In this blog we explore the muscles which sit at the front of the hip (hip flexors). We take a look at what these muscles do, and we take a look at hip flexor/iliopsoas related hip & groin pain.
Hip Flexor Pain May Be Related To Which Muscles and What Do They Do?
The muscles that sit at the front of the hip are called the hip flexors and act to lift your knee towards your chest (flexion). It is these muscles that can be involved with hip flexor pain. The main hip flexor, the iliopsoas muscle is made up of two parts – the psoas muscle that starts at the lumbar spine, and the iliacus that starts from the inside of the pelvis. They come together in the pelvis and run forwards over the front of the pelvis, deep across the front of the hip and join onto the upper thigh bone (femur). The iliopsoas muscle provides important support for the front of the hip joint, the sacroiliac joint of the pelvis and the lower back (lumbar spine). It is also a powerhouse for moving your legs forward in walking, running and stairclimbing.
A number of other longer, more superficial (closer to the surface) hip flexor muscles run from the pelvis and down into the thigh and connect below the knee – the Sartorius, Rectus Femoris and Tensor Fascia Lata (TFL) muscles. These muscles help the iliopsoas muscle with lifting the thigh, but their effect also extends across the knee.
Hip Flexor or Iliopsoas Related Hip & Groin Pain
Tears or strains may occur within the hip flexor muscles; where the muscles and tendons join (musculotendinous junction); or within the tendons. Traumatic injury resulting in rapid onset of pain is usually associated with sporting actions such as:
- kicking
- sprinting, particularly rapid acceleration
- changing direction at speed.
Changes in tendon health often evolve more slowly, related to your body’s natural make-up (e.g. bony shape, hypermobility) or postural, movement, or athletic training habits.
The iliopsoas tendon that joins the iliopsoas muscle to the femur (thigh bone) sits deep at the front of the hip and is separated from the hip joint by a large bursa (iliopectineal or iliopsoas bursa). This bursa reduces friction and helps the tendon slide freely across the front of the hip. The tendon and/or the bursa may become involved and you may receive a diagnosis of:
- iliopsoas tendinopathy – a painful iliopsoas tendon
- anterior snapping hip – snapping of the iliopsoas tendon which can sometimes become painful
- iliopsoas bursitis – inflammation or thickening of the iliopsoas bursa
- iliopsoas impingement – impingement or compression of the iliopsoas tendon against the underlying bone
The hip flexors muscles, and particularly the iliopsoas muscle, have become incorrectly demonised in the popular media for being the source of many problems. These are generally thought to be related to the muscles becoming overly active and tight. There is unfortunately much misinformation on the internet regarding the hip flexors and poor advice regarding management of true hip flexor issues.
Many people are stretching the hip flexors and placing high loads on the front of the hip unnecessarily, often worsening their problem.
