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Sports Medicine

Hip flexor pain

01/06/2009

Question:

Active, fit 59 year old male has had increasing pain in the top front and groin of the left leg. I experience pain when lying flat on my back and raising my left leg. Also experience pain when walking more than 1 mile. My aerobic exercise consists of a stationary bike (which does not cause pain). I also weight train. Leg curls are the only leg exercise that cause pain. I have had an xray - no arthritis. I have also tried accupuncture, chiropractic and pressure point massage.

Help? Any ideas?

Answer:

Although it is possible - as you suggest in the title of your question - that you have "hip flexor pain," tendinitis or a strain of the hip flexors is unusual, and would typically result from overuse or an acute injury. If this is not the case for you, pain from what may seem to be a "hip flexor" problem may actually be due to something else, including a hernia (inguinal, femoral, or "sports hernia"), a hip joint problem which doesn't show up on X-rays (including mild arthritis, "iliopectineal bursitis," a stress fracture, or a torn labrum/cartilage rim), or a sacroiliac joint problem, among other possible causes.

A history and physical examination by your primary care physician, or if necessary, referral to a sports medicine physician, should indicate the most likely cause of your symptoms and therefore the most appropriate treatment, although further testing such as an MRI scan may be felt to be necessary, if results would change treatment options.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University