Sports Medicine: Pelvic Apophysitis

Apophysitis (uh-paa-fuh-sai-tuhs) is pain and swelling (inflammation) of a growth plate that has a muscle attached to it and can happen in many locations throughout the body. The growth plate is an area of weakness and is prone to injury. Apophysitis occurs because of repeated stress to the muscles that attach at that site. Pelvic apophysitis refers to the group of growth plates around the hip and pelvis.

Sometimes the muscles will pull the growth plate away from the rest of the bone (avulsion fracture) and it is important to be able to tell apophysitis apart from this injury. Because the growth plates in the pelvis close later than many other growth plates in the body, athletes are at risk for this injury into their late teens and early 20s.

Signs and Symptoms

  • Tender to the touch along the growth plate
  • Usually starts slowly and then gets worse
  • Pain with activity like running, jumping, kicking, and with twisting like batting or pitching

Increased Risk

  • Intense or repeated exercise, such as running and jumping, with quick increase in the amount of exercise done
  • Sports that require body twisting (golf, baseball)
  • Sports that require sprinting and kicking (soccer, football)
  • Growth spurts
  • Poor physical conditioning (decreased strength and flexibility)

Treatment

  • Medicine
    • Anti-inflammatory medicines like ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
    • Other minor pain relievers like acetaminophen (Tylenol®) may be taken.
  • Use of cold and heat
    • Cold should be applied for 10 to 15 minutes every 2 to 3 hours and after any activity that makes symptoms worse. Use ice packs or an ice massage and raise the foot and ankle at or above heart level to reduce swelling.
    • Heat may be used before doing stretching and strengthening activities ordered by your doctor, health care provider, or athletic trainer. Use a heat pack or a warm soak. Apply for 10 to 15 minutes.
  • Rest
    • Decreasing or stopping painful activity may be necessary to allow the injury to heal.
  • Exercises
    • Exercises to improve strength and flexibility of the abdominal and hip muscles are helpful. These can be done at home, but often a referral to a physical therapist or athletic trainer may be advised by your health care provider along with a slow return to sports.

How to Prevent

  • Do correct warm-up and cool down before and after practice or competition.
  • Exercise carefully, avoid extremes.
  • Maintain proper conditioning, strength, flexibility, endurance, and cardiovascular fitness.
  • Use proper technique.

When to Call the Doctor

Call your doctor, health care provider, or the Sports Medicine team at (614) 355-6000 if:

  • Symptoms get worse or do not improve in 4 weeks, even with treatment.
  • New, unexplained symptoms develop.

 

Sports Medicine: Pelvic Apophysitis (PDF)

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