By his own account, there has never been a time that 13-year-old Heath Winchester doesn't remember playing soccer. As soon as he could walk, he played soccer with his two older siblings; by the time he was four, he was a high-scorer on his neighborhood recreation team; and by the time he was nine, he had moved on to the competition league, competing in the premier bracket and travelling to additional tournaments as a guest player on various teams. Most of his spare time has always been spent outside practicing skills and shots with friends in his front yard soccer net. Not only had he never been injured playing soccer, Heath had never asked his coach to take him out of a game. That all changed during this summer's Impact League tournament.
While setting up a play as an attacking midfielder, Heath made a typical side-angled pass with his right foot. He heard an instant popping sound and felt a shooting pain in his leg and hip at the same time. Even though there was no impact with another player, he immediately dropped to the ground and asked to be taken out of the game. His coach was unsure what had happened, so when the second half started, he put Heath back in at his starting position. He lasted all of two minutes — he was unable to run without extreme pain. His mom, Suzanne, didn't think too much of it until she found out he wouldn't be able to play at all during the rest of the tournament. A few days later when Heath mentioned "My leg feels fine except when I kick or pass," she realized it was time to consult a specialist, even though she figured it was just a pulled muscle and there probably wouldn't be much need for treatment.
Fortunately, they were referred to Joy English, MD, a sports medicine specialist, and were able to get an appointment the next day at the Orthopaedic Injury Clinic. Dr. English immediately ordered an x-ray of Heath's right hip, compared it to his left, and found that he had an acute AIIS (anterior inferior iliac spine) apophyseal avulsion fracture. In other words, he had fractured the growth plate on his right hip.
Dr. English asked if Heath had been through a rapid growth spurt in recent months. Suzanne mentioned that it was almost as if she woke up one day and he was unrecognizable due to his sudden changes in height and muscle accumulation. Dr. English told them that young athletes, particularly boys, are susceptible to hip apophysitis during periods of extreme growth.
"These bones are growing at such an incredibly rapid rate," Dr. English said. "The muscles are just hanging on for dear life to keep up."
Without giving their bones the proper time to heal and regenerate, young athletes like Heath run the risk of permanent damage, and can compromise their ability to compete in high school and beyond.
Dr. English outlined a simple regimen for Heath's recovery: no soccer for six weeks. This meant no training or crossfit with his team, although he attended practices to observe his friends playing without him. For a kid who trains up to five days a week, the inactivity drove both Heath and his mom crazy. And although not much progress was seen on his second x-ray, by the third follow-up visit, Dr. English could see definitive signs of bone regrowth, and Heath was cleared to get back on the field.
This was significant for Heath because it was just in time for a special training camp with the AC Milan youth coaches, and right before fall season got up and running. Now, he's back to his normal routine of soccer training twice a week, games twice a week, and some conditioning in between. He's looking forward to a training trip in Italy next summer and fulfilling his long-term goal of one day planning soccer in college. For her part, Suzanne is extremely grateful for the insights and expertise of Dr. English. Because Heath was really never in significant pain, she knows his injury could easily have been overlooked.
"He's a tough kid and rarely complains because he just wants to play soccer," Suzanne said. "If we'd missed the hip fracture and he ended up with permanent damage down the road, I'm not sure how I would have been able to explain that to him."