Hip Flexor Pain or Hip Joint Pain? How to Tell the Difference

October 20, 2026

Do you have pain in the front of your hip or groin? You might assume you’ve strained your hip flexor or that your hip muscles are simply too tight.

But what if the pain isn’t coming from your hip flexors at all?

Pain in the front of the hip can originate from several different structures, including the hip flexor muscles and tendons, the hip joint itself, or even nearby areas such as the lower back.

Two people can experience pain in almost the exact same location but have very different underlying problems.

At Gordon Physical Therapy in Spokane Valley, WA, we frequently evaluate hip pain to help determine which structures may be contributing to a patient’s symptoms. Understanding the source of your pain is important because the best treatment for an irritated hip flexor may be quite different from the treatment for a problem inside the hip joint.

Let’s explore some of the most common causes of anterior hip pain and how to tell them apart.

Where Is Your Hip Pain Coming From?

The front of your hip is a relatively small area containing several important structures.

These include:

• Hip flexor muscles: Including the iliopsoas and rectus femoris, which help lift your thigh and move your hip.

• Hip flexor tendons: Connect the muscles to bones and can become irritated with repetitive activity.

• Hip joint: The ball-and-socket joint where the femur meets the pelvis.

• Hip labrum: A ring of cartilage around the hip socket that helps provide stability and maintain the joint’s seal.

• Other nearby structures: Including additional muscles, nerves, and structures associated with the lower back and pelvis.

Because these structures are close together, the location of your pain doesn’t always tell us exactly what’s wrong.

However, certain symptoms and movement patterns can provide useful clues.

1. Hip Flexor Muscle Pain: Strains, Tightness, and Overuse

One common cause of pain in the front of the hip is irritation involving the hip flexor muscles or tendons.

Your hip flexors are responsible for lifting your thigh toward your body. You use them during walking, running, climbing stairs, and many other activities.

Common symptoms of hip flexor pain

People with hip flexor-related pain may experience:

• Pain in the front of the hip or upper thigh

• Discomfort when lifting the knee toward the chest

• Pain when walking uphill or climbing stairs

• Tenderness in certain areas of the front of the hip

• Pain during running, sprinting, or kicking

• Discomfort when stretching the hip flexors

Hip flexor strains often occur following a sudden movement or increased physical activity.

For example, a runner who suddenly increases mileage or adds hill workouts may develop pain involving the hip flexor muscles or tendons.

Other people develop symptoms more gradually without a specific injury.

Why stretching might make hip flexor pain worse

If your hip flexors are irritated, repeatedly stretching them may not solve the problem.

In some cases, aggressive stretching can increase discomfort, especially when a muscle or tendon is already sensitive.

This is something we discussed in our first article:

Why Are My Hip Flexors So Tight? Why Stretching May Not Be the Answer

The important takeaway is that a muscle that feels tight doesn’t necessarily need more stretching.

Sometimes the better starting point is reducing irritation, improving comfortable movement, and gradually rebuilding strength and tolerance for activity.

2. Hip Joint Pain: Could It Be Hip Impingement?

Another possible source of anterior hip pain is the hip joint itself.

One condition that can cause symptoms in this region is femoroacetabular impingement (FAI).

FAI involves certain variations in the shape of the hip bones that can create contact between the femur and the rim of the hip socket during particular movements.

Not everyone with these structural variations develops pain. When they contribute to symptoms, the condition is sometimes called femoroacetabular impingement syndrome.

Common symptoms of hip impingement

People with symptomatic hip impingement may notice:

• Deep pain in the front of the hip or groin

• Pain with deep squatting

• Discomfort when bringing the knee toward the chest

• Pain when rotating the hip

• Difficulty sitting in certain positions

• Pinching sensations in the front of the hip

A common complaint is that the hip feels like it’s being pinched when bending deeply.

For example, someone might experience pain at the bottom of a squat or when bringing their knee toward their chest.

Unlike some hip flexor problems, these symptoms may be related to how the hip joint moves rather than primarily to an irritated muscle.

However, symptoms alone cannot confirm hip impingement. A physical therapist can evaluate hip motion, strength, and symptom responses to help determine whether the joint may be involved.

3. Could Your Hip Pain Be Caused by a Labral Tear?

Another potential cause of anterior hip pain is a problem involving the hip labrum.

The labrum is a ring of cartilage surrounding the hip socket. It helps support hip stability and joint function.

Labral tears can develop following an injury or over time, sometimes in association with hip impingement or other joint conditions.

Common symptoms of a hip labral tear

Possible symptoms include:

• Deep groin or anterior hip pain

• Pain with twisting or pivoting

• Clicking or catching sensations in the hip

• Discomfort during prolonged sitting

• Pain with certain hip movements

• A sensation that something is catching inside the joint

One important distinction is that clicking in the hip doesn’t automatically mean you have a labral tear.

Many people experience painless clicking or popping in their hips, and labral abnormalities can also be present in people who have no symptoms.

Additionally, hip flexor tendons can sometimes create snapping sensations that feel similar to joint-related clicking.

A labral tear cannot be reliably diagnosed based on symptoms alone. A thorough clinical evaluation, and sometimes imaging (like an MRI), may be needed to determine whether a labral problem is contributing to your pain.

Does a hip labral tear always require surgery?

No.

Many people with labral-related hip pain improve with nonsurgical treatment, including physical therapy.

Treatment may focus on improving hip strength, modifying aggravating activities, addressing mobility limitations, and gradually restoring comfortable movement.

Surgery may be considered in selected cases, but a labral finding on an MRI doesn’t automatically mean surgery is necessary.

4. Hip Arthritis Can Also Cause Pain in the Front of the Hip

Hip osteoarthritis is another possible cause of anterior hip pain, particularly in middle-aged and older adults.

Osteoarthritis involves changes within the joint that may contribute to pain, stiffness, and reduced mobility.

Common symptoms of hip arthritis

Symptoms can include:

• Groin or anterior hip pain

• Stiffness after sitting or resting

• Difficulty putting on shoes and socks

• Reduced hip rotation

• Pain with walking or prolonged standing

• Difficulty getting in and out of a car

One particularly useful finding during a physical therapy evaluation is limited hip internal rotation, which can occur with hip osteoarthritis.

However, reduced hip rotation can have several causes and does not independently establish a diagnosis.

People with hip arthritis may benefit from physical therapy to improve strength, mobility, walking tolerance, and everyday function.

Hip Flexor Pain vs. Hip Joint Pain: Key Differences

Although these conditions can overlap, the following table summarizes some common patterns.

Important: These are general patterns, not diagnostic rules. There is considerable overlap, and more than one structure may contribute to hip pain.

This is why an examination is often more useful than trying to diagnose yourself based on a single symptom.

How Physical Therapists Determine What’s Causing Your Hip Pain

At Gordon Physical Therapy, we don’t simply assume that pain in the front of your hip means you have a tight hip flexor.

Instead, we look at several factors to help identify the likely source of your symptoms.

1. Understanding your symptoms

We start by asking questions such as:

• Where exactly does your hip hurt?

• Did the pain begin suddenly or gradually?

• Does walking, running, sitting, or squatting make it worse?

• Do you experience clicking, catching, or pinching?

• Have you noticed changes in your hip mobility?

• Have you tried stretching or strengthening, and did either help?

These details can help us determine which structures may need closer examination.

2. Evaluating hip mobility

Next, we assess how your hip moves in different directions.

For example, limitations or pain during hip rotation may suggest that the joint deserves further examination.

We also look at mobility in surrounding areas, including the lumbar spine and pelvis when appropriate.

3. Testing muscle strength and symptom responses

We evaluate the strength and function of your hip flexors, gluteal muscles, and other muscles surrounding the hip.

For example, pain when resisting hip flexion may suggest involvement of the hip flexor muscles or tendons.

We may also use specific hip movement tests to help determine whether symptoms appear to be coming from within the joint.

No single physical examination test is perfect, so we consider the overall pattern rather than relying on one finding.

4. Looking at how you move

Finally, we assess the activities that are causing problems.

That might include walking, squatting, climbing stairs, or running.

The goal is to understand not only where your pain is coming from, but also what factors may be contributing to it.

How Physical Therapy Can Help With Hip Flexor and Hip Joint Pain

One of the biggest mistakes people make with persistent hip pain is assuming that every problem needs the same treatment.

For example, aggressively stretching an irritated hip flexor may make symptoms worse.

Similarly, forcing a painful hip joint into deep stretches may aggravate certain joint-related conditions.

That’s why treatment should be based on the findings of your evaluation.

Hands-On Manual Therapy to Reduce Pain and Improve Mobility

At Gordon Physical Therapy in Spokane Valley, WA, hands-on treatment is an important part of our approach to eliminating hip pain.

If the muscles around your hip are painful, tight, or guarded, we may use manual therapy techniques to help reduce discomfort and improve comfortable movement.

Depending on your symptoms and examination findings, this might include:

• Soft tissue mobilization around the hip flexors and surrounding muscles

• Hands-on treatment for painful or guarded muscles

• Hip joint mobilization and traction when appropriate

• Manual treatment of nearby areas that may be contributing to symptoms

We often find it helpful to address pain and movement restrictions early in treatment, especially when discomfort is preventing someone from exercising comfortably.

However, manual therapy isn’t appropriate for every hip condition, and it generally works best as part of a broader rehabilitation program rather than as the only treatment.

Targeted Strengthening and Mobility Exercises

Once we identify the main contributing factors, we can develop an individualized exercise program.

Depending on your condition, this may include:

• Hip flexor strengthening

• Gluteal and hip stabilizer strengthening

• Core and trunk exercises

• Gentle mobility exercises

• Balance and movement retraining

• Gradual return to walking, running, or sports

For hip joint-related pain, we may also modify certain exercises or positions that create painful pinching or excessive joint irritation.

The goal is to improve your ability to move comfortably while building the strength and capacity needed for everyday activities.

Getting Back to the Activities You Enjoy

Whether your goal is to walk without pain, return to running, exercise at the gym, or simply get in and out of your car more comfortably, treatment should focus on the activities that matter most to you.

Our goal isn’t just temporary pain relief.

We want to help you understand what’s contributing to your symptoms and develop a plan to improve your long-term function.

When Should You See a Physical Therapist for Anterior Hip Pain?

An occasional sore hip after an unusually difficult workout isn’t necessarily a cause for concern.

However, an evaluation may be helpful if:

• You’ve had pain in the front of your hip or groin for several weeks

• Stretching your hip flexors isn’t helping

• You experience painful clicking, catching, or pinching

• Walking, running, squatting, or climbing stairs causes discomfort

• Your hip mobility seems increasingly restricted

• The pain keeps returning when you exercise

• You’re unsure whether your symptoms are coming from a muscle or the hip joint

Seek prompt medical evaluation for severe pain after an injury, inability to bear weight, fever with a painful hip, or other rapidly worsening symptoms.

Persistent hip pain shouldn’t automatically be attributed to tight muscles.

Hip Pain Physical Therapy in Spokane Valley, WA

If you’ve been dealing with persistent pain in the front of your hip, you don’t have to keep guessing whether it’s a tight hip flexor, tendon irritation, or something involving the hip joint.

At Gordon Physical Therapy in Spokane Valley, our physical therapists provide individualized, one-on-one treatment in private treatment rooms.

Our approach combines hands-on manual therapy, when appropriate, with targeted exercises designed to improve mobility, strength, and everyday function.

Whether you’re dealing with hip flexor pain, hip joint irritation, or another musculoskeletal problem, our goal is to identify the factors contributing to your symptoms and help you return to the activities you enjoy.

Ready to get your hip feeling better? Call or text us today to schedule an evaluation!

Frequently Asked Questions About Hip Flexor and Hip Joint Pain

How can I tell if my hip pain is muscular or coming from the joint?

Muscle-related pain may be more noticeable when contracting or stretching a particular muscle, while joint-related pain may occur with deep hip bending, rotation, or certain weight-bearing movements. However, these patterns overlap considerably. A physical therapy evaluation can help identify the most likely source.

Can a hip labral tear feel like a tight hip flexor?

Yes. Some people with hip labral problems experience anterior hip discomfort, stiffness, or sensations that resemble muscle tightness. However, these symptoms can also occur with other conditions, so they don’t necessarily indicate a labral tear.

Can hip flexor tendonitis cause groin pain?

Yes. Irritation involving the iliopsoas tendon or other hip flexor structures can contribute to pain in the front of the hip or groin. The term tendinopathy is often more appropriate than tendonitis for persistent tendon-related symptoms because inflammation isn’t always the primary problem.

Will stretching help hip joint pain?

It depends on the condition and the type of stretching. Gentle mobility exercises may help certain hip problems, but aggressive stretching into painful pinching positions may aggravate symptoms. Exercises should be selected based on your specific limitations and symptom responses.

Can physical therapy help a hip labral tear without surgery?

Yes. Many people with labral-related symptoms can improve through individualized physical therapy that addresses strength, movement tolerance, activity modification, and hip function. Some cases require further medical evaluation or surgical consideration, but surgery isn’t automatically necessary.

Can hip pain actually come from my lower back?

Yes. Certain lumbar spine conditions can refer pain toward the hip or groin. That’s one reason a comprehensive hip evaluation may also include an examination of the lower back and surrounding areas.