Pain guide · Hip pain

Hip flexor pain when doing sit-ups: the front of the hip, anchored feet, the groin and swaps

Hip flexor pain when you do sit-ups usually comes in the second half of the rep. Once your shoulder blades leave the floor, the hip flexors at the front of the hip pull you the rest of the way up, and in lab studies every kind of sit-up worked them several times harder than a curl-up. Holding your feet down shifts even more work from your tummy to your hip flexors, and bending your knees doesn't switch them off. Where it hurts is the best clue: a pulling ache at the front of the hip is usually the hip flexors working hard, a sudden sharp pain a strain, a deep pinch in the hip crease at the top the hip joint, and a lump in the groin a possible hernia. No study has counted hip pain from sit-ups, so this guide says where its advice comes from: free feet, a crunch or curl-up instead of the full sit-up, fewer reps, and swaps such as the dead bug, side plank and ab wheel usually help. Sit-ups aren't the best way to train your abs anyway.

This guide starts with the signs that need checking, from a 999 call for a femoral hernia (a small lump at the top of the thigh) with very bad tummy pain or being sick, and for numbness around the genitals or bottom, to an urgent general practitioner (GP) appointment or the National Health Service's 111 line (NHS 111) for a hot, swollen hip with a fever, and a GP for a groin lump. It then maps the causes by where it hurts, explains what the muscle studies show about anchored feet, bent knees and the hip flexors, and what the groin and hip studies found, shows how to change your sit-ups today, and gives a three-stage plan with a 3D demo of every move, back to sit-ups with your feet free.

3-stage exercise plan When to get help 52 sourcesUpdated 28 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: severe hip pain after a fall or injury, or you cannot stand, walk or put weight on the leg. In an older adult this can be a broken hip; the leg may be at an odd angle or look shorter. Don't drive yourself.
Call 999 or go to A&E: tingling or loss of feeling in the hip or leg after an injury.
Ask for an urgent GP appointment or get help from NHS 111 if you have severe hip pain that started suddenly but you've not had a fall or injured your hip, your hip is swollen and feels hot, the skin around your hip has changed colour, or you have hip pain, feel generally unwell and have a high temperature (or feel hot, cold or shivery). A hot, swollen hip with a high temperature can be a joint infection.
Call 999 or go to A&E if your child gets sudden pain in their hip, knee or thigh (hip problems can sometimes be felt in the thigh or knee) or cannot put any weight on their leg. If your child is limping, ask for an urgent GP appointment or get help from NHS 111 the same day. This applies to teenagers too, and in some children knee pain is the only sign.
Same day, for an X-ray: a teenager with sudden pain at the front of the hip bone or along its rim during a sprint, kick or jump, often with a pop and no knock, especially if walking or lifting the leg is painful. It can be a piece of growth plate pulled off the pelvis (an avulsion fracture), which is often mistaken for a strain.
Call 999 or go to A&E: loss of feeling or numbness around the genitals or bottom, new trouble peeing or controlling your bladder or bowels, changes in genital sensation during sex or problems with erections or orgasm, or pain, tingling, weakness or numbness in both legs. These are signs of cauda equina syndrome, which needs treating in hospital urgently. Don't drive yourself.
Same day: leg weakness that is getting worse.
Call 999 or go to A&E now if you have a femoral hernia (a small lump at the top of your thigh, in your groin) and very bad tummy pain, you feel sick or you're being sick, you cannot fart or poo, you have a high temperature or you feel hot, cold or shivery, or you've suddenly become confused. Do not drive to A&E. With any other hernia and pain in or around it, a bloated tummy, feeling or being sick, vomiting blood or vomit that looks like coffee grounds, constipation, a high temperature or feeling hot, cold or shivery, or sudden confusion, get help from NHS 111.
Call 999 or go to A&E: tummy pain that started suddenly and is severe, you're vomiting blood or your vomit looks green or like ground coffee, there's a lot of blood coming from your bottom or your poo is black and sticky, you cannot pee at all, you cannot poo or fart at all, you have spots or a rash that does not fade when you press it (it may be harder to see on brown or black skin), or you're struggling to breathe. Don't drive yourself.
Call 999 or go to A&E for severe pain in your tummy, or tummy pain with confusion, blotchy or paler skin than usual, or difficulty breathing, which could be sepsis. Ask for an urgent GP appointment or get help from NHS 111 for tummy pain that is gradually getting worse or doesn't go away, or that moves to the lower right side: appendicitis usually starts around the belly button and can come with feeling or being sick, a loss of appetite or a high temperature.
Go to A&E or call 999 for sudden, severe pain in a testicle, testicle pain with feeling or being sick or tummy pain, or testicle pain that has lasted more than an hour or continues at rest. It can be a twisted testicle (testicular torsion), which needs treating straight away. Don't drive yourself. For aching or discomfort in your testicles that you're worried about, a lump, swelling or a change in a testicle's size, shape or feel, ask for an urgent GP appointment or get help from NHS 111.
Groin or pubic pain with a high temperature, or feeling hot, cold, shivery or generally unwell; severe pain that started suddenly; or you can't move the leg or put weight on it: ask for an urgent GP appointment or get help from NHS 111. An infected pubic joint can look like osteitis pubis and needs treating quickly, usually in hospital. It's more likely after pelvic, bladder or incontinence surgery, with a weakened immune system, or if you inject drugs.
If you take a blood thinner (an anticoagulant) and notice severe bruising or bleeding, get medical help immediately: call 111 or go to A&E. A painful lump in the tummy wall that grows after a cough, a strain or a knock can be bleeding into the muscle (a rectus sheath haematoma), which is more likely on blood thinners and easily mistaken for a strain.
Same day (call NHS 111, or go to A&E if you feel very unwell): after a big or unusual session, such as hundreds of squats, sit-ups, back extensions or burpees, a challenge or a new class, muscle pain, swelling or weakness far worse than the session explains, and dark pee (red, brown, tea or cola coloured), sometimes starting hours or days later. Dark pee isn't always there, so muscles far sorer, more swollen or weaker than the session explains still need the same-day check. It can be rhabdomyolysis, a breakdown of muscle that can harm the kidneys.
Same day, and stop running now: groin or front-of-hip pain in a runner, sometimes felt in the thigh or knee, that builds with running, hurts with every step or at night, or hurts when the hip is turned to the end of its range. Keep weight off the leg, using crutches if you have them, and get an urgent GP appointment or help from NHS 111 the same day: a stress fracture of the hip (femoral neck) needs urgent imaging.

See a doctor or physiotherapist if

Hip pain that stops normal activities or disturbs sleep, keeps getting worse or keeps coming back, or has not improved after 2 weeks of looking after it at home.
Stiffness lasting more than 30 minutes after waking.
Painful catching or locking deep in the groin, or a hip that gives way: get it assessed.
Pain that has not improved after a good 3 months of exercise-based treatment: ask about a hip specialist.
A lump in the groin, upper thigh or tummy, especially one that appears when you cough or strain and goes when you lie down: see a GP, as it may be a true hernia. A femoral hernia (a small lump at the top of the thigh, mainly in women over 50, though it can happen to anyone) needs treating in hospital.
Groin pain just above the crease that comes on when you brace, strain or cough under a heavy lift, with no lump: see a GP or sports physiotherapist, as it is often inguinal-related groin pain, and a lump that appears when you strain may be a hernia (our suggestion).
A strain that is getting worse, or isn't feeling better after looking after it yourself: see a GP or physiotherapist. In many areas you can refer yourself to physiotherapy.
A ridge or doming down the middle of your tummy when you strain, during or after pregnancy: see our diastasis recti guide, and ask about a pelvic health physiotherapist.
Hip or groin pain that hasn't settled after 6 weeks, especially with a normal X-ray, or new hip pain if you take high-dose steroids, drink heavily, or have sickle cell disease or lupus: ask your GP about an MRI (magnetic resonance imaging) scan and a hip specialist. It can be avascular necrosis, which an X-ray can miss early on.
Bone pain that is constant or worse at night, especially with a lump, unexplained weight loss, fever or tiredness, or a past history of cancer.
New weakness lifting your knee or straightening it, a knee that gives way, or numbness on the front of the thigh, especially with back pain: see a GP. A nerve from the upper part of the lower back may be trapped (our suggestion). Weakness or numbness in both legs, or numbness around the genitals or bottom, is the 999 emergency above.
Pain, tingling or numbness spreading below the knee that isn't settling after a few weeks, is getting worse or stops your normal activities: see a GP.
Groin pain with no clear link to sport: see a GP, as it's unlikely to be a sports injury. With blood in your pee, ask for an urgent GP appointment or get help from NHS 111. With pain or burning when you pee, a pharmacist can help first if you're a woman aged 16 to 64 and not pregnant or breastfeeding; ask for an urgent GP appointment or get help from NHS 111 if you're a man, you're pregnant or 65 or over, or you have a very high or low temperature or feel hot, cold or shivery, pain low in your tummy or in your back just under the ribs, or symptoms that get worse quickly or don't improve within 48 hours.

Where does it hurt?

Location narrows the likely causes; it does not diagnose.

The front of the hip or the top of the thigh, a pulling ache as you sit up past halfway, worse with your feet hooked or on a decline bench, easing when you stop

Usually the hip flexors working hard: the commonest pattern in our reading. Free feet, a smaller range or a crunch usually ease it.

A sudden sharp pain at the front of the hip during a sit-up, a kick or a sprint, then pain lifting the knee against resistance

Often a strained hip flexor or an irritated iliopsoas. Our hip flexor guide has the plan.

Read: Hip flexor pain →A deep pinch in the hip crease at the top of a full sit-up, or bringing the knee to the chest, in a younger active adult

Often hip impingement, where the ball and socket meet as the hip bends deeply.

Read: Hip impingement (FAI) →Deep groin pain with catching, locking or painful clicking

Possibly a tear in the labrum, the rim of the socket. Tears also show on scans of many hips that don't hurt.

Read: Hip labral tear →A click or clunk at the front of the hip as you lower, often painless

Usually the hip flexor tendon flicking over bone (a snapping hip), very common in dancers.

Read: Snapping hip →Just above the groin crease, worse with sit-ups, coughing or sneezing, with no lump

Often inguinal-related groin pain, sometimes called a sports hernia.

Read: Sports hernia →A lump in the groin or at the top of the thigh, bigger when you strain or cough, smaller when you lie down

A possible hernia: see a GP, and read the warning signs for when it is urgent.

Read: Groin pain →The inner thigh close to the groin, when your feet are hooked or you squeeze your legs together

Often an adductor (groin) strain, the commonest groin injury in athletes.

Read: Groin strain →A sudden sharp pain in one spot of the tummy wall, sore to tense, cough or sit up

Usually a strained tummy muscle.

Read: Abdominal strain →Across the lower back as you sit up or lower, or the tailbone on a hard floor

Our lower back pain in sit-ups guide covers the back and the tailbone.

Read: Back pain in sit-ups →The front of the neck

The neck muscles lifting your head through every rep.

Read: Neck pain in sit-ups →A stiff ache in the groin or the front of the thigh from mid-life, worse getting going

Often hip arthritis, which is diagnosed without an X-ray from 45.

Read: Hip arthritis →Numbness or weakness at the front of the thigh, often with back pain

Possibly a nerve from the upper part of the lower back. Our lower back and hip guide sorts the back from the hip.

Read: Lower back and hip pain →A teenager with a pop and sudden pain at the front of the hip bone after a sprint, a kick or a hard sit-up

A piece of growth plate can pull off the pelvis. It needs an X-ray the same day.

Read: Hip pointer →

Tummy pain that started around the belly button and moved low on the right, worse moving the right leg, with feeling sick or a fever

Possibly appendicitis rather than the hip: see the warning signs.

Achy fronts of the hips or tummy a day or two after a big ab session

Muscle soreness, which fades within days.

Read: Hip pain after a workout →The same front-of-hip pain when you lift your leg or do leg raises

The same hip flexors on a longer lever: our leg raise and lifting your leg guides cover them.

Read: Hip pain lifting your leg →

Understand it

What a sit-up asks of the hip, and what no study has countedEmerging evidence

A crunch curls your head and shoulders up until your shoulder blades leave the floor. A sit-up keeps going until your trunk is upright, so the hip flexors (the psoas and iliacus deep in the hip, and the rectus femoris at the front of the thigh) pull your trunk up the rest of the way. Every form of sit-up worked the psoas at 15% to 35% of its maximum in 8 people, against under 10% in a curl-up.

Holding the feet down lowered tummy-muscle activity and raised rectus femoris activity in 14 people, and in 23 British Army personnel feet-held sit-ups and curl-ups raised it further as they tired. Bent knees don't switch the hip flexors off: in a small study of 6 men, bent, supported legs raised hip flexor activity in sit-ups that bend at the hip (the iliacus at 80 on that study's scale, against 60 with straight legs and about 17 in a curl that only lifts the trunk). What lowered it was a smaller range, a sit-up that curls the trunk rather than swinging up from the hips, and squeezing the hamstrings as you rise (the Janda sit-up).

No study has counted hip or groin pain caused by sit-ups, tested anchored against free feet for pain, or followed people with hip flexor pain on sit-ups. The lab studies are in healthy, mostly young adults and soldiers.

Sources 1, 2, 3, 4, 5, 6, 7

Who gets it: the groin and hip flexor data come from athletesEmerging evidence

About a third of acute groin injuries in male athletes are hip flexor injuries: in 33 confirmed on MRI (magnetic resonance imaging), the rectus femoris was hurt in 16, the iliacus in 12 and the psoas in 7, rectus femoris injuries mostly from kicking. In 207 athletes with long-standing groin pain, the inner thigh muscles were the main problem in 58% and the iliopsoas in 36%, and in elite football over 7 seasons, 399 hip and groin injuries involved the inner thigh muscles against 52 the iliopsoas.

No study links these injuries to sit-ups. In our reading, it bothers people who jump to full, decline, GHD (glute-ham developer) or weighted sit-ups, timed tests or challenges with their feet hooked, people who also kick or sprint, dancers, and hips with an impingement shape.

Sources 8, 9, 10, 11

The groin, a hernia and the hip jointStrong evidence

An international agreement sorts groin pain in athletes into the inner thigh muscles, the hip flexors (iliopsoas), the area just above the groin crease (inguinal), the pubic bone and the hip joint, and defines hip flexor groin pain as tenderness there with pain when you lift the leg against resistance or stretch the front of the hip. Examination is a rough guide: hip flexor tests placed MRI findings poorly in 81 male athletes. Pain just above the crease is 5% to 20% of groin problems in male athletes, rare in women, and true hernias are rarely found in it.

A true hernia is usually a lump that gets bigger when you cough or strain and smaller when you lie down. Femoral hernias are small lumps at the top of the thigh, mainly in women over 50, and most become tightly squeezed, so they need hospital treatment: in Denmark they were 3% of groin hernia repairs and 70.2% were in women, and in Sweden 35.9% of femoral repairs were emergencies against 4.9% of inguinal repairs. About 27% of men and 3% of women have an inguinal hernia repaired in their lifetime.

For the hip joint, an international agreement says femoroacetabular impingement (FAI) syndrome needs symptoms, examination signs and scan findings together, and a later consensus groups hip-related pain in active adults into impingement, a shallow socket and problems with the labrum or cartilage. In 51 people waiting for surgery, the pain was in the groin in 83% and their hip bend was limited to about 97 degrees on average; the top of a full bent-knee sit-up bends the hip further than sitting does (our reading).

Sources 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22

What a scan shows, and when it mattersStrong evidence

Not at first for a hip flexor ache or a strain: the NHS says try home care for 2 weeks and see a GP if it isn't improving. Scans of hips without pain often show bumps and tears: an impingement-shaped ball in 37% of 2,114 pain-free hips (54.8% of athletes) and labral damage in 68%, and labral tears in 54% of people without hip pain against 62% with it. Hip tests are good at ruling out but offer only screening accuracy.

Tests matter for a lump in the groin (a GP examines it first), a teenager's pop at the front of the hip bone (an X-ray the same day), groin pain in a runner that builds with every step, catching or locking, and pain that hasn't settled after 3 months of exercise.

Sources 23, 24, 25, 26, 27, 15

How it usually goesEmerging evidence

No study follows hip flexor pain from sit-ups. Our hip flexor guide says mild strains often settle within a few weeks of gradual loading. Snapping at the front of the hip is very common and often painless: 91% of 87 elite ballet dancers reported one, and 58% had pain with it. A review says most snapping hips settle with 6 to 12 months of non-surgical care, and 97% of 228 teenage pelvic avulsions healed without surgery, though 14% still had pain after 3 months. For hip impingement, a consensus asks for at least 3 months of exercise-based treatment. No one can promise a date.

Sources 28, 29, 30, 31, 27

What helps, and how strong the evidence is

Feet free and a smaller range take work off the hip flexorsEmerging evidence

Holding the feet moved work from the tummy to the hip flexors in two lab studies (14 people and 23 soldiers), and a part sit-up with a short hand slide gave the lowest rectus femoris activity. Bent knees didn't help in a small study of 6 men, where bent, supported legs raised hip flexor activity. A sit-up that curls the trunk worked the tummy more and the rectus femoris less than the traditional army sit-up in 18 men, and the Janda sit-up lowered rectus femoris activity in 16 men. These are muscle studies in healthy people; none tested pain.

Sources 4, 5, 2, 1, 6, 7

Sit-ups aren't the best ab exerciseStrong evidence

Of 12 ab exercises in 9 volunteers, partial curl-ups gave the most tummy work for the least load on the spine, and a fine-wire study found the side bridge the best exercise for the tummy wall. The ab wheel roll-out drew 63% of the upper six-pack's maximum with rectus femoris activity of only 6% to 10%, as low as the crunch. The bent-knee sit-up, the ab wheel pike and knee-up and an incline reverse crunch drew the highest rectus femoris activity, which the authors say may be a problem for some people with back pain.

Sit-ups don't burn belly fat either: 6 weeks of ab exercise didn't reduce belly fat, waist size or skinfolds in 24 adults. One small trial in 16 men reports a small local fat loss, so any effect is small and contested.

Sources 32, 1, 33, 34, 35, 36, 37

Sit-ups and the back: no extra harm found in soldiersStrong evidence

In a model of 12 young men, full sit-ups compressed the lower spine by more than 3,000 newtons whether the knees were bent or straight. Yet in 1,141 young soldiers, sit-up training caused no more injuries than core exercises, and in 4,147 soldiers followed for 2 years, core exercises prevented no more back pain than a daily programme of sit-ups and crunches. Core work alone kept sit-up test scores up. These were healthy young soldiers, so sit-ups aren't harmful for most backs, though a sore back swaps them, as our lower back sit-up guide explains.

Sources 38, 39, 40, 41

Hip flexor strength responds quickly to band trainingEmerging evidence

In 33 healthy adults, about 10 minutes of elastic-band hip flexor training 3 times a week for 6 weeks, building from a weight they could lift 15 times to one they could lift 8 times, raised hip flexion strength by 17%. It hasn't been tested in people with pain, but it is a sensible way to load a recovering hip flexor, which the international groin agreement recognises as a distinct cause of groin pain. Stretching the hip flexors improved hip extension over 6 weeks in 33 people, whether done passively or actively, but stretching isn't a treatment for a fresh strain: loading comes first.

Sources 42, 12, 43

Hip impingement: exercise first, and surgery's edge is smallMixed evidence

An international consensus recommends exercise-based treatment for at least 3 months, staying physically active (sport included) and shared decisions. In the UK FASHIoN trial (348 people), keyhole surgery beat personalised physiotherapy by 6.8 points on a 100-point hip quality-of-life score at a year, just above the smallest difference patients notice; in the FAIT trial (222 people), by 10.0 points on a function score at 8 months. In a US military trial of 80 people there was no clear difference at 2 years, and a 2025 analysis of 21 trials found differences below what patients notice. Exercise first, and a hip specialist if 3 months hasn't helped.

Sources 31, 44, 45, 46, 47

Hernias: a GP for a lump, surgery for symptomsStrong evidence

International guidelines say groin hernias that cause symptoms should be treated surgically, and name being female and having a femoral hernia among the risk factors for a hernia becoming stuck. The NHS recommends surgery for a femoral hernia because it can become strangulated, and after an inguinal hernia repair says no heavy lifting or strenuous activity for at least 4 to 6 weeks.

Sources 48, 16, 49, 18

How much pain is OK while you exercise?

Up to about 5 out of 10, settled within an hour, no worse the next morningEmerging evidence

This guide uses the hip hub's rule, as our other hip movement guides do. During the exercise, pain up to about 5 out of 10 is acceptable. It should settle within an hour or so, and your hip should be no worse that night or the next morning. If it is, do less next time (fewer repetitions, a smaller range, a lighter load), not nothing. Pain can go up a little when you start a new exercise programme; guidelines for arthritis say so and still recommend keeping going. If pain climbs week after week, or a warning sign appears, stop and get it checked.

For pain just above the groin crease, it adds our sports hernia guide's next-morning check. Coughing, sneezing, sitting up from lying and a resisted sit-up are the movements that bring this pain on. If they're more painful the next morning than before, the load was too much: drop back a step (our suggestion).

When the lower back is involved, our back guides' rule applies. Some discomfort during exercise is fine, and it does not mean you are doing damage. Aim for pain you would call mild to moderate, no more than about 5 out of 10. It should settle within an hour or so, and your back should be no worse the next morning. If it is worse, do less next time (fewer reps, a smaller range, a lighter load), not nothing.

The 5 out of 10 limit matches NHS inform's hip exercise bands (0 to 3 minimal, 4 to 5 acceptable, 6 to 10 excessive, and no worse the morning after), and the pain-monitoring model was used with continued activity, without harm, in Achilles tendon pain. In long-lasting pain, exercise that allowed some pain did no worse than pain-free exercise across 7 trials, none in the hip. For a fresh hip flexor strain, our hip flexor guide keeps pain at 3 out of 10 or less in its first stage.

For sit-ups (our suggestion, built on the same rule): judge each set by its last reps and by the next morning, and use the step of the ladder (dead bug, curl-up, crunch, part sit-up with free feet, full sit-up, then decline sit-ups and tests), the range and the number of reps where the front of the hip stays at 5 out of 10 or less (3 for a fresh strain). If not, go back one step, not to nothing. A pinch in the hip crease is a range question: stop the rep before it. A lump in the groin, a pop, tummy pain with feeling sick, or pain, tingling or numbness down a leg isn't a pain-rule question: see the warning signs.

Sources 50, 51, 52

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Keep training your trunk, take the hip flexors out of it

About weeks 0 to 2: tummy and trunk work that doesn't bend the hip under load, gentle hip flexor movement, and walking. No full, decline or GHD sit-ups, V-ups, hanging knee raises or leg raises for now. With a diagnosed condition (a strain, impingement, a labral tear, a hernia or a repair, a teenager's avulsion), that guide's plan or your team's comes first.

Dead bug heel taps demonstrated on the 3D figure

3D demoDead bug heel tapsBeginner · No equipment

2 sets of 6 to 8 each side · As in our hip flexor and lower back sit-up guides (editorial)

Easier: Bent-knee fall-out · Harder: Forearm plank

McGill curl-up demonstrated on the 3D figure

3D demoMcGill curl-upBeginner · No equipment

Holds of about 10 s in falling sets of 5, 3 and 1, chin slightly tucked · As in our McGill big 3 routine, as our lower back sit-up guide uses it (editorial)

Harder: Crunch

Chest lift (Pilates curl-up) demonstrated on the 3D figure

3D demoChest lift (Pilates curl-up)Beginner · No equipment

8 to 10 reps · The move page's dose. Rest your head between reps (our lower back sit-up guide's cue)

Harder: Single-leg stretch (Pilates one leg stretch)

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

2 sets of 10 · As in our hip flexor guide (editorial): the hip straightens while the hip flexors rest

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Knee side plank demonstrated on the 3D figure

3D demoKnee side plankBeginner · No equipment

3 holds of 15 to 20 s each side · As in our back pain and lower back sit-up guides (editorial). The side bridge trained the tummy wall best in a lab study

Harder: Side plank

Standing march demonstrated on the 3D figure

3D demoStanding marchBeginner · No equipment

10 each side, a low knee · As in our hip flexor guide (editorial): gentle hip flexor work without a long lever

Easier: Seated march · Harder: Standing band hip flexion

Move on when: Walking and stairs are comfortable, these pass the pain rule (3 out of 10 for a fresh strain), and your hip is no worse the next morning, for a week (editorial, as in our hip flexor guide).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Load the hip flexors gently, and curl a little more

About weeks 2 to 6, 2 or 3 sessions a week: hip flexor strength with a band, crunches with your feet free, and holds that resist arching and bending sideways.

Standing band hip flexion demonstrated on the 3D figure

3D demoStanding band hip flexionBeginner · A band + An anchor point

3 sets, 3 times a week, building from a weight you could lift 15 times to one you could lift 8 times over the weeks · The Thorborg trial's progression, as our hip flexor guide uses it

Easier: Standing march · Harder: Captain's chair knee raise

3D demoCrunchBeginner · No equipment

2 sets of 12 to 20, feet free, fingertips light at your head, stopping 1 to 3 reps short of failure · The crunch track of our crunch and sit-up workout (editorial)

Easier: McGill curl-up · Harder: Sit-up (3/4 sit-up)

3D demoDead bugBeginner · No equipment

2 to 3 sets of 6 to 8 each side · As in our lower back sit-up and hip flexor guides (editorial)

Easier: Dead bug heel taps · Harder: Forearm plank

Side plank demonstrated on the 3D figure

3D demoSide plankIntermediate · No equipment

2 holds of 15 to 30 s each side · Our crunch and sit-up workout's dose (editorial)

Easier: Knee side plank · Harder: Side plank with leg lift

Straight-leg raise demonstrated on the 3D figure

3D demoStraight-leg raiseBeginner · No equipment

2 to 3 sets of 8 to 10 each side, lowering slowly · As in our hip flexor guide (editorial). Skip it if it pinches: the hip flexors work hardest around 60 degrees of lift

Easier: Quad set (static quads) · Harder: Leg extension

Half-kneeling hip flexor stretch demonstrated on the 3D figure

3D demoHalf-kneeling hip flexor stretchBeginner · No equipment

2 to 3 holds of 30 s, a mild stretch only, once loading is pain-free · As in our hip flexor guide (editorial)

Harder: Couch stretch

Move on when: Band hip flexion is strong and passes the pain rule on both sides, and 2 sets of 20 crunches are easy and comfortable the next morning (editorial; 20 is our crunch and sit-up workout's step).

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to sit-ups, feet free

From about weeks 4 to 8, often later: sit-ups with your feet free, then your usual ab work, one change at a time by the written steps below, keeping the tummy-heavy swaps. No trial has tested a return to sit-ups after hip flexor pain, so the order is editorial.

Sit-up (3/4 sit-up) demonstrated on the 3D figure

3D demoSit-up (3/4 sit-up)Intermediate · No equipment

2 sets of 8 to 15, feet free if you can, lowering three-quarters of the way under control, stopping 1 to 3 reps short · The sit-up track of our crunch and sit-up workout (editorial), once 2 sets of 20 crunches are easy

Easier: Crunch · Harder: Jackknife sit-up (V-up)

Ab wheel rollout from the knees demonstrated on the 3D figure

3D demoAb wheel rollout from the kneesAdvanced · An ab wheel

3 sets of 6 to 10, rolling towards a wall only as far as your back stays flat · Step 3 of our ab wheel progression workout (editorial). Little hip flexor work in a lab study

Easier: Suspension trainer fallout · Harder: Standing ab wheel rollout

Forearm plank demonstrated on the 3D figure

3D demoForearm plankIntermediate · No equipment

3 holds of 20 to 45 s · Our plank guide's dose, as our lower back sit-up guide uses it (editorial)

Easier: Stomach vacuum (drawing-in) · Harder: Plank walk-up

Reverse crunch demonstrated on the 3D figure

3D demoReverse crunchIntermediate · No equipment

2 to 3 sets of 8 to 12, a small curl, a mat under your tailbone · As in our lower back sit-up and tummy strain guides (editorial). On the flat, not an incline

Easier: Cross-body crunch · Harder: Captain's chair knee raise

Hanging knee raise demonstrated on the 3D figure

3D demoHanging knee raiseIntermediate · Pull-up bar

3 sets of 6 to 10, last and only if your sport needs it · As in our hip flexor guide's last stage (editorial): a heavy hip flexor move

Easier: Reverse crunch · Harder: Hanging straight-leg raise

Move on when: Your usual ab sessions pass the pain rule for 2 weeks. Keep to about 60 bending reps a session at most (our sit-ups guide, from one expert review), and if a session flares it, go back a stage for a few days, not to nothing (editorial).

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Your sit-up for now (written steps)

Our 3D figure can't show where your feet go, how far you come up or a test's rules. These steps come from lab studies, our sit-ups guide and the NHS; where a step is our suggestion, it says so. No trial has tested a change to the sit-up for hip flexor pain.

1. Feet free, not hooked under a bar or held by a partner: holding them moved the work from your tummy to your hip flexors in two lab studies. Hook them lightly only while you can't come up without it (our sit-ups guide).
2. A crunch or curl-up instead of the full sit-up while it hurts, curling until your shoulder blades leave the floor.
3. Don't rely on bending your knees more: in a small study of 6 men, bent, supported legs raised hip flexor work. Keep them bent for comfort and your back.
4. A pinch in the hip crease: stop before your trunk comes fully upright, since the deepest hip bend is at the top (our suggestion).
5. If your sport or a test needs sit-ups, try the Janda version: press your heels down and squeeze your hamstrings as you rise, which lowered hip flexor work in a lab study.
6. Fewer reps, slowly, breathing out as you curl, 2 or 3 days a week, about 60 bending reps a session at most (our sit-ups guide; the 60 is one expert review's untested suggestion).
7. Leave decline, GHD, weighted and V-up sit-ups and timed tests until the last stage passes the pain rule (editorial).
8. Keep moving: the NHS says keep moving if you can without overdoing it, and avoid carrying heavy things and sitting in low chairs while your hip hurts.

Sources 4, 5, 2, 22, 7, 27

Back to your usual training and sport (written steps)

No study has tested how sit-ups come back after hip flexor pain, so these steps are our suggestion unless a source is named.

1. One change at a time: more crunches, then part sit-ups with free feet, then full sit-ups, then decline or weighted sit-ups, then tests and challenges.
2. Running, kicking and sprinting come back after band hip flexion and part sit-ups pass the pain rule, with short strides and easy kicks first (editorial; our hip flexor guide stages them).
3. Before a sit-up test that holds your feet, practise that way for a few weeks with your fingertips light; core work alone kept soldiers' sit-up test scores up.
4. After a hernia repair: no heavy lifting or strenuous activity for at least 4 to 6 weeks, then build up, following your surgical team (the NHS).
5. Keep two days a week of planks, side planks and dead bugs alongside.
6. If a session flares it, go back a stage for a few days, not to nothing.

Sources 41, 49

Positions to swap, and why

Habit or position	Why it matters	Instead
Feet hooked under a bar or held by a partner	It lowers tummy work and raises hip flexor work, more so as you tire.	Feet free, in a crunch for now.Try: Crunch
Full sit-ups while the front of your hip hurts	The hip flexors do the second half of the rep.	A curl-up or chest lift.Try: McGill curl-up
Bending your knees more as the fix	Bent, supported legs raised hip flexor activity in a small study.	Feet free and a smaller range.
Coming all the way up into a pinch in the hip crease	The deepest hip bend is at the top, and hips with impingement bend less.	Stop before the pinch, or crunch instead.Try: Crunch
Decline, GHD or weighted sit-ups and timed tests	The heaviest versions, which the GHD sit-up's move page says to avoid with current back pain.	Flat crunches, then part sit-ups.Try: Crunch
Hanging knee raises, leg raises and V-ups while it's sore	Long-lever, hard-working hip flexor moves: the hip flexors work hardest around 60 degrees of lift.	Dead bug heel taps.Try: Dead bug heel taps
Incline reverse crunches	Among the highest hip flexor activity of the ab exercises tested.	The ab wheel roll-out from the knees, later.Try: Ab wheel rollout from the knees
Hard hip flexor stretching on a fresh strain	Loading comes first, and stretching hard early is likely to aggravate a strain, as our hip flexor guide says.	Standing marches and band work.Try: Standing march
Hundreds of sit-ups in a challenge	Muscle breakdown has followed sudden, unaccustomed volume, as the warning signs say.	About 60 bending reps a session at most, and planks.Try: Forearm plank
Ignoring a groin lump that comes and goes	It may be a hernia, and a femoral hernia can become strangulated.	See a GP; the warning signs say when it is urgent.
Resting completely	The NHS says keep moving if you can, without overdoing it.	The stage 1 moves.Try: Dead bug heel taps

Routines to follow

Crunch and sit-up workout: from the crunch to the full sit-up

A 15-minute ab workout with a crunch track and a sit-up track, about 60 bending reps at most, plus a side plank and bird dog to balance it.

15 minBeginner10 movesNo equipment

Beginner core workout

A 15-minute beginner core workout on the floor: dead bugs, bird dogs, knee planks, side planks and curl-ups.

15 minBeginner6 movesNo equipment

McGill big 3 core routine

The McGill big three for the core: curl-ups, side planks and bird dogs, each held for 10 seconds at a time in falling sets of 5, 3 and 1 reps.

12 minBeginner3 movesNo equipment

Ab wheel progression workout: from planks to full rollouts

A 20-minute ab wheel ladder: planks, fallouts, kneeling rollouts to a wall and at full reach, barbell rollouts from a bench, then standing rollouts.

20 minBeginner8 movesAn anchor point, An ab wheel

Tight hip flexors routine: stretch, then strengthen

Hips that feel tight: a tucked hip flexor stretch, then band knee drives, leg raises, dead bugs, bridges and lunges. Strength through range loosens hips too.

15 minBeginner8 movesA band, An anchor point

Stretch-and-strengthen Pilates for the hip flexors: a 25-minute class for the front and back of the hip

A 25-minute Pilates class for the hip flexors: pelvic control, hip flexor strength, the glutes and back of the hip, and a gentle pelvis-tucked stretch.

25 minBeginner16 movesA band, An anchor point

More moves for this area

Questions people ask

Why do my hip flexors hurt when I do sit-ups?

Once your shoulder blades leave the floor, your hip flexors pull you the rest of the way up, and sit-ups worked them several times harder than curl-ups in a lab study. Holding your feet down shifts even more work to them. Free feet, a smaller range or a crunch usually ease it.

Should I anchor my feet when doing sit-ups?

Leave them free if you can: anchoring lowered tummy-muscle work and raised hip flexor work in lab studies. Hook them lightly only while you can't come up without it.

Does bending my knees take the hip flexors out of a sit-up?

No: in a small study of 6 men, bent, supported legs raised hip flexor activity. Keep your knees bent for comfort, but it's free feet and a smaller range that spare the hip flexors.

Why do I get a pinch in my hip at the top of a sit-up?

The hip bends furthest at the top, and a pinch there can be the ball and socket meeting, as in hip impingement, where hip bend is often limited. Stop before the pinch or swap to a crunch. See a GP or physiotherapist if it catches, locks or keeps coming back.

Why does my groin hurt when I do sit-ups?

Pain just above the groin crease with sit-ups and coughing is often inguinal-related groin pain, the inner thigh can strain when your feet are hooked, and a lump that comes and goes may be a hernia. Our groin pain and sports hernia guides cover each.

Could it be a hernia?

A lump in the groin or at the top of the thigh that gets bigger when you strain and smaller when you lie down can be: see a GP. A femoral hernia with very bad tummy pain or being sick is a 999 call, and any other painful hernia with sickness or a swollen tummy needs NHS 111.

Can sit-ups cause a hip flexor strain?

They can, like a kick or a sprint start, though no study has counted it. About a third of acute groin injuries in male athletes are hip flexor injuries, and a sudden sharp pain at the front of the hip is the sign.

What ab exercises don't use the hip flexors?

Crunches, curl-ups, dead bugs, side planks and the ab wheel roll-out from the knees use them much less than sit-ups. In lab studies the crunch and the roll-out drew little hip flexor activity, and the side bridge trained the tummy wall best.

Are sit-ups bad for you?

Not for most healthy people in sensible doses: young soldiers who trained sit-ups had no more injuries than those doing core exercises. They aren't the best ab exercise, though, and they load the hip flexors and the lower back more than crunches.

Do I need a scan?

Usually not at first: bony bumps and labral tears are common in hips that don't hurt. A lump, a teenager's pop at the front of the hip bone, or pain that hasn't settled after 3 months of exercise needs checking, sometimes with a scan.

How long will it take to get better?

A mild hip flexor strain often settles within a few weeks of gradual loading, and the NHS says see a GP if hip pain hasn't improved after 2 weeks at home. No one can promise a date.

When should I see a doctor?

Call 999 for a femoral hernia with very bad tummy pain or being sick, or for numbness around your genitals or bottom or new bladder or bowel trouble. Get a same-day check for a hot, swollen hip with a fever or a teenager's pop at the hip bone, and see a GP for a groin lump or pain that isn't improving after 2 weeks. In the US, call 911 where this page says 999.

Related exercise guides

Sit-ups guide

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.

When to get help first

Get urgent medical help if

See a doctor or physiotherapist if

Where does it hurt?

Understand it

What a sit-up asks of the hip, and what no study has countedEmerging evidence

Who gets it: the groin and hip flexor data come from athletesEmerging evidence

The groin, a hernia and the hip jointStrong evidence

What a scan shows, and when it mattersStrong evidence

How it usually goesEmerging evidence

What helps, and how strong the evidence is

Feet free and a smaller range take work off the hip flexorsEmerging evidence

Sit-ups aren't the best ab exerciseStrong evidence

Sit-ups and the back: no extra harm found in soldiersStrong evidence

Hip flexor strength responds quickly to band trainingEmerging evidence

Hip impingement: exercise first, and surgery's edge is smallMixed evidence

Hernias: a GP for a lump, surgery for symptomsStrong evidence

How much pain is OK while you exercise?

Up to about 5 out of 10, settled within an hour, no worse the next morningEmerging evidence

The exercise plan: 3 stages

Keep training your trunk, take the hip flexors out of it

Load the hip flexors gently, and curl a little more

Back to sit-ups, feet free

What to change for now

Your sit-up for now (written steps)

Back to your usual training and sport (written steps)

Positions to swap, and why

Routines to follow

Crunch and sit-up workout: from the crunch to the full sit-up

Beginner core workout

McGill big 3 core routine

Ab wheel progression workout: from planks to full rollouts

Tight hip flexors routine: stretch, then strengthen

Stretch-and-strengthen Pilates for the hip flexors: a 25-minute class for the front and back of the hip

More moves for this area

Questions people ask

Related exercise guides

Other pain guides

Sources