knee toward your chest. The largest is the iliopsoas, which runs from the lower spine and pelvis across the front of the hip to attach on the inner thigh bone. Its tendon crosses right over the front of the hip joint.
Hip flexor problems range from an acute muscle strain during a sprint or kick to longer-standing tendinopathy from repetitive use. Some people also notice a snapping or clunking at the front of the hip as the tendon slides over the bone, a pattern often called snapping hip.
These injuries are common in runners, soccer players, dancers, hockey players, and martial artists. Pain at the front of the hip can also come from the hip joint itself, so sorting out the source is an important first step.
Common symptoms
- Pain in the front of the hip or groin when lifting the knee
- Pain with running, kicking, climbing stairs, or getting out of a car
- A snapping or clunking at the front of the hip with leg movement
- Tightness in the front of the hip after sitting
- Tenderness deep in the crease of the hip
Common causes and risk factors
- Sudden sprinting, kicking, or changes of direction
- A rapid increase in running, hill work, or sit-ups
- Weak core and hip muscles that shift load onto the hip flexors
- Long periods of sitting that leave the hip flexors stiff
- Hip joint problems, such as a labral tear, that change how the hip moves
How we diagnose it
Our physicians examine the hip with strength and movement tests and check the lower back and hip joint as possible sources of pain. Diagnostic ultrasound at the exam table lets us see the iliopsoas tendon and bursa, look for tearing or fluid, and watch the tendon in motion to capture a snapping hip as it happens. X-rays or an MRI are ordered when we suspect a problem inside the hip joint, such as a labral tear or arthritis.
How Propel treats hip flexor strain and iliopsoas tendinopathy
Most hip flexor problems respond to a progressive rehab program that strengthens the hip flexors, glutes, and core and restores comfortable hip motion. We modify running and training so you can keep moving while the tendon calms down, then gradually rebuild speed and power.
If pain persists, an ultrasound-guided injection into the iliopsoas bursa can reduce irritation and also help confirm the source of pain. PRP may support healing in a damaged or partly torn tendon, and shockwave therapy is a noninvasive option for longer-lasting tendinopathy. Snapping that stays painful despite these steps, or a problem inside the hip joint, may call for a surgical opinion.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about hip flexor strain and iliopsoas tendinopathy
- Is a snapping hip dangerous?
- Snapping without pain is common and usually harmless. It becomes a problem when it is painful or limits activity, and that is when an evaluation and treatment make sense.
- Should I stretch my hip flexors if they hurt?
- Gentle stretching can help stiffness, but an irritated tendon usually needs strengthening more than aggressive stretching. We build a plan that balances both.
- How do I know if my pain is from the hip flexor or the hip joint?
- The two can feel similar. An exam, diagnostic ultrasound, and sometimes X-rays or an MRI help us sort out whether the tendon, the joint, or both are involved.