Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board
Hip flexor tendonitis is a common cause of pain in the front of the hip and thigh.
It is typically an overuse injury which often affects active individuals, particularly if there is muscle tightness or weakness.
Front hip pain when running, going up stairs or bending the hip, particularly if you’ve been sitting for a while may be accompanied by a clicking or snapping in the hip with hip flexor tendinopathy.
Here we look at what hip flexor tendonitis is, the different types, common causes and symptoms, how it is diagnosed, the best treatment options and how to stop it from coming back.
Hip flexor tendonitis is when there is inflammation or irritation of the tendons that bend and lift the hip.
It typically occurs from overuse or repetitive strain, especially during activities that involve repeated hip flexion like running, kicking, or cycling.
Hip flexor tendonitis is also known as hip flexor tendinopathy or iliopsoas tendonitis.
The hip flexors are a group of muscles that bring the thigh up towards the chest. Each of these muscles has a tendon that can become irritated or inflamed, leading to different types of tendonitis of the hip flexors:
Hip flexor tendinopathy is typically caused by:
Typical symptoms of hip flexor tendonitis include:
Hip flexor tendonitis pain typically worsens with activity and improves with rest. It is just one possible cause of front hip pain.
Hip flexor tendonitis diagnosis begins with a thorough clinical assessment. Because hip flexor pain can have several causes, getting an accurate diagnosis is essential to ensure proper treatment and recovery.
A healthcare professional, typically a physiotherapist or doctor, will assess your symptoms, movement patterns, and muscle function to pinpoint the exact source of the hip flexor pain.
Your clinician will usually begin by asking about:
A hands-on physical assessment for suspected hip flexor tendonitis will likely include:
Pain reproduced with resisted hip flexion or passive hip extension is often a strong indicator of iliopsoas tendonitis.
In some cases, imaging may be used to confirm the diagnosis of hip flexor tendonitis or to rule out other conditions:
Because hip flexor tendinopathy shares symptoms with other conditions, it is important to differentiate between possible causes of hip flexor pain:
An accurate diagnosis of front hip pain is key to successful treatment, so if symptoms of hip flexor tendonitis are persistent, worsening, or interfering with daily life, it is worth seeking professional assessment early on.
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Early and effective hip flexor tendonitis treatment can make a big difference in recovery and typically involves:
The best place to start with hip flexor tendonitis treatment is to temporarily reduce or avoid activities that aggravate symptoms. Switch to low-impact alternatives like swimming or cycling (if pain-free).
Applying ice packs for 15–20 minutes several times a day can help reduce inflammation in the early stages of hip tendonitis. With more chronic cases of hip flexor tendinopathy, heat packs can help improve blood flow and aid healing
Short-term use of painkillers e.g. paracetamol or NSAIDs e.g. ibuprofen may reduce hip flexor pain and swelling.
Physical therapy is a key part of hip flexor tendonitis treatment. Hands-on techniques can help release tight muscles and improve mobility e.g. joint mobilisations or deep transverse friction massage
Shockwave therapy or therapeutic ultrasound may be used to stimulate tendon healing
A tailored rehab program focusing on flexibility, strength, and correcting biomechanics is key.
Exercises for hip flexor tendonitis usually involve a combination of hip flexor stretches and glute strengthening exercises. Always avoid pain during exercise. Progress gradually under professional guidance.
In severe or persistent cases of hip flexor tendinopathy, corticosteroid injections may be considered, though they should be used cautiously as they can temporarily weaken the tendon. Injections should be used alongside other hip flexor tendonitis treatments.
Surgery for hip flexor tendinopathy is rare and usually only considered when conservative treatment has failed after several months, typically in chronic or severe cases of hip flexor pain.
If symptoms persist despite physiotherapy, injections, and activity modification, your specialist may consider hip flexor surgery, typically:
Hip flexor surgery outcomes are generally positive when appropriate rehabilitation follows, but surgery is considered a last resort and not suitable for every patient. Recovery can take several months and usually involves a structured rehab program guided by a physiotherapist.
Tendonitis of the hip flexors recovery varies depending on the severity and how early you start treatment. For most mild to moderate cases:
The key to successful hip flexor recovery is a structured rehab program that gradually reintroduces load without overstraining the damaged tendon.
There are lots of things you can do to help reduce the risk of developing hip flexor tendinopathy:
Hip flexor tendonitis is a common cause of front hip pain, particularly in active individuals or those with tight hip flexors. Caused by overuse, muscle imbalance or poor movement patterns, it leads to inflammation and pain in the front of the hip, thigh and groin.
The good news is that with early diagnosis, proper treatment, and targeted exercises, hip flexor tendinopathy is very treatable. Whether you are an athlete or spend long hours at a desk, making small adjustments to your routine can help you recover fully, and stay pain-free in the future.
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Last Updated: June 10th, 2025
Next Review Due: June 10th, 2027