## AIIS avulsion: exercises by authorised stage

Only in the late stage, after confirmed healing and clearance for movement, full weight bearing, stretching and strengthening. Do not use during the acute or protected phase; return to kicking and sport is a separate decision.
- ![Isometric knee extension (quad set)](https://ortopediaevolutiva.com/clinical-print-figures/9207b109f6506635.webp) #### 1. Gently tighten your thigh Lie on your back with your leg straight and supported, and put a small towel under your knee. Gently tighten your thigh by pressing your knee into the towel; hold, then relax. 5 contractions lasting 5 seconds, on 3 non-consecutive days each week; relax for 5 seconds. Stop for pain at the front of the hip.
- ![Shallow wall hold](https://ortopediaevolutiva.com/clinical-print-figures/wall-mini-squat-home.png) #### 2. Shallow wall hold When full weight bearing and strengthening are allowed. Rest your back against a wall with feet slightly forwards. Slide down a little, hold the shallow bend while breathing, then slowly slide back up; do not bend deeply. Hold for 15 seconds 3 times; rest for one minute between holds. Once daily. A shallow knee bend does not automatically make this safe during the acute phase.
- ![Standing quadriceps stretch after healing](https://ortopediaevolutiva.com/clinical-print-figures/a5e9775319482fdc.webp) #### 3. Stretch the front of your thigh Stand near a support, bend one knee and hold your ankle. Gently bring your heel towards your buttock without trying to make it touch or arching your back. Release and put the foot down. Hold for 20 seconds twice on each side; release fully between holds. Once daily. Stop for pain at the avulsion site.
- ![Eccentric step-down (advanced phase)](https://ortopediaevolutiva.com/clinical-print-figures/42d5e980b6084475.webp) #### 4. Step down from a low step After painless walking and small squats, with clearance for single-leg exercise. Stand on a low fixed step and hold a support. Bend the supporting leg, bring the other heel towards the floor, touch lightly and rise without pushing off quickly. 5 repetitions on each side, on 3 non-consecutive days each week; rest for one minute. Stop for injury-site pain or poor control; time alone does not give clearance.
- ![Glute bridge](https://ortopediaevolutiva.com/clinical-print-figures/4425f07c25374655.webp) #### 5. Two-leg bridge Lie on your back with knees bent and feet hip-width apart on the floor. Squeeze your buttocks and lift your pelvis to line up shoulders, hips and knees. Lower slowly without arching your back. 10 repetitions with a 3-second hold, once daily. Stop for pain at the front of the hip or in the groin.
- ![Hip-flexor stretch, if prescribed](https://ortopediaevolutiva.com/clinical-print-figures/ebff4e8c5a88e0e6.webp) #### 6. Stretch the front of your hip Rest one knee on a cushion and place the other foot in front. Squeeze the back buttock and move your pelvis forwards slightly, keeping your trunk upright. Hold, then return and change sides; do not arch your back. 2 holds of 20 seconds per side daily; release between holds. Stop for pain at the front of the hip or in the groin.

Suitability depends on the individual medical assessment. Starting exercises without assessment can be dangerous.

### When to stop
- Stop for sudden or increasing pain, swelling or difficulty moving; contact your clinician.
- Fever, a hot/red joint, inability to bear weight, tingling, numbness or sudden weakness: urgent assessment; emergency care if severe.

**Dott. Daniele Priano** · Paediatric orthopaedics
[Exercise instructions and videos online](https://ortopediaevolutiva.com/en/parents-kids/exercises/pelvis-groin/aiis-avulsion) · Printed: 28/10/2026

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# AIIS avulsion: exercises by authorised stage

6 exercises

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Only in the late stage, after confirmed healing and clearance for movement, full weight bearing, stretching and strengthening. Do not use during the acute or protected phase; return to kicking and sport is a separate decision.

## Exercises
- 1 #### Gently tighten your thigh ![Illustration: Gently tighten your thigh](https://ortopediaevolutiva.com/assets/176-quad-set-isometrico-v1-D-aGral6.webp) Lie on your back with your leg straight and supported, and put a small towel under your knee. Gently tighten your thigh by pressing your knee into the towel; hold, then relax. Stop for pain at the front of the hip. 5 contractions lasting 5 seconds, on 3 non-consecutive days each week; relax for 5 seconds.
- 2 #### Shallow wall hold When full weight bearing and strengthening are allowed. ![Illustration: Shallow wall hold](https://ortopediaevolutiva.com/clinical-home-color/high-wall-sit-color.webp) Rest your back against a wall with feet slightly forwards. Slide down a little, hold the shallow bend while breathing, then slowly slide back up; do not bend deeply. A shallow knee bend does not automatically make this safe during the acute phase. Hold for 15 seconds 3 times; rest for one minute between holds. Once daily. Shallow wall squat | OrtopediaEvolutiva Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=OHoUPcR7JWY) The video shows the movement. Follow the dose and precautions on this sheet.
- 3 #### Stretch the front of your thigh ![Illustration: Stretch the front of your thigh](https://ortopediaevolutiva.com/assets/206-stretch-quadricipite-v1-BlnH3urq.webp) Stand near a support, bend one knee and hold your ankle. Gently bring your heel towards your buttock without trying to make it touch or arching your back. Release and put the foot down. Stop for pain at the avulsion site. Hold for 20 seconds twice on each side; release fully between holds. Once daily. Standing thigh stretch | OrtopediaEvolutiva Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=IA8tbScKrf0) The video shows the movement. Follow the dose and precautions on this sheet.
- 4 #### Step down from a low step After painless walking and small squats, with clearance for single-leg exercise. ![Illustration: Step down from a low step](https://ortopediaevolutiva.com/assets/121-step-down-supported-v1-D3aY4Eou.webp) Stand on a low fixed step and hold a support. Bend the supporting leg, bring the other heel towards the floor, touch lightly and rise without pushing off quickly. Stop for injury-site pain or poor control; time alone does not give clearance. 5 repetitions on each side, on 3 non-consecutive days each week; rest for one minute.
- 5 #### Two-leg bridge ![Illustration: Two-leg bridge](https://ortopediaevolutiva.com/assets/168-ponte-glutei-v1-dSZhOjbI.webp) Lie on your back with knees bent and feet hip-width apart on the floor. Squeeze your buttocks and lift your pelvis to line up shoulders, hips and knees. Lower slowly without arching your back. Stop for pain at the front of the hip or in the groin. 10 repetitions with a 3-second hold, once daily. Glute bridge Press Play to watch the movement. The video shows the movement. Follow the dose and precautions on this sheet.
- 6 #### Stretch the front of your hip ![Illustration: Stretch the front of your hip](https://ortopediaevolutiva.com/assets/201-stretch-ileopsoas-v1-GJWHvNEJ.webp) Rest one knee on a cushion and place the other foot in front. Squeeze the back buttock and move your pelvis forwards slightly, keeping your trunk upright. Hold, then return and change sides; do not arch your back. Stop for pain at the front of the hip or in the groin. 2 holds of 20 seconds per side daily; release between holds.

## Exercise sheet

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Gently tighten your thigh Shallow wall hold Stretch the front of your thigh Step down from a low step Two-leg bridge Stretch the front of your hip

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For children, an adult stays nearby. Use a clear surface, a stable support and secure band anchors; avoid small objects that could be swallowed.

## When to stop

Stop exercising and contact your clinician for:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- A red or hot joint, or inability to bear weight: seek prompt assessment; use emergency care if severe.

Suitability depends on the individual medical assessment. Starting exercises without assessment can be dangerous.

Sources
- [RCH — Pelvic Avulsion Injuries, ED](https://www.rch.org.au/clinicalguide/guideline_index/fractures/Pelvic_Avulsion_Injuries_%E2%80%93_Emergency_Department/)
- [NHS Norfolk — Movement Activities & Exercises](https://www.justonenorfolk.nhs.uk/occupational-therapy-for-parents-carers/movement-activities-exercises/)
- [NHFT — Children’s Physiotherapy, Posture](https://www.nhft.nhs.uk/childrens-physio)
- [AAOS — Spine Conditioning Program](https://www.orthoinfo.org/recovery/spine-conditioning-program/)
- [NHS Inform — Exercises for thigh problems](https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/exercises-for-thigh-problems/)

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