Paediatric Orthopaedic Specialist
ASIS avulsion fracture (post acute phase)
Home Exercise Program
Not every exercise listed here is suitable for every child: the selection is individual and is defined during the consultation.
For whom: After an apophyseal avulsion, only with individual clearance for movement, stretching, resistance and loading based on verified healing. Absence of pain alone does not authorise progression.
Dose and frequency: Perform only the exercises selected during the visit. The listed dosages are examples to adapt: follow the dose, frequency, rest and progression prescribed for age, symptoms and phase. Do not automatically perform the whole list.
Equipment and supervision: A stable, clear surface, comfortable clothing and a secure support. Check resistance-band anchors. Adult supervision; avoid marbles and small objects if the child may put them in their mouth, using a towel instead.
Avoid: Forcing a painful or unauthorised movement; Increasing load, resistance or frequency without the agreed rest periods; Doing balance exercises without stable support or supervision.
1.Assisted hip flexion (gentle ROM)
Hip mobility recovery after rest phase
Only after individual authorisation for this movement and loading, based on healing at follow-up. Lie on your back. Bring knee toward chest SLOWLY and gently, helping with hands behind the thigh. Movement must be PAINLESS — stop before pain. Return slowly to starting position. Never force range of motion in the first weeks.
10 slow reps, 3 sets, twice daily
2.Glute bridge
Gluteal strengthening after the required loading is authorised.
Only after individual authorisation for this movement and loading, based on healing at follow-up. Lie on back with knees bent and feet on floor. Lift pelvis off ground by squeezing glutes. Hold the top position for 3-5 seconds. Lower slowly.
12-15 reps, 3 sets
3.Hip flexor stretch (gentle)
Progressive hip flexor stretching after healing
Only after individual authorisation for this movement and loading, based on healing at follow-up. In low lunge position (one knee on ground, other foot forward). Keep trunk upright and GENTLY push pelvis forward until feeling a stretch in the front of the thigh/hip of the kneeling leg. Gradually increase intensity.
3 × 20-30 seconds per side, only if pain-free
4.Single-leg glute bridge
Progression of glute strengthening with pelvic control
Only after individual authorisation for this movement and loading, based on healing at follow-up. Lie supine with one knee bent and foot on the floor, the other leg lifted and straight. Lift the pelvis pushing through the heel of the supporting leg. The pelvis must stay level: it should not tilt toward the lifted leg. Hold 2-3 seconds at the top and lower slowly.
8-10 reps per side, 3 sets
5.Front plank (core)
Core stabilization: reduces traction on the apophysis while running
Only after individual authorisation for this movement and loading, based on healing at follow-up. Place forearms on the floor with elbows under the shoulders. Lift the body keeping a straight line from head to heels, engaging abdominals and glutes. The pelvis must not sag or pike. Start with short holds and progress gradually. No groin pain should appear.
3 sets × 20-30 seconds (progress to 45-60 seconds)
6.Active hip flexion against light resistance
Progressive sartorius and hip-flexor strengthening, specific to ASIS avulsion
Only after individual authorisation for this movement and loading, based on healing at follow-up. Seated or standing, with a light band around the thigh anchored behind. Drive the knee upward against the resistance, stopping just above 90° of hip flexion. Return SLOWLY under control. Start only after 6 weeks and only if pain-free; increase resistance over the following weeks.
10-12 reps per side, 3 sets, every other day
7.Progressive walking and gradual sprints
Progressive return-to-sport reconditioning
Only after individual authorisation for this movement and loading, based on healing at follow-up. Resume sport-specific loading only after the treating team confirms adequate healing, pain-free movement and strength, and readiness to progress. Begin with easy straight-line activity, then increase speed and finally direction changes or kicking power. Do not progress by calendar alone. Pain during or after a session requires reducing loading and reassessment.
Follow progressive phases, 3-4 times per week
RED FLAGS - When to stop and contact the doctor immediately
Stop the exercises immediately and contact the specialist (or go to the emergency department if severe) if any of the following occur:
- 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.
In case of doubt, always prefer a check-up over continuing the exercises.
Dott. Daniele Priano
Paediatric Orthopaedics - ASST Gaetano Pini-CTO
Content version: 9 September 2026
ortopediaevolutiva.com • Printed: 13/09/2026
Web version
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Before You Start
Who is this guide for?
After an apophyseal avulsion, only with individual clearance for movement, stretching, resistance and loading based on verified healing. Absence of pain alone does not authorise progression.
What you need
A stable, clear surface, comfortable clothing and a secure support. Check resistance-band anchors. Adult supervision; avoid marbles and small objects if the child may put them in their mouth, using a towel instead.
Suggested frequency
Perform only the exercises selected during the visit. The listed dosages are examples to adapt: follow the dose, frequency, rest and progression prescribed for age, symptoms and phase. Do not automatically perform the whole list.
Common mistakes to avoid
- •Forcing a painful or unauthorised movement
- •Increasing load, resistance or frequency without the agreed rest periods
- •Doing balance exercises without stable support or supervision
⚠️ Red flags — when to stop and contact the doctor immediately
Stop exercises immediately and contact the specialist if any of the following occur:
- 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.
Detailed Exercises
- 1
Assisted hip flexion (gentle ROM)
Hip mobility recovery after rest phase
Only after individual authorisation for this movement and loading, based on healing at follow-up. Lie on your back. Bring knee toward chest SLOWLY and gently, helping with hands behind the thigh. Movement must be PAINLESS — stop before pain. Return slowly to starting position. Never force range of motion in the first weeks.
10 slow reps, 3 sets, twice daily - 2
Glute bridge
Gluteal strengthening after the required loading is authorised.
Only after individual authorisation for this movement and loading, based on healing at follow-up. Lie on back with knees bent and feet on floor. Lift pelvis off ground by squeezing glutes. Hold the top position for 3-5 seconds. Lower slowly.
12-15 reps, 3 sets - 3
Hip flexor stretch (gentle)
Progressive hip flexor stretching after healing
Only after individual authorisation for this movement and loading, based on healing at follow-up. In low lunge position (one knee on ground, other foot forward). Keep trunk upright and GENTLY push pelvis forward until feeling a stretch in the front of the thigh/hip of the kneeling leg. Gradually increase intensity.
3 × 20-30 seconds per side, only if pain-free - 4
Single-leg glute bridge
Progression of glute strengthening with pelvic control
Only after individual authorisation for this movement and loading, based on healing at follow-up. Lie supine with one knee bent and foot on the floor, the other leg lifted and straight. Lift the pelvis pushing through the heel of the supporting leg. The pelvis must stay level: it should not tilt toward the lifted leg. Hold 2-3 seconds at the top and lower slowly.
8-10 reps per side, 3 sets - 5
Front plank (core)
Core stabilization: reduces traction on the apophysis while running
Only after individual authorisation for this movement and loading, based on healing at follow-up. Place forearms on the floor with elbows under the shoulders. Lift the body keeping a straight line from head to heels, engaging abdominals and glutes. The pelvis must not sag or pike. Start with short holds and progress gradually. No groin pain should appear.
3 sets × 20-30 seconds (progress to 45-60 seconds) - 6
Active hip flexion against light resistance
Progressive sartorius and hip-flexor strengthening, specific to ASIS avulsion
Only after individual authorisation for this movement and loading, based on healing at follow-up. Seated or standing, with a light band around the thigh anchored behind. Drive the knee upward against the resistance, stopping just above 90° of hip flexion. Return SLOWLY under control. Start only after 6 weeks and only if pain-free; increase resistance over the following weeks.
10-12 reps per side, 3 sets, every other day - 7
Progressive walking and gradual sprints
Progressive return-to-sport reconditioning
Only after individual authorisation for this movement and loading, based on healing at follow-up. Resume sport-specific loading only after the treating team confirms adequate healing, pain-free movement and strength, and readiness to progress. Begin with easy straight-line activity, then increase speed and finally direction changes or kicking power. Do not progress by calendar alone. Pain during or after a session requires reducing loading and reassessment.
Follow progressive phases, 3-4 times per week
Frequently Asked Questions
When can I start exercises after an ASIS avulsion?
Gentle mobilization exercises generally begin 2-3 weeks after the injury, when pain allows. Active strengthening starts after 4-6 weeks, under specialist guidance.