Download a Free Hip Flexor Strengthening Exercises PDF

Maintaining strong and flexible hip flexors is fundamental to movement efficiency and injury prevention, especially for patients recovering from surgery, managing chronic pain, or striving to improve athletic performance.

Addressing hip flexor weakness can be a key component in managing conditions such as hip impingement, low back pain, and gait dysfunction. Why? Because adequate hip flexor strength is crucial for connecting the upper and lower body along the kinetic chain, ensuring efficient and coordinated movement.

To support your clinical practice, we’ve developed a hip flexor strengthening exercises PDF with five progressive exercises designed to guide patients through different stages of recovery and performance improvement. 

In this article, we will explore the benefits of hip flexor strengthening, share strategies for integrating it into your practice, and provide an overview of the exercises included in the program. Start by downloading your free, printable hip flexor strengthening exercises PDF below, and incorporate it into your practice to enhance patient outcomes.

Why strengthen the hip flexors?

The hip flexors, including muscles such as the iliopsoas, rectus femoris, and sartorius, are integral to nearly all lower-body movements. Whether your patients are walking, running, or climbing stairs, these muscles provide stability, control, and force production. Without sufficient strength and flexibility of the hip flexors, patients may adopt compensatory patterns that potentially lead to musculoskeletal complaints.

Identifying patients who need hip flexor strengthening

Understanding when to address hip flexor strength is key to delivering personalized care and improving patient outcomes. 

Hip strains can result from acute injuries, such as falls or direct blows during contact sports, as well as from overuse caused by repeated movements. Intrinsic factors like muscle tightness or prior injury can also increase the risk of strain, highlighting the importance of targeted strengthening and mobility exercises for both prevention and recovery. Patients who may benefit include:

• Post-surgical patients: Individuals recovering from low back or lower body procedures like hip arthroscopy, ACL reconstruction, or total hip replacement often experience weakened hip flexors due to prolonged immobilization, post-surgical precautions, or altered movement patterns. Strengthening these muscles early in the rehabilitation process can help restore functional movement and prevent secondary complications.

• Patients with gait abnormalities: Decreased hip flexor strength can significantly affect walking mechanics. For example, decreased hip flexion during the swing phase could result in compensatory knee lift or lumbar extension. Assessing hip flexor strength and flexibility can guide which targeted interventions could improve gait efficiency.

• Chronic pain population: Patients with persistent hip or low back pain often develop compensatory strategies that overload related body areas, such as the glutes or legs. Addressing hip flexor imbalances can alleviate strain and promote healthier movement patterns, reducing discomfort over time.

During initial evaluations, assessing hip flexor strength and range of motion using manual muscle testing or functional movement assessments can help identify areas of weakness or tightness. This information is essential for tailoring exercises to the patient’s specific needs and ensuring a progressive plan that aligns with their functional goals.

Benefits of hip flexor strengthening

Incorporating structured hip flexor strengthening into your treatment plans provides numerous benefits for patients across different clinical presentations. These include:

• Improved mobility and stability: Strengthening the hip flexors supports hip and lumbar stability which improves coordination between the trunk and lower extremities and reduces strain on adjacent structures, improving overall movement quality.

• Injury prevention: Addressing muscular imbalances and weaknesses of the hip minimizes the risk of overuse injuries throughout the kinetic chain, particularly in the low back, hips, and knees.

• Enhanced athletic performance: Strong hip flexors are crucial for movements requiring power and speed such as sprinting, jumping, and quick directional changes, making them essential for athletes across levels and sports.

Incorporating hip flexor exercises can help your patients reach a variety of movement goals.

Why use the hip flexor strengthening exercises PDF

This handout was designed to support you in improving patient outcomes. Here’s why it’s a valuable addition to your practice:

• Promotes adherence: The structured and straightforward layout of the hip flexor strengthening exercises PDF makes it easy for patients to follow their exercises consistently. By providing clear guidance, you increase the likelihood that patients will stay engaged and complete their program.

• Streamlines patient education: With step-by-step instructions and visuals, the PDF is an easy-to-follow resource. This makes it easier for patients to learn how to perform each exercise, understand the purpose, and ultimately increases their confidence in continuing their exercises independently at home.

• Encourages consistency across care plans: Having a reliable, easily shared resource allows you to provide consistent recommendations for hip flexor strengthening, not only with patients but also with other clinicians involved in a patient’s care plan.

• Saves time in program development: With ready-made, outcome-driven exercises at your fingertips, the hip flexor strengthening exercises PDF allows you to simplify your workflow. It’s a practical solution for busy clinicians who want to deliver high-quality care efficiently.

When to use the hip flexor strengthening exercises PDF

Integrating this resource can benefit your patients at various stages of their rehabilitation journey. 

• Post-surgical rehabilitation: Use the hip flexor strengthening exercises PDF to provide safe, structured exercises that support mobility early in recovery after joint replacements, hip arthroscopy, or other orthopedic procedures. These targeted exercises can help facilitate gradual recovery, reduce strain on healing tissues, and promote restoring functional movement.

• Prevention programs: Provide this resource to individuals with sedentary lifestyles or at risk for developing hip dysfunction. The exercises can help prevent deconditioning and related issues by promoting strength, mobility, and stability in the hip flexors.

• Chronic pain management: The hip flexor strengthening exercises PDF can help address underlying weaknesses or imbalances that contribute to conditions like hip impingement or lower back pain. 

• Return-to-sport protocols: Use these exercises as part of a gradual progression toward return to participation in sports or other high-level activities. Incorporating these exercises into your plan can help patients rebuild the strength and dynamic stability that is foundational in preparing for sport-specific movements.

How to use the hip flexor strengthening exercises PDF

This printable resource is a progressive strengthening guide that helps you tailor exercises based on each patient’s recovery stage. Here’s how you can incorporate the handout into your practice:

• During sessions: Have this resource printed for your patients so they may reference it as you're demonstrating the exercises in real time. They can take notes, and connect what they learned in the clinic to what they do at home.

• For home exercise programs: Provide the hip flexor strengthening exercises PDF as a structured guide for patients to follow independently between visits. Reviewing the exercises in advance and answering any questions can boost their confidence in completing the program at home. You can also encourage patients to use the PDF as a visual reminder to stay consistent with their exercises.

• Convenient access: Print the PDF for patients to take home, or share it digitally for convenience. Offering both options ensures the resource fits seamlessly into their routine, whether they prefer a physical copy to reference during exercise or a digital version they can access on their devices anytime.

5 hip flexor strengthening exercises

Here are five recommended exercises to build hip flexor strength and mobility. These movements start with gentle activation and progress toward functional strengthening, providing an example of how to progress the amount of challenge over time.

1. Seated march

2. Supine hip flexion with resistance loop

3. Mountain climbers (slow)

4. Standing hip flexion AROM

5. Runner’s step up/down

These exercises are designed to target the hip flexors in different functional positions, making them adaptable to various stages of recovery or training. With the hip flexor strengthening exercises PDF, you’ll have clear visuals and instructions to guide your patients in performing each movement safely and confidently, whether during sessions or at home.

Let’s look at how these exercises work and how you can help your patients get the most out of them.

1. Seated march

• Why it works: This low-impact movement gently engages the hip flexors in a supported position, reinforcing neuromuscular activation while minimizing strain. It’s ideal for patients in the early stages of rehabilitation to restore basic mobility.

• Clinician tip: Cue patients to maintain an upright posture and avoid arching their back or leaning backward as they lift their legs.

2. Supine hip flexion with resistance loop

• Why it works: Strengthens the hip flexors in a controlled, supported position while also building core stability. The resistance loop provides an added challenge.

• Clinician tip: Remind patients to keep their hips level and to avoid excessive hip sway while moving their legs to maximize focus on the hip flexor and core muscles.

3. Mountain climbers (slow)

• Why it works: Strengthens the hip flexors while reinforcing core stability and endurance. This movement helps develop coordination and strength necessary for high-demand activities.

• Clinician tip: Direct patients to engage their core by posteriorly tilting the pelvis and maintain alignment of their shoulders over their hands throughout the exercise.

4. Standing hip flexion AROM

• Why it works: This exercise improves hip flexor strength and motor control in a weight-bearing position, progressing patients toward functional activities like stair climbing and running.

• Clinician tip: Encourage patients to keep an upright posture and avoid leaning to the side to maintain focus on hip flexor engagement.

5. Runner’s step up/down

• Why it works: Simulates daily activities like stair climbing and running, enhancing dynamic control and coordination. 

• Clinician tip: Ensure that patients are using a stable step or surface at home for safety. Assess your patient’s single leg stability before having them perform this exercise independently.

A step toward stronger, healthier movement patterns

Incorporating hip flexor strengthening into your care plans gives patients the tools to address key areas of weakness and improve their functional outcomes. By using structured exercises that align with their individual goals, you can help patients recover more effectively, reduce their risk of injury, and enhance their overall quality of movement. With the hip flexor strengthening exercises PDF, you can bridge the gap between in-clinic interventions and home-based programs, fostering consistency and better results.

A patient-centered approach to rehabilitation goes beyond prescribing exercises—it’s about empowering individuals to actively participate in their recovery. By offering clear instructions, outcome-driven movements, and ongoing progress tracking, you can support your patients in building strength, regaining confidence, and achieving long-term success.

Reference

1. American Academy of Orthopedic Surgeons. (n.d.). Hip strains. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/hip-strains/