As spoken about in previous articles, the youth footballer is particularly susceptible to growth-related pain and injuries which occur around the growth plates.
To recap, growth plates are located all over the body and are at the end of a bone where muscles/tendons attach - There are lots of these around the pelvis! They are one of the “weak links” in the body and are prone to injury from direct trauma or repetitive stress due to not yet being fused properly in children and adolescents.
Growth-related injuries, known as “apophysitis”, simply means inflammation of a growth plate. In the pelvis, this is most common in adolescents between the ages of 14 and 18 years old.
Where are these growth plates on the pelvis?
The five main growth plates around the pelvis are shown in the pictures below:
Anterior Superior Iliac Spine (ASIS) - this is the pointy part that you can feel at the front of the pelvis.
The sartorius muscle attaches here, which helps mainly with flexing the hip.
Anterior Inferior Iliac Spine (AIIS) - another bony point at the front of the hip where your biggest quadricep muscle attaches, rectus femoris. This also works to flex the hip and straighten the knee - a very important muscle for footballers!!
Iliac Crest - the curved part of the pelvis where the abdominal muscles attach to
Pubic symphysis - this is where the adductor tendons attach to and these muscles are extremely important for changing direction and side-foot passing during football
Ischial tuberosity - located at the back of the pelvis, the hamstrings attach here which are important for running and sprinting
Due to the nature of football and movements required, the ASIS and AIIS are the most common locations for apophysitis - as mentioned above the muscles that attach here are responsible for movement during running, sprinting and kicking so you can see why these may be placed under stress! When combined with rapid growth spurts this can be a major contributor to pain in these areas.
How do I know if the growth plates are the problem?
Apophysitis can often be mistaken for a muscle strain due to the crossover in symptoms experienced but the main symptoms are usually:
Dull pain in the groin or front side of the hip
Pain that gets worse with continued activity
Tenderness over the site of injury
How is this problem managed?
Resting from the aggravating activity is the most important part of the management of this complaint - you should be completely pain free before returning to football as returning too soon can actually make the pain worse. Ice is recommended several times a day to help with the pain initially. Once daily activities can be completed with no pain in the area, gentle stretching and strengthening of surrounding muscles can be initiated and progressed gradually until you are ready to start sport-specific activities. Things like sports massage can also be a great help for painful areas too!
A Sports Therapist can help to guide you through this process, providing advice on activities and providing a bespoke stretching and strengthening plan to match your progress in recovering from this type of injury, as well as advice on how to safely return to football!
Here at SV Sports Therapy, we can help young footballers and athletes to deal with growth-related injuries by assessing their individual needs, using a variety of treatment methods and providing bespoke rehabilitation and management plans to get them safely back onto the pitch pain-free.
Did you know that alongside SV Sports Therapy, Emily works alongside the academy at Watford Football Club, providing pitch-side first aid, injury assessment and injury rehabilitation to players aged 9-16? She knows her stuff!
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She would love to serve you!