Any physical therapists, or knowledgeable in othropedics, in here?

[ct]

My step-son, age 14, hurt his hip a a bit over a month ago at a track meet. Non-contact, a sprint event. Never said anything about any popping or feel anything slipping, so we didn't go to the doctor, just went with a rest stretch rehab. Not sure how much he followed with the stretching part though, he's 14 ya know?

He sat out most the rest of track season, but did try just before the final meet to start jogging during practice, which was fine, no problems. But the day before the final meet, he tried a 3/4 effort sprint as a test, and couldn't do it. Said he would reach a point and his hip just had no strength, and his left just would cooporate, like he was dragging a dead leg. This concerned me, but we still just went with rest.

So yesterday, about 3 weeks later now, he really straings himself in P.E., during some running exercises. This time, he can barely walk, so to the Dr. we go, his regular Ped office. Our insurance requires a referral to a specialist, so we have to go here 1st. They take x-rays, and initially they say nothing structually seems wrong, but they will take a closer and longer look, and set up an appt with the Orthopedist(for 2 weeks out, but they're still working to get him in Monday). Today they call my wife with an update on rescheduling his appt progress (none so far), and more info on the x-ray. The Dr detects a slight fracture in his ilium, and sees the muscle has torn away from the bone(this is what I had been afraid of all along). They aren't sure what the ortho will want to do, as in surgery or not, but for sure he's looking at a lot of physical therapy, probably 6-8 weeks of no running.

What really tears me up here, is I've got a healthy (I hope), active, and pretty strong and athletic (helluva lot better than me, good for him he's got better genes then mine!) 14 year old boy, with a fractured hip. That just freaks me out!

Anyone out there with any knowledge of orthopedics or physical therapy have any advice or information?

Thanks in advance!

[Phobia]

Actually, I believe we have a regular who is local to you. Hopefully she'll see this. I think her handle is WarCry.

[Demonpenz]

not much you can do just listen to the doctors and have him rest as much as he can. Whenever i get hurt the stupidest thing i do is get back out there to fast and not rest enough, i am a knuckle head and always go right back to lifting even though i know i shouldn't

[tyton75]

Don't worry.. he's young.. he'll bounce right back..

just make sure that he doesnt' get any Icy/Hot on his package!

[ct]

My thoughts all along was a simple muscle or ligament/tendon strain, or a bit worse on the same tract a muscle or ligament/tendon tearing away from the bone partially. Both of which just need rest to heal up fine. Keep in mind after the track meet the kid was fine! He was certainly sore, and his mobility was not what it should be, but that's exactly what you'd expect of a minor injury.

Another note, Zach has been known to 'drama queen' his injuries before, even requiring 2 costly trips to ERs for 'nutin to see here, go home, and we'll bill ya later' things.

[Kclee]

And he hasn't had a MRI? Just X-rays?

[Simplex3]

Another note, Zach has been known to 'drama queen' his injuries before, even requiring 2 costly trips to ERs for 'nutin to see here, go home, and we'll bill ya later' things.
You did the right thing. My mom never believed me about my knee hurting. 5 years later she took me to the doc just to shut me up. She was pretty sorry about the whole thing after the surgery. Of course the defect in my knee only got worse while it wasn't treated, I've had another surgery since and I'm due for another in the next year or two. You only have one chance to get "it" fixed in time.

[ct]

And he hasn't had a MRI? Just X-rays?

Not at the pediatrician, only x-rays. The orthopedist will I'm sure.

[Kclee]

Not at the pediatrician, only x-rays. The orthopedist will I'm sure.

That's when you should know exactly what you're dealing with.

[BIG_DADDY]

Good luck with that Cory, sorry to hear it.

[penguinz]

and sees the muscle has torn away from the boneHow can they tell this from an x-ray? You would need an MRI to see a muscle dettachment or tear.

[Kclee]

How can they tell this from an x-ray? You would need an MRI to see a muscle dettachment or tear.

You wouldn't. Good call. But by what is seen on the x-ray, you can interpret it to be. But yeah, MRI should be the next step I would suppose.

[WilliamTheIrish]

Coryt,

it's not a fracture of the hip per se.

an ilium fx is an area above the hip joint that is the main weight bearer of the pelvis. Lots of muscle attatchment in this area too.
I'm not certain that the physician you talked to actually saw "muscle pulled away from bone."

Probably saw an area of the ilium that has avulsed (pulled away from the pelvis with such force that it tears the bone). In essence the muscle contracted and tore the bone.

Also, there are lots of nerves (mainly the sciatic) that run through this area, so I imagine your son really did fell a lot of discomfort, especially when he tried to apply force by sprinting.

The good part of this is that it's not a fx of the acetabulum or the hip itself. That where you run the risk of of avascular necrosis. (Bo Jackson injury.)

Get your physician in gear. If your not satisfied with their advice then seek a second opinion.

Personally, I'd be on your providor like ugly on an ape to see a pediatric sports medicine guy. However, it's in your providor's interest to keep you 'in network.'

Good luck. Keep us posted.

[mcan]

Avascular necrosis usually only happens when a blood supply is cut off from something that needs healing, but it can't heal without a blood supply. So, no worries there, I'm sure.

As for the joint itself, I don't know much about it. There is a ton of this kind of info on the net though, and probably a bulletin board with people who have this exact injury and all the news that is related to how to treat it. The internet is wonderful.

One thing is for sure though, if he is experiencing "dead leg" I don't envy what he could be going through the next time he pushes himself. The sciatic nerve is touchy and the first couple times you poke at it, you think, 'wow that's strange.' Then one day, partial paralysis. It happened with my lower back (sciatica). My hampstring started tingling a bit. Then... Nothing... Then my calf started tingling... and after a few more days it went away too. I walked around for months unable to move my posterior leg muscles, so my ankle and shin did all the work. Through my own physical therapy akin to "wiggle your big toe" from Kill Bill, I managed to get my leg back. Then, the pain set in... And my God, it feels like you're in HELL. After awhile (through smart exercise and stretching and building the muscle in my lower back) I've gotten to the point where my back doesn't bother nearly as much. But it took two years to get there, and I still take medication if I do any kind of sports.

[ct]

Coryt,

it's not a fracture of the hip per se.

an ilium fx is an area above the hip joint that is the main weight bearer of the pelvis. Lots of muscle attatchment in this area too.
I'm not certain that the physician you talked to actually saw "muscle pulled away from bone."

Probably saw an area of the ilium that has avulsed (pulled away from the pelvis with such force that it tears the bone). In essence the muscle contracted and tore the bone.

...

Good luck. Keep us posted.

I agree, this is likely the cause of the 'fracture', which my guess is a hairline or stress crack from the muscle injury. I don't think he said(I didn't speak to him) he saw the muscle torn away, just that's what the x-ray may have indicated, combined with Zach's descriptions.

They are pretty sure he'll get in to see the orthopedic specialist on Monday. On a good note, Zach is feeling much better, and barely using my crutches I brought out for him, only for stairs and as walking assistance. He can put some weight on it, but I'm telling him for now not to. He's 14, what can you expect?

Thanks for all the tips and advice, keep em coming.