Hip Flexor Pain, What Are the Causes?

A Tender Hip Flexor?

If you have some or all of the following symptoms, you may have hip flexor issues. Hip flexor issues afflict a large percentage of active people and can be very painful.


  • Mild to serious pain that may feel like a pulling in the front of the hip.
  • A sharp or dull pain that may cause limping while walking.
  • Bruising, spasms, or swelling; the top of the thigh muscle may bulge. It will be difficult to walk.
  • Some sufferers may even experience hip pain when sitting down.



best treatment for hip flexor injury

You may ask: what is your hip flexor, well the hip flexors are a muscle group in front of the hips which are commonly used for raising the legs and knees toward the chest during movement, especially bending, walking and running.

what is your hip flexor?
The Hip Flexor Muscles


In most cases, a very tight hip flexor or hip flexor pain results from a sports injury or strain of some type. They are prevalent, especially if you are not stretching adequately before physical exercise or activities.


Hip flexor strain is not uncommon, and therefore it can be helpful and informative to understand hip flexor pain and its causes. Inform yourself now to help prevent hip flexor pain in the future and how to unlock your hip flexors.


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Why Does My Hip Flexor Hurt?

First, understanding hip flexor strain requires an understanding of what the hip flexor muscles actually are and how they are used in movement and stretching.

The hip flexor muscles are incredibly strong; they are some of the strongest muscles in the body. They can be found deep in the abdominal cavity and aid the bending of the knees and legs toward the chest during movements such as running, walking and crouching.

The hip flexors are under constant pressure when exercising and as a result, they are often subject to injury and tearing.

The most common muscle in the hip flexor group that is prone to injury is known as the Iliopsoas. Without getting too scientific, the iliopsoas resides on your lower back and inserts into your thigh bone. Now you know a little bit about what the hip flexors are, let us investigate what hip flexor pain actually is.

As previously mentioned, hip flexor strain is the result of excessive athletic activity without hip flexor stretching or proper preparation. Individuals who are prone to experiencing hip injuries are runners, soccer players and martial artists, all of who require excessive use of their knees, legs, and hips.

Whenever the hip flexors are under pressure from such activities, the muscle fibers are put under tension. If the tension is too great, these muscle fibers can tear, resulting in intense pain and a lack of mobility.

A pulled hip flexor will definitely put you out of your sporting activities for a few days, and it is important to seek medical help if the tear is severe.

In the medical dictionary, hip flexor pain is actually known as a hip flexor strain, and the strain/tearing can vary from small/minimal to severe/rupturing, resulting in complete disability.

Grades of Hip Flexor Injury

When you damage your hip flexor, you may experience varying levels of pain. The torn hip flexor can be categorized into three different grades of tears: Grade 1, Grade 2 and Grade 3,  with the latter being the most severe, which we hope you’ll never experience.


  • Grade 1 – This is where a few hip flexor fibers are torn, but you are still able to move. The pain is only slight.
  • Grade 2 – A significant amount of fiber damage has occurred. You may not be able to function properly for a few days.
  • Grade 3 – This is very severe; you may have ruptured your entire muscle, resulting in immense pain and complete loss of functioning (seek medical treatment immediately).



The good news is with the proper recovery techniques and the most recommended rehabilitation methods, you can come back from a hip flexor tear in one to three weeks. However, with larger tears, recovery can take significantly longer.

Hip Flexor Strain

What Are The Causes of A Hip Flexor Strain?

There is a range of causes of hip flexor strain. It can be helpful to know what the causes are, so you can prevent it in the future. As mentioned earlier, hip flexor injury results from drastic movements involved with sports, and it is not uncommon for a running or soccer player to suffer from this injury.

Something as simple as an accelerated kick or leg movement can microscopically tear your hip muscle and result in a sharp pain.

There is also the possibility of re-injuring your hip muscles. Patients can develop a condition where they suffer from torn hip flexor muscles from even simple tasks as a result of previous muscular tearing. If you are continually damaging your hip flexors and are not performing hip flexor stretches before a physical activity, you may suffer in the long term.

There are also a number of factors that can be aggravating your hip muscle pain including additional tears and damage, particularly around the hip flexor areas. Other muscles can affect the performance of the hip flexors, and if they become damaged, may cause a lot of problems in regards to knee bending and running.

One of these injuries involves the groin. Tears and pulls in this region can contribute to the hip flexor strain. It can sometimes be difficult to distinguish the difference between hip flexor pain and groin pain, and more often than not, the two tend to complement each other.

Another common injury which contributes towards hip issues involves the hamstrings, which run down the back of the thigh and operate with the hip flexor to move the knees. As with any muscle, the hamstring can become damaged and may affect the performance of your hip flexor muscles, resulting in a dull pain.

Symptoms of Hip Flexor Strains

As with the cause, identifying when you tore your hip flexor muscle will be be beneficial when it comes to either seeking medical attention or applying self-rehabilitation, which is effective if you know the correct methods. One of the most common symptoms experienced with a hip flexor injury is a sharp, sudden pain at the front of the hip or groin. This pain will immediately follow the tear or strain. Keep in mind, it is difficult to decipher whether an injury is associated with the groin or hip flexor independently and in some cases, it may be both.

The pain, of course, varies depending on the severity of the injury and the more minor the tear the less pain will be felt. In some cases, a minimal hip flexor strain will only inhibit the activity slightly and you may be able to continue throughout your day as normal. However, if you experience extreme pain and difficulty with movement, something more serious may have occurred. Severe tearing may result in muscle spasms, muscle weakness and an inability to continue with the activity. Severe muscle damage may also result in a complete loss of mobility, and it may be appropriate to seek medical attention quickly.

Accompanying either a dull or severe pain (depending on the injury), you should also experience pain specifically when the knee is raised toward the chest. Occasionally, you may not experience this type of pain, but instead, will be met with resistance in the movement. Unfortunately, this doesn’t mean you’re in the clear. You still may require medical attention.

Stiffness and swelling are also common features of hip flexor damage. If you experience a bit of difficulty walking the next morning, you may need to perform some self-rehabilitation. There are various ways to accomplish this. If you have read the grading mentioned above, a Grade 3 tear may result in complete muscle deformity and you should see a doctor as soon as possible.

What Predisposes Us To Hip Flexor Pain?

Any individual can suffer from a hip flexor strain, but more often than not, the main victims are athletes and sportsmen. Nonetheless, we have probably all experienced hip flexor pain when running, jumping or bending down. However, there are a number of factors that may contribute to damage to your hip flexor muscles, and it’s vital you understand your own physical limitations. Age is a big contributor to hip flexor damage, and the older you are the more prone you will be to pull and tear muscles. If you’re above the age of seventy, you probably shouldn’t be performing gymnastics if you want to prevent muscle damage. With older age comes muscle weakness and a tight hip flexor, all contributing towards injury.

Another major, aggravating factor which can promote hip flexor strain is training and warm-up related. Before you engage in any physical activity, familiarize yourself with the proper warm-up techniques that will help you perform with maximum efficiency, decreasing the possibility of hip flexor injury. Before any exercise, learn the warm-up techniques for the hip flexors and prepare yourself for quick, aggressive movements (depending on the activity).

Two examples of warm-up exercises will be listed below. Another factor that needs to be considered is the athletic ability. This applies to individuals who have made that New Year’s resolution and want to lose some pounds. Inappropriate training and poor biomechanics (the way your body moves) can aggravate the hip flexors and may result in muscle damage. If you are a beginner in the athletic world, start easy and work your way up. Do not go full throttle right of the bat as you may suffer from serious hip damage.

Hip Flexor Treatment And Rehabilitation

One of the final predispositions that can result in a hip flexor accidents is the previous rehabilitation from another hip flexor-related injury. This is a major factor, as previous hip flexor strains can result in future strains. There are a number of professional and well-known techniques that can be used as your hip flexor recovery plan. This will help you if you have suffered from minor or severe hip flexor damage. It is important you know these methods; they may spare you a trip to the doctor and save you time and money.

Self-healing can be just as effective if done correctly. Through a number of intermediate and advanced rehabilitation training techniques, you should be on your way to a full recovery. It may also be necessary to have a hip flexor-rehabilitation protocol, which you follow if you suffer from hip flexor pain often.

What Can You Do To Prevent Hip Issues?

Hip flexor stretches are the best way to prepare for an activity and ensure that you don’t suffer from any hip flexor pain or related issues. Flexor stretches are easy to perform and can be beneficial to the muscle fibers. It should be noted that these exercises do not help with rehabilitation of hip flexor injuries! Hip flexor rehabilitation techniques are more advanced. Performing flexor stretches on an existing muscle injury may result in further pain and/or injury.


  • Try standing up and raising your knee to your chest as if you are marching in a band. Hold it there for a period of time and then bring it down. Repeat the same with the other leg. Do these movements at least 15 times.
  • You can also perform a maneuver sitting down. Sit down and hold your sides. Lift your leg so it is parallel with the floor and hold it in place for a few seconds. Let it fall to the floor and repeat with the other leg. Try doing this 5 times.


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These are just two basic exercises and there are more out there. Again, do not use these for rehabilitation as those exercises are very different.

Take Good Care of Your Hips

The hip flexor is one the main components of the body and is heavily involved in athletic tasks and quick movements. However, on occasion, it can tear and cause significant pain preventing you from moving and performing activities. There are a number of causes to hip flexor injury, one of the main ones being excessive tension placed on the muscle through sporting activities. Nonetheless, through a number of exercises and techniques, the pain can be remedied and the muscle can be self-healed. Remember to warm-up before you exercise. Don’t predispose yourself to the possibility of injury.


OIC (Opioid Induced Constipation)

oic bannerr

If you take opioid pain medicine, you might have trouble with bowel movements or will develop issues. Opioid-induced constipation (OIC) is one of the most common side effects of this type of pain medication. Constipation resulting from opioid-based pain relievers is called OIC. OIC differs from other forms of constipation because it is a direct result of the medication’s effects on the human intestine. Once it starts, it can continue as long as the patient continues taking the pain medication. If you take opioids for pain, here are seven signs you should consider speaking with your health provider to determine if you are at risk. Any of the following seven signs could indicate you suffer from OIC.

Understanding opioids

Opioids are a powerful type of drug that doctors commonly prescribe to patients because they offer pain killing or analgesic properties. Examples include morphine, methadone, oxydodone, and codeine. Common brand names of opioids include Vicodin, Demerol, Fentanyl, OxyContin, Darvon, Percocet and Demerol, to name a few.

Opioids are classified by the type of materials used in their manufacturing process. Some of the first opioids were made from a resin produced by the opium poppy and are known as natural opioids. They include morphine and codeine. When manufacturers begin with these same natural resins but altered them chemically, the resulting drugs are part of a class of medications known as semi -synthetic opioids. Oxycodone and hydrocodone are two members of this class of drugs. Scientist manufacture other drugs beginning with non-opioid substances in laboratories beginning with other materials. This class of drugs including methadone, is classified as synthetic opioids. The body also naturally produces endorphins and other types of endogenous opioids but these do not interfier with bowel movements.

How do these drugs work?

Opioid receptors are found in the gastrointestinal tract, brain and spinal cord. Opioids bind to these proteins and prevent the brain from sensing pain. At the same time, the opioid stimulates the brain’s pleasure centers, causing the user to sense a state of euphoria.

The proper use of opioids

In the field of medicine, opioids are useful because they block the brain from perceiving pain. In palliative care patients, pain is one of the factors found most distressing as the individual approaches the end of his or her life. Pain is a common complaint in 70% of advanced cancer patients and 65% of individuals facing death from non-malignant disease. Doctors prescribe opioid-based medication to lower their pain while improving their overall quality of life. Patients who are in the advanced stages of these diseases most commonly receive long-term prescriptions for opioids.

Do opioids have side effects?

While beneficial in preventing pain, these medications also result in side effects. The patient may experience nausea and drowsiness. The medication depresses the overall respiratory system and slows the patient’s breathing rate. Opioids also slow the movement of matter through the digestive system and cause constipation. For many patients, OIC is an uncomfortable side effect of the medication they take to reduce their pain. For a large percentage of patients, opioid addiction is also a side effect.

Opioid Induced Constipation Symptoms

Nausea: Opioid medications cause some patients to experience queasiness or vomiting. Some of the nausea is due to consumption of the medication itself; however, patients who cannot pass a bowel movement often experience an enhanced nauseous feeling. When the nausea is combined with a reduction in bowel movements, OIC should be suspected.

Discomfort: For some OIC sufferers, pressing on the abdomen reveals tenderness. It is important to consult with your physician anytime the stomach becomes sensitive to touch as such pain can indicate a serious medical condition. However, if you experience tenderness in the abdomen along with the other symptoms we outline, constipation is a common cause.

Bloating: Many patients suffering OIC also describe feelings of bloating, fullness, swelling or tightness in their abdomen. They might also experience excess gas. While bloating can have many different causes, one common cause is constipation.

Painful Toileting: If you suffer OIC, you might find yourself experiencing pain and straining when you use the bathroom. For some OIC patients, the process is a fight through the entire toileting process that leaves them feeling sore once they finish. OIC can cause your normal bathroom break to become a workout.

Incomplete Evacuation: One of the bothersome side effects of opioid action on the gastrointestinal track is a feeling that your gut is still full even after you use the bathroom. Some patients describe the sensation of feeling that they are not having full bowel movements when they are victims of OIC.

Less Frequent Bowel Movements: The medication can decrease the number of bowel movements you have during a week. If you notice such a frequency decrease when taking opioids, you could be suffering OIC.

Hard Stools: Patients with OIC often experience hard, dry stools. Such stools are an indication of constipation. While you may not find it intuitive to study your stools, fecal matter appearance provides some important clues to overall digestive health. Normal bowel movements should have a smooth, soft shape resembling the shape of a sausage or snake. Constipated bowel movements often break into pieces or lumps or have a dry, cracked appearance. If you take opioid pain medication, check your stool the next time you go to the bathroom.

It may be possible to reduce some or all of the symptoms using home remedies. If the symptoms are mild, consider these simple remedies first. However, if the symptoms continue longer than seven to 14 days, you should see your doctor.

OIC home remedies

Natural fiber laxatives: These over-the-counter medications help to increase fiber and can help if you have trouble increasing fiber in your diet. Some are available as powders you mix in a liquid drink. If you do not enjoy the gritty texture of the mix-ins try the capsule form.

Improve your diet: Reduce the fat and processed foods in your diet. Try eating five or six smaller meals instead of three large one. Choose natural foods for a healthier you.

Exercise: Exercise can help to relieve many health issues, including OIC. The process of exercising helps to reduce stress while stimulating the bowels. Another plus is that exercise results in better health overall.

Mineral oil: This OTC medication provides lubrication while also softening the stool; however, it is only recommended as a short-term solution for constipation.

Check your fiber: Fiber helps you to be more regular and produces a softer stool. There are many sources of fiber, including oatmeal, fruits, prunes or prune juice, bran cereal, apple cider (not juice), rhubarb, apricots, watermelon, grapes, cabbage, asparagus, raisins and dried fruits, whole grains and carrots. This fiber helps to improve the efficiency of the digestive system.
Soften the stool: Over the counter medications including the stool softener Docusate cause the muscles of the intestines to contract rhythmically to mechanically soften stool. Other types of OTC stool softeners add moisture to the stool so it passes with less strain.

Increase your water intake: The human body is composed largely of water. If you are dehydrated, your poop tends to dry out. Drink plenty of water each day to ensure your body stays hydrated and your stool passes easily.

Squat to Pot: The typical American toilet eliminates squatting to defecate. A device called the Squatty Potty lifts the legs so the body is in a more natural position. The position relieves the stress on the colon and is said to reduce issues with both constipation and hemorrhoids.

Squaty Potty

Combine your methods: With the above tips, you are not limited to a single choice. Add two, three or more to your regiment to find what actually helps. If one works for a while but the issue returns, try using a different remedy.

Prescription Medications and Treatments for OIC
If the home remedies do not bring relief, it is time to talk with your doctor.

Medications and drugs that treat OIC

Because opioids often cause constipation, your doctor may prescribe another medication along with your pain medication. Doctors find it beneficial to provide the two medications instead of eliminating the opioid because of the increase pain control brings to the patient’s life. Your doctor may prescribe a laxative or cathartics with the pain medication as a preventative measure. Cathartics are medications that accelerate defecation while laxatives make the process easier, usually working as a stool softener. Some medications provide relief using both mechanisms.

While most patients find relief of OIC with the other methods, sometimes doctors recommend rectal intervention. These measures can help to relieve OIC symptoms quickly so the patient is more comfortable.

Possible prescription medications to treat OIC

Emollients: These oily substances provide lubrication and soften the stool so it passes easier.
Bulk cathartics: These laxatives also soften the stool and increase bulk.

Osmotics: these medications work by increasing the water in the intestines. Water softens the stool and increases bulk.

Stimulants: These medications provide a direct counteraction of opioids on the gut by increasing the motility of the intestines so the stool is forced through the digestive system.

Prokinetic drugs: These medications reduce the absorption of electrolytes and water by the intestines, increasing the weight of the stools. They reduce transit time and increase the frequency of defecation.

Other options include medications that prevent opioids from slowing the bowels and reduce OIC.

Methylnaltrexone (sold under the brand name Relistor(R)) works by blocking the gut’s opioid receptors and has a limited ability to cross the barrier between the brain and blood. It only affects the receptors in the gastrointestinal track, so it reverses OIC without causing symptoms of withdrawal or preventing the opioid from reducing pain in the rest of the body.

It also helps to restore bowel function when patients face advanced illnesses and require opioids for their pain-relieving benefits. The injectable medication is designed to target OIC. It should be given along with the opioid so the patient can receive the opioid benefit without the side effect of OIC.

This medication decreases the chance of constipation by reducing the opioid’s effect on the GI tract while maintaining the pain medication’s ability to bring relief and increase the patient’s quality of life.

For patients who have the option, the best choice to stop OIC is eliminating the use of pain-relieving opioids. However, in patients where this is not an option, doctors should consider the appropriate OIC treatment.

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Raise Your Hand If You’re Tired Of Too Much Sweat

Are your teen’s summer whites marred by unsightly underarm stains? Does your high schooler layer on oversized hoodies or sweatshirts, even on a warm day? If you notice pee-colored perspiration stains on every white tee in your son or daughter’s laundry and the acrid smell of armpit lingers even after washing, it might be time to have a chat about sweat.


Sure, sweating is healthy for us. Our bodies were designed to sweat to prevent us from overheating. During times of exertion or excessive heat, our nervous system naturally responds by stimulating our eccrine glands and releasing a mixture of water, sodium and other chemicals which drain from the glands to cool us. Consider the process like running under a yard sprinkler on a hot summer day.



But what happens when the nervous system begins to send the wrong signal? Rather than perspiring on the basketball court, suddenly your child begins sweating while sitting in an air-conditioned classroom. Your son’s armpits may always be ringed with wetness, or your daughter’s palms may continuously sweat or the soles of her feet may always feel damp. Some may even perspire excessively around their hairline.

If this is happening to your child, it may be a condition called hyperhidrosis, which—when broken down—means too much sweat. Hyperhidrosis is a treatable medical condition which can negatively impact a person’s life, affect their self-esteem and limit them socially. Students’ participation in class may be hindered by their unwillingness to raise their hand for fear of exposing their underarms. Certain tasks may prove difficult if their palms are damp and slippery with sweat. Their books and papers may be dotted with sweat as it drips from their forehead. Dating life may be hampered by the embarrassment of too much sweat. Imagine being a teen and struggling with the social anxiety of such a visible ailment.

But adolescents aren’t the only population to suffer this condition. Though the onset of hyperhidrosis is more commonly seen in puberty, the condition can affect males or females in any climate, at any age and of any race. Adults in the work place may struggle with the embarrassment and discomfort of excessive sweating just as students do in the school setting.

Why My Child?

Though it is not known what triggers the nervous system to begin to overcool the body, there are some known associations. Often times hyperhidrosis is seen in more than one family member which identifies a genetic component. The condition may also affect those with certain medical conditions such as diabetes, gout or menopause. Some medications—such as certain steroids and antidepressants to name just two—may contribute to excessive perspiration. Additionally, the onset of hyperhidrosis may occur after an accident or injury.

What Can We Do?

The first step is to see a doctor. Once the condition has been properly diagnosed, your physician may start with the first line of defense: antiperspirants. Though use of over-the-counter antiperspirants may have already been tried, your physician may choose to provide a prescription-strength formula. Antiperspirants are generally inexpensive and easy to apply. They work to block sweat glands which tells the body that no further sweat need be produced in that area. Antiperspirants may be applied to the underarms, the palms and the soles of the feet.


Another form of treatment for the hands and feet is iontophoresis. Iontophoresis involves soaking the hands and/or feet in a small vat of water under low-voltage current. Sweat glands in the affected area are deadened temporarily providing relief for an unspecified period of time. This method generally costs more than antiperspirants and requires a greater time commitment as multiple treatments are recommended. Treatment would need to be revisited as the effect wears off.


Botulinum toxin injections, or Botox, is also being used in the treatment of hyperhidrosis. Multiple, small injections are given in the treatment area. The medication works to block the chemical which activates the sweat glands. Treatment lasts 4 to 6 months and can be repeated as needed. Botox is also showing promise in treating hyperhidrosis at the hairline and in the palms and soles of the feet.

Prescription medications are also available for the treatment of hyperhidrosis. These medications are not targeted to a specific area, and therefore affect the entire body’s cooling mechanism. Medication should be used with caution and under a physician’s direction as your body may not be able to cool itself when it really needs to.

Other forms of treatment include surgical removal of sweat glands through excision, laser surgery, curettage or liposuction. Sympathectomy is another form of surgery which may be performed in certain cases. Hand-held devices are also being used in the treatment of overactive sweat glands beneath the arms.

End the Sweat



If you suspect your teen may be struggling with the discomfort and embarrassment of hyperhidrosis, why not open up the conversation? Most kids aren’t even aware their problem has a name. Let your child know there is help available. As mentioned earlier, there are a number of treatment options on the market today and new methods on the horizon as well. If your son or daughter is not quite ready to tackle the problem, allow for time and space and offer support. That in itself can go a long way in easing anxiety. When living with hyperhidrosis, teens need to know they’re not alone, and that it’s okay to raise their hand if they’re tired of too much sweat.

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