From the Research
Iliac apophysitis is best managed with 4 to 6 weeks of rest, as evidenced by a case series from 1, and a more recent case report from 2 that highlights the importance of a staged return to sport protocol.
Treatment Overview
Treatment of iliac apophysitis involves:
- Rest from aggravating activities for 4 to 6 weeks, as supported by 1 and 2
- Ice application for 15-20 minutes several times daily to reduce inflammation
- Over-the-counter anti-inflammatory medications like ibuprofen (400-600mg three times daily with food) or naproxen (220-440mg twice daily with food) for pain relief, although the efficacy of NSAIDs is supported by moderate quality evidence from 3
Rehabilitation and Prevention
- Physical therapy focusing on gentle stretching of hip flexors and strengthening of core and hip muscles is essential for recovery and prevention
- A gradual return to sports should only begin when activities can be performed pain-free, typically starting at 50% intensity and increasing by 10-15% weekly, as outlined in 2
- Prevention strategies include proper warm-up routines, avoiding sudden increases in training intensity, maintaining flexibility in hip muscles, and strengthening core muscles
Condition Overview
Iliac apophysitis, also known as anterior superior iliac spine (ASIS) apophysitis, is an overuse injury that occurs in adolescent athletes when repetitive traction forces cause inflammation at the growth plate where the hip flexor muscles attach to the pelvis. This condition occurs primarily during growth spurts when bones grow faster than muscles, creating tension at attachment sites, and typically resolves completely with appropriate management and once skeletal maturity is reached. The use of NSAIDs, as discussed in 4, 3, and 5, should be considered in the context of their potential benefits and risks, with a focus on minimizing adverse events and promoting safe use.