Chronic Hip Flexor Pain with Intro

I received an email from a dad asking me about his daughter’s hip flexor injury. She is a runner and she has been dealing with it for a couple months.
Legal Stuff: I am not a doctor, licensed physical therapist or in any way qualified to treat such things. Especially if I have never seen her. So the following is just an idea. Something to think about and if it makes sense, try it.

My best guess is that she is very quad dominant, meaning her front muscles used for running are stronger than her hamstrings and glutes. This is very common in runners and causes a lot of their issues.

Very few runners really work the posterior chain.The posterior chain being the hamstrings and glutes.But these are very important muscles to stabilize the leg while running. If they don’t do their job, the pelvic girdle can move causing tight hamstrings and/or hip flexors.

So this is what I would do as an idea.


1. Foam roll the quads and see if there are any knots.
2. Foam roll the hamstrings and see if there are any knots.
3. Do a piriformis stretch (shown in video) with a lacrosse ball or tennis ball under the cheek. This is where the hip flexors attach to the back. This is extremely painful if there is an issue there. But if she does it for a minute or so, she should feel looser.

Half-pigeon, not shown in video
Hip flexor stretch shown in video
Piriformis stretch shown in video

Do exercises that work the posterior chain.
1. Bridges 3 sets 15-25 reps
2. Stiff Legged Deadlifts 3 sets 8-10 reps
3. Deadlifts with dumbbells 3 sets 8-10 reps

Make sure she is doing a hip hinge with the stiff-legged deadlifts and deadlifts. This means the butt goes back first to engage the hamstrings as opposed to bending over and using her lower back.

She can also put her feet up against the wall. Make sure her rear end is as close to the wall as possible. Push the lower back into the floor and squeeze the pelvic muscles. These are the muscles you use when you have to pee but can’t find a restroom. stay there 10 minutes 1-2 times a day and see if that helps.

Also think about an MRI to see if there is a tear.

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