My son had an iliac crest avulsion fracture in 2 places, which happened while playing soccer, during COVID19. This is how he healed, and the steps we took to get him through this.

I know this is random, but I could not find much information online about this injury nor how other’s recovered from it. So I wanted to write this article to help any other parents with teens who may have a broken hip/growth plate or any similar injury.

Disclaimer: This is our opinion and personal experience. I am not a doctor or physical therapist, so seek medical treatment if you or someone you know has these symptoms. Use any ideas from this article at your own risk.

What Is An Avulsion Fracture?

Wikipedia says:
“An avulsion fracture is a bone fracture which occurs when a fragment of bone tears away from the main mass of bone as a result of physical trauma. This can occur at the ligament by the application of forces external to the body (such as a fall or a pull) or at the tendon by a muscular contraction that is stronger than the forces holding the bone together. “

The avulsion fracture to the iliac crest for a young person is very rare.

From what I understand, it happens with a very specific recipe. This happens almost exclusively to teen boys, aged 15-17, while they are sprinting, playing soccer or other sports requiring quick direction changes.

During a growth spurt, the muscles and the bones grow at different rates, and at any given time, the muscle fibers can be stronger and tighter than the bone.

In my son’s case, the bone along the growth plate, at the iliac crest, was in the weaker part of the growth cycle then the muscles attached to that area at the time of this injury.

How Did The Avulsion Fracture Happen?

During the intense running sprint, with a hard plant of his left leg along with a quick twist of his torso to the right, put pressure on the iliac crest. The muscles pulling on the iliac crest were stronger than the growth plate area of the bone— at that PARTICULAR moment, and pulled the bone apart.

There is a loud “POP”, and the bone is fractured in 2 places.

I would describe this “pop” as “A DEEPER SOUND POP” than the tearing of an ACL, for example, of which I have been around 2 of my own and several of teammates and players.

The sound of the ACL tearing is a higher pitched “POP”, in my opinion. Not that this matters, but, in the moment, when you hear a “POP” of either kind, it raises an immediate fear response. If you have been through any “POPPING” injury, then you will remember exactly what I mean, when time seems to stand still, and you have floods of thoughts of how this has just changed the trajectory of your life.

It’s in the milliseconds before you feel any pain, as you are still falling to the ground, and all your surroundings become extraordinarily clear, slow and intense.

Immediately After The Avulsion Fracture

My son was screaming bloody murder BEFORE he hit the ground, and it was terrifying for his 2 teammates and for all the passers by in the park. Those kind friends stood by him, blocked the sun to shade his face, and were very helpful.

People from the walking path started to gather closer to us as we comforted my son and deciding what to do. The passers by offered to call an ambulance, or to help carry him to our van.

A broken hip was NOT on the list of injuries I was trying to cross off the list of possibilities. It looked like he was grabbing his side, which was confusing. His hip was clearly NOT dislocated and there was no pain on his glut or leg.

His knees were fine, back was fine, ribs were fine. I could NOT figure out what had happened. Yet, he was clearly in pain and was starting to go into shock.

I called my husband for help, who immediately got in touch with some emergency personnel. After describing the fall, they said we could carry him to then car without causing further damage.

We ended up carrying him to the van after and his heart rate had come down a little bit. He was very clammy & grey.

X-rays And Diagnosis of The Avulsion Fracture

Next, a few hours later, we headed to get x-rays. The orthopedic surgeon who knows our family and my son from grade school on, plus previous bone breaks, predicted that our son had torn his rectus femoris muscle (the middle and long quad muscle) off of the bone.

“Oh, no problem, it’s just a few screws to secure it back, and you’ll be up and running in about 14-16 weeks. That’s probably the “pop” you heard, was that coming off of the bone,” said Dr. Jeff Rocca.

This didn’t sound good, but didn’t sound unreasonable with what my son had just gone through.

After 2 sets of x-rays, they found the fractures. One looked like a V and the second was a square chip off the bone.

Activity Before The Avulsion Fracture

He had been working hard, meeting with 2 other friends at the park to run and practice soccer. Their goal was to run 2 miles in under 12 minutes, and to improve all personal soccer skills. His mile was a 6:32, so he was close. He was also working on his ball skills, shooting, kicking and sprinting for the past 6 weeks.

These 3 friends had met at 7:15 am during the summer and they had been meeting for weeks, staying far apart because of the pandemic, but still encouraging one another and working hard.

It’s so much easier to work harder when you have a partner!!

When he broke his hip, he was doing 2 versus 1 with his 2 soccer buddies. They had just run 2 miles in 16 minutes, finished a dynamic warmup & stretching, gone through dribbling, trapping, long kicks and exercises in between including push-ups, burpees, split lunge jumps and pulsing squats.

We were in the last round of the last drill before practice was over. There were girls watching, lol.

Can An Avulsion Fracture Of The Iliac Crest Be Prevented?

This is the question I have been asking myself over and over since.

After coaching soccer for decades, and being around other sports and other activities with thousands of athletes, I have NEVER heard of this injury before. It was hard to find case studies online. That is one reason I decided to put this article on our website, in case anyone else has this happen.

What could you do to prevent it? I’m still wondering about that. My son was in great shape, he was flexible, well balanced with muscle growth and eating plenty of protein and calcium.

It’s not like we can predict where the boys are in their growth cycle at any given time. But, I still feel responsible.

Our Treatment Plan To Heal The Avulsion Fracture Of The Iliac Crest

He healed much faster than we were expecting!

The first few days were the worst. He was very tired, and there was pain even while he was resting without moving.

His worst pain came from scooting out of bed after not moving for a long time. Where the hip had the fracture, naturally, was painful with any muscle pulling on it, or with any pressure on it.

He learned to use his arms and his other leg to push or pull himself while holding the left leg high.

Most of the first fews days were spent in bed or on the couch, only getting up to go to the bathroom. We had to help him stand, and get his crutches ready for the first 2 days, but he figured it out after that and didn’t need our help.

We are feeding him soups and stews in between his remedies, herbal tea, ibuprofen & acetaminophen. He likes Kiefer and other soft foods, like rice pudding or scrambled eggs.

Stairs are a challenge if you have never used crutches before, haha. Crutches go first on your way down, legs go first on your way up, FYI.

The First Week Of Healing:

• Rest (encouraged 14 hours of sleep, plus several naps)
• Walking only with crutches or wheel chair
• No weight for 1 week
• Hydration
• No ice, nothing on broken bone area
• Ibuprofen every 4 hours
• Acetaminophen every 4 hours in between the Ibuprofen
• Arnica 200 (soft tissue healing)
• Symphytum 200 (bone healing)
• Calcaneous Phos 6c (growing pains/growth plate support)
• Ruta Grave. 200 (tendon healing)
• Rhus Tox 200 (ligament healing)
• Acupuncturist’s Herbal Tea 3x day with honey (Dr. Eric Zhao)
• Stretching areas other than his hip (arms, neck, upper back, shoulders, calves, and the other leg)
• Foot, neck and upper back massage
• Getting outside
• Took shower on the 5th day which helped, but it was challenging to figure it out before he could stand alone

It was shocking to have this injury, especially to hear someone say it out loud. He was sad about loosing all the hard work he had put in, plus having a routine and friends to meet during the pandemic was nice. Now, he had to sit for months.
So, we encouraged other things, games, reading, and cooking once he could stand.

Day 10:

We are 10 days into this injury right now, and though pain is low while he isn’t moving, he feels very achy at night after putting any weight on his leg during the day.
He’s only using one crutch and sometimes forgets, but doesn’t feel the pain until later in the day.  His mood is mostly good, but can get down at times.

Second-Fourth Week Of Healing:

• Continued the Tea 3x day
• Continued the Homeopathic remedies 3x day
• No more Ibuprofen or Acetaminophen after the 6th day
• Weight bearing as tolerated after 1 week
• Still using crutches if we go somewhere
• Push-ups, pull-ups about 9 days in
• Deeper & more involved stretches
• Deeper massage, still avoiding the hip area
• Sitting outside
• Watching happy movies
• Reading Harry Potter

Fifth-Tenth Week Of Healing:

• Tea 2x day
• Continued the Homeopathic remedies 2x day
• Walking normally
• Full workouts as tolerated (he couldn’t do planks or any oblique specific exercises, but all else was ok)
• Deeper & more involved stretches
• Deeper massage, still avoiding the hip area
• Started running
• Reading Harry Potter

Week 8:

We went back to the doctor yesterday and had a followup X-ray. His x-rays looked good, the bone wasn’t completely filled in, but was much better. The doctor released him, saying the could do any activity that he could tolerate.
He met his 2 soccer friends to start running again. He was excited to get out there and get his mile running time down. But, it was too early in his healing to try. He didn’t make it 1/2 mile before the needed to walk and then stop. That achy soreness took a few days to go away. This was a big blow to him mentally, and he was down for a few days.

Week 12:

He is working out fully and running again (on a treadmill), this time without pain or aches.  His soccer friends met him and they played for about an hour.  There was no pain during or after.   Because of COVID, there is not a season or practice.  This is his description, “I would be ready to go 100% if there was practice today.”

Week 15:

He is fully recovered, probably for a few weeks now. Yesterday he played touch football for 2 hours without any problem at all. Also, he is running a mile without pain or even a mention of aching or anything different.

Conclusion: How My Son Healed From An Avulsion Fracture

It was an easy injury to heal from as far as injuries go.

The most impact we saw was from the herbal tea and the homeopathic remedies!  We would definitely do those again.

The timing for all of the remedies, tea and meds, were the most complicated part. No ice. No cast or wraps. Just rest and no weight baring.

I was raised in the “Ice on every injury” era, and it was my first instinct.  But, it was better without the ice, and he didn’t want ice on it. This was a change for my thinking, but I’m thankful we did it that way.

He stayed in bed or on the couch for a full week, using the crutches to hold his hip up when he went to the bathroom. He didn’t shower for about 5 days and couldn’t handle it anymore, haha, and then he used a hand held shower head. My husband stood outside the bathroom, and my son stood in the shower with the crutches.

After 7 days, he used a little bit of weight on his leg each day. The doctor said he could add weight as tolerated.

He felt perfect and able to sprint again at around 13-14 weeks.

If you or your teen are going through this and want some support, please email us and we will get back to you. ?

Other articles on healing:

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• 7 Hand Pain Relieving Tips
• What Is Emotional Pain?
• How To Laugh With Your Family To Relieve Stress
• Release Stress & Emotions From Your Body: 19 Effective Ideas