May 26, 2026 //
Rob Anderson //
Gym News //
6 min read
If your child has ever felt a sudden, sharp pain in their hip during a sprint, a kick, or a jump and maybe even heard or felt a pop, this post is for you.
This is not a pulled muscle. It is not something to run off. And it is definitely not something to ignore.
What your child may have experienced is a pelvic apophyseal avulsion injury. It sounds complicated, but the concept is straightforward and once you understand it, you will never look at hip pain in young athletes the same way again!
The Anchor And The Rope
Think of a climber attached to a wall by a rope and an anchor. The climber is safe as long as both hold. But if one fails, the climber falls.
In adults, the bone is stronger than the tendon. So when something gives way, it is usually the rope… a tendon tear or strain.
In children, it is the opposite. The bones of a growing child are still largely made up of cartilaginous tissue, not solid bone. The growth plates (called apophyses) are immature and vulnerable. So when a powerful muscle contracts explosively, the tendon holds, but the bone gives way. The anchor pulls out of the wall.
That is an avulsion injury. A small piece of bone, still attached to the tendon, is pulled away from the pelvis.
Why Does This Happen During Puberty?
This injury is almost exclusively a puberty problem. Before puberty, children rarely have enough muscle strength to cause an avulsion. After puberty, the growth plates have fused and the bone is strong enough to withstand the load.
The danger window is in between.
During the growth spurt, the thigh bone grows rapidly in length, placing greater traction on the muscles where they attach to the pelvis. At the same time, a surge in hormones like testosterone dramatically increases the power a young athlete can generate during kicking, jumping, and sprinting.
The result is a mismatch: more force being applied to an attachment point that is not yet mature enough to handle it.
The muscle attachment points on the pelvis do not fully fuse and mature until somewhere between 16 and 30 years old, depending on the specific muscle:
This means that even a 17 or 18 year old is not fully out of the danger window for some muscle groups.
Who Is Most At Risk of hip pain in young athletes?
Avulsion injuries are more common in sporty children, particularly boys, who participate in repeated high-intensity activities involving kicking, deep squats, hopping, jumping, and rapid changes of direction.
Football, rugby, gymnastics, and athletics are among the highest-risk sports, not because they are dangerous in themselves, but because they involve the exact movement patterns that place the greatest demand on these immature attachment points.
The 4 Warning Signs of hip pain in young athletes
If your child reports any of the following after a training session or match, take it seriously:
Sudden onset of severe pain during activity, particularly during a kick, sprint, or jump
A popping sensation at the time of injury
Pain, swelling, and tenderness directly over the pelvic bone
Difficulty weight bearing on the affected leg
If your child has sudden, severe hip pain accompanied by a popping sensation, they should not return to sport until they have been assessed by a health professional who understands youth athlete development. An X-ray is needed to assess the degree of separation, and an MRI is often more effective for identifying mild injuries.
Can They Still Play?
No.
This is one of the most important messages in this post. Pelvic avulsion injuries require a supervised rehabilitation programme, typically lasting between 16 and 20 weeks depending on the extent of the injury and which muscle is involved.
Returning to sport too early risks increasing the separation between the bone fragment and the parent bone, which can complicate healing and, in some cases, require surgery.
The vast majority of these injuries heal without surgery. But they will not heal if the child keeps playing through the pain.
The Rehabilitation Journey
Recovery from a pelvic avulsion injury follows a clear progression:
Phase 1: Protect (Weeks 1-4)
The priority is to protect the injury from further traction or stretching. Running and kicking are off the table. If pain is severe, crutches may be used for the first few weeks. The focus is on maintaining overall strength through exercises that do not load the injured attachment.
Phase 2: Repair (Weeks 4-12)
Once pain settles, the athlete can begin low-impact activity: water-based exercise, a static bike, and gentle movements with the injured muscle. The bone still takes approximately 12 weeks to heal, so even when pain has gone, the structure is not yet ready for full load.
Phase 3 : Start To Move (Weeks 8-14)
Squats, lunges, and sport-specific movements are gradually reintroduced at low intensity. Hopping, running, and skipping are added progressively as the attachment repairs.
Phase 4: Return To Training (Around Week 12+)
Low-impact training elements are reintroduced first. It is important to remember that teammates will have continued training and growing during the recovery period. The demands of returning to full training may be greater than before the injury.
Phase 5: Return To Competition
Once the athlete has trained at full intensity for two consecutive weeks without pain, they can begin to reintroduce competitive sport, starting with short spells and building up gradually.
What This Means For You As A Parent
If your child is in the middle of their growth spurt and playing high-intensity sport, this is the most important time to monitor their training load carefully.
This is not about stopping them from playing. It is about understanding that the body they are training in right now is not the same body they will have in two or three years. The attachment points are vulnerable. The forces being generated are increasing rapidly. And the window where this injury can occur is finite.
The best protection is not wrapping them in cotton wool. It is making sure they are being coached by people who understand youth athlete development, that their training load is managed sensibly, and that when they report pain especially sudden, sharp hip pain, it is taken seriously.
A Note On Diagnosis of hip pain in young athletes
This injury needs to be assessed by a health professional with experience in treating young athletes. Do not rely on a general assessment alone. An X-ray is the minimum requirement to assess the degree of separation. An MRI is preferable for identifying mild injuries and assessing healing potential.
If your child is in pain that does not settle within a few weeks, or that is affecting their sleep, seek specialist help.
