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Ask the Lab: Hip Flexors

PLEASE NOTE: The medical opinions in USTA.com's Ask the High Performance Lab are responses intended for the average player. Please consult with your primary physician before beginning any new exercise program.

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From: Paul Schulz, Texas: How do you deal with a hip flexor injury?  I have stretches and stuff but after two and half months still feel I cannot move side to side enough to play tennis.

Cori Thompson: Great question! With a hip flexor injury, as with many musculoskeletal injuries, the healing process is based upon three stages of healing. These stages include the acute inflammatory phase, the intermediate (repair) phase, and the advanced (remodeling) phase. Although it has been two and a half months, your muscle remains in the advanced remodeling phase. This phase typically begins three weeks after injury and can last up to six months. During this period, the scar tissue that was formed during the repair phase undergoes remodeling and becomes stronger. Therefore it is necessary to continue treatment and rehabilitation of the hip flexor. This includes ice post practice, flexibility training, and strengthening of the hip region.

Since the hip flexor plays a large role in the movement of the anterior (front) leg during tennis it is important to have full strength before returning to play. The atrophy or weakness that occurs during injury will cause other muscles of your leg to compensate. In your case, difficulty with side to side movement may be caused by the stress placed on the side and back of your leg which is compensating to take the load for the weakness in the hip flexor. For this reason, it is important to strengthen the entire hip. This includes the front, side, and back of the leg. More specifically, be sure to strengthen the quadriceps, hamstring muscle group, hip abductors (iliotibial band) and hip adductors. Here are some exercises that will help you:

Ask the Lab Figure 1b Straight Leg Raise

Ask the Lab Figure 1a Straight Leg Raise

Ask the Lab Figure 2 Forward/Backward Monster Walk

Ask the Lab: Figure 3a Side to Side Monster Walk

Ask the Lab Figure 3b Side to Side Monster Walk

Ask the Lab Figure 4a Squat

Ask the Lab Figure 4b Squat

Ask the Lab Figure 5a Leg Extension

Ask the Lab Figure 5b Leg Extension

In order to allow your body to continue healing and prevent further injury, be sure to perform a proper warm-up and cool down each time you play. The warm up should include dynamic stretching exercises such as straight leg marching and carioca. This will help you increase body temperature and allow your muscles to work more efficiently. After you finish playing cool down with light jogging or biking and static stretching. Both the warm-up and cool down should be done for 10-15 minutes.

About the Author

Cori Thompson, MS, ATC, PES,joined the USTA Sport Science staff in June 2007 as a Strength and Conditioning Coach/ Athletic Trainer. Based in Boca Raton, Cori is responsible for providing strength and conditioning as well as medical support to High Performance players and prospects. She works closely with the Sport Science and Coaching Education staff to provide education, testing, and training to players, coaches and parents.

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