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The large bones that make up the hip joint—the femur (thighbone) and the pelvis—serve as anchors for several muscles. Some of these muscles move across the abdomen or the buttocks (hip flexors, gluteals). Others move down the thigh to the knee (abductors, adductors, quadriceps, hamstrings).

The lower abdominal muscles and hip flexor muscles are often involved in a hip strain.

Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010.

In a hip strain, muscles and tendons may be injured. Tendons are the tough, fibrous tissues that connect muscles to bones. Hip strains frequently occur near the point where the muscle joins the connective tissue of the tendon.

The strain may be a simple stretch in your muscle or tendon, or it may be a partial or complete tear of muscle fibers or of the muscle and tendon combination.

Once the muscle is injured, it becomes vulnerable to reinjury. Repeated strains in muscles about the hip and pelvis may be associated with athletic pubalgia (also called sports hernia). A sports hernia is a strain or tear of any soft tissue (muscle, tendon, ligament) in the lower abdomen or groin area. This condition is discussed in Sports Hernia (Athletic Pubalgia).

The lower abdominal muscles and hip flexor muscles are often involved in a hip strain.

Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010. 

A hip strain can be an acute injury—meaning that it occurs suddenly, such as from a fall, a stretch injury, or a direct blow during contact sports. Hip strains are also caused by overuse—when the muscle or tendon has slowly become weakened over time by repetitive movements.

Factors that put you at greater risk for a hip strain include:

• Prior injury in the same area
• Muscle tightness
• Failure to warm up properly before exercising
• Attempting to do too much, too quickly, when you exercise
• Exhaustion or deconditioning

A muscle strain causes pain and tenderness in the injured area. Other symptoms may include:

• Increased pain when you use the muscle
• Swelling
• Limited range of motion
• Muscle weakness

Many hip strains will improve with simple home treatment. Mild strains can be treated with the RICE protocol. RICE stands for rest, ice, compression, and elevation.

• Rest. Avoid activities that put weight on the hip for the first few days after the injury.
• Ice. Apply ice immediately after the injury to keep the swelling down. Use cold packs for 20 minutes at a time, several times a day. Do not apply ice directly on the skin.
• Compression. To prevent additional swelling, lightly wrap the area in a soft bandage or wear compression shorts.
• Elevation. As often as possible, rest with your leg raised up higher than your heart.

In addition, nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen and naproxen, can help reduce swelling and relieve pain.

If the pain persists or it becomes more difficult to move your hip and leg, contact your doctor.

Medical treatment for muscle strains is designed to relieve pain and restore range of motion and strength. The majority of hip strains are treated nonsurgically.

In most cases, you should avoid the activity that caused your injury for 10 to14 days. A severe muscle strain may require a longer period of recovery. If your pain returns when you resume more strenuous activity, however, discontinue what you are doing and go back to easier activities that do not cause pain.

You can take the following precautions to help prevent muscle strains in the future:

• Condition your muscles with a regular program of exercise. Ask your doctor about exercise programs for people of your age and activity level.
• Warm up before any exercise session or sports activity, including practice. A good warm up prepares your body for more intense activity. It gets your blood flowing, raises your muscle temperature, and increases your breathing rate. Warming up gives your body time to adjust to the demands of exercise. It increases your range of motion and reduces stiffness.
• Wear or use appropriate protective gear for your sport.
• Take time to cool down after exercise. Instead of performing a large number of rapid stretches, stretch slowly and gradually, holding each stretch to give your muscle time to respond and lengthen. You can find examples of stretching exercises in the Related Media section of this article or ask your doctor or coach for help in developing a routine.
• Take the time needed to let your muscle heal before you return to sports. Wait until your muscle strength and flexibility return to preinjury levels.