Explanation of Diagnosis

A pelvic avulsion fracture occurs when a tendon or ligament pulls a piece of bone away from the pelvis, usually at the hip flexors (ASIS), hamstrings (ischial tuberosity), or adductors (pubic bone). This injury commonly affects young athletes involved in sprinting, jumping, or sudden acceleration sports (soccer, track, gymnastics). Symptoms include sharp pain at the injury site, swelling, bruising, weakness, and difficulty walking or moving the leg.

Specific Work Modifications

• Avoid prolonged standing, walking, or weight-bearing activities until cleared by a doctor.
• Use crutches or a walker if non-weight-bearing is required.
• Modify tasks to limit bending, lifting, or excessive leg movement.
• Use a cushioned seat or ergonomic chair to reduce strain.
• Apply ice (15-20 min, 3-4 times daily) if swelling increases.

Specific Activity Modifications

• Avoid high-impact activities (running, jumping, sprinting, or heavy lifting).
• Modify workouts by switching to non-weight-bearing exercises like swimming or stationary cycling (once cleared by a doctor).
• Perform controlled mobility and strengthening exercises before returning to activity.
• Gradually reintroduce sports and weight-bearing movements after healing.

Recommended Supplements

• Collagen peptides (10 g daily) – Supports bone and soft tissue healing.
• Vitamin D3 (1000-2000 IU daily) – Aids in calcium absorption for bone repair.
• Calcium (1000-1200 mg daily) – Strengthens bones and accelerates fracture healing.
• Magnesium (300-400 mg daily) – Helps with muscle relaxation and recovery.
• Omega-3 fatty acids (1000 mg daily) – Reduces inflammation and promotes tissue repair.

Recommended Nutrition and Hydration

Diet Recommendations:

• Bone-healing foods: Dairy, leafy greens, almonds, salmon, and fortified cereals.
• Anti-inflammatory foods: Fatty fish (salmon, sardines), turmeric, berries, walnuts, and olive oil.
• Protein-rich foods: Chicken, eggs, lentils, and dairy to support muscle and ligament repair.
• Limit processed foods, sugar, and alcohol, which can slow healing.

Hydration Tips:

• Drink at least 2–3 liters of water daily to maintain joint lubrication and circulation.
• Limit caffeine and alcohol, which can interfere with calcium absorption.

Home Exercise Prescription

Follow weight-bearing restrictions as advised by your doctor. Avoid aggressive stretching or high-impact movements.

Phase 1: Pain Relief & Mobility (Weeks 1-3, Reduce Swelling & Maintain Movement)

1. Ankle Pumps & Toe Wiggles (For Circulation)

1. • Move the ankle up and down to promote circulation.
   • 10 reps, 3 times daily.

2. Pelvic Tilts (Gentle Core Activation)

1. • Lie on your back with knees bent, tighten your core, and flatten your lower back.
   • 10 reps, 2 times daily.

3. Seated Knee Extensions

1. • Sit with feet flat, slowly straighten the affected leg, then lower it.
   • 10 reps per leg, 2 times daily.

Phase 2: Strength & Stability (Weeks 4-8, Once Cleared for Light Weight-Bearing)

4. Glute Bridges (Core & Hip Activation)

1. • Lie on your back, bend knees, and lift hips while squeezing the glutes.
   • 10 reps, 2 times daily.

5. Clamshells (Hip Abductor Strengthening)

1. • Lie on your side with knees bent, lift the top knee without moving your hips.
   • 10 reps per side, 2 times daily.

6. Standing Hip Abduction (Controlled Motion)

1. • Stand tall and lift one leg sideways without tilting the torso.
   • 10 reps per leg, 2 times daily.

Phase 3: Return to Activity (Weeks 8+, If Pain-Free & Doctor Approved)

7. Bodyweight Squats (Avoid Deep Squats Initially)

1. • Keep weight in heels and avoid excessive hip flexion.
   • 10 reps, 2 times daily.

8. Single-Leg Balance Exercise

1. • Stand on the affected leg for 15-30 seconds, increasing time as tolerated.
   • Repeat 2-3 times per leg.

Avoid sprinting, jumping, deep squatting, and cutting movements until fully healed (typically 8-12 weeks).

Helpful Books

1. "The Healthy Runner's Handbook: Injury Prevention & Recovery" – Jason Karp, PhD
2. "Rehab Science: How to Overcome Pain and Heal from Injury" – Tom Walters, DPT

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.