88% of hip avulsion fractures were associated with physical activity while 12% were associated with a history of a surgery. The average age was 16 when physical changes are still being made. Youth Athletes muscles, tendons and ligaments will continue to go through a variety of changes leaving exercise selections, progressions and professional trainers to continue to evaluate and monitor changes.
Flexibility of the Rectus Femoris was another factor in injury, even more prevalent in soccer, ruby and track and field than other sports. The Rectus Femoris (RF) is on the most used muscles while running but most active while playing Soccer. The hips in running sports, which is most, will get tight through a few specific muscles like the Tensor Fascia Latae, Piriformis and Rectus Femoris and should be attended to regularly with Foam Rolling, Dynamic Mobility and Isometric strength work.
The other factors for Hip Avulsions were Gender played a role in these findings as well with 84% of avulsion fractures being male and 100% surgical procedure being female. Though I believe the high prevalence of injury for females is due to the wider structure of the hips. The RF attaches from the helps Flex at the hip and extend at the knee as you can see in the below photo.
The muscle is almost directly located in the middle of the thigh, helping the Psoas muscle flex the thigh.
The RF also helps to generate force and torque with change of direction movements. Sudden movements in sprinting or change of direction is typical for the sudden avulsion to happen.
(2)"The peak torque and the highest neuromuscular activation of RF occurred at 90° of flexion of knee and hip joints. On the other hand, the lowest peak torque and neuromuscular activation occurred at 30° of knee extension and 90° of hip flexion."
What Can be done to reduce the amount of Hip Avulsions
The most practical and easiest approach is to increase the Length of the RF by reducing the limitations of the Quadriceps and TFL of the hip. There are several exercises that can be done to improve the muscle quality of the quads through eccentric and isometric exercise like the Reverse Nordic and Single Leg Step Down.
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References:
(2) CINI et al. Int J Sports Exerc Med 2020, 6:159 Volume 6 | Issue 1 DOI: 10.23937/2469-5718/1510159