Slipped Capital Femoral Epiphysis (SCFE)
Slipped Capital Femoral Epiphysis (SCFE)
Slipped Upper Femoral Epiphysis (SUFE)
What is Slipped Capital Femoral Epiphysis (SCFE)?
Slipped Capital Femoral Epiphysis (SCFE), also known as Slipped Upper Femoral Epiphysis (SUFE), is a disorder involving the hip joint. It occurs in adolescence. It means weakness of the growth plate (epiphyseal plate) located at the top of the femur (thigh bone), causing the head of the femur to slip backwards and downwards.
What Causes Slipped Capital Femoral Epiphysis?
The cause of Slipped Capital Femoral Epiphysis is unknown; however, there is speculation that increased weight and hormones may play a role. In some cases, it may be caused by trauma or a fall.
Slipped Capital Femoral Epiphysis Symptoms
- Gradual onset over weeks to months
- Complaints of the groin, hip, thigh or knee pain (similar to that of a muscle strain)
- Walking with a limp
- Hip joint range of motion restricted
- It can also be associated with the shortening of the affected leg
- Slipped Capital Femoral Epiphysis Diagnosis
Clinical examination will show a decrease in hip joint range of motion. Diagnosis includes an X-ray and possibly a CT scan.
Slipped Capital Femoral Epiphysis Treatment
Treatment usually requires an operation where an Orthopaedic Surgeon inserts a screw to stabilise the growth plate and prevent further slipping of the femoral head. Post-operatively, your child will be unable to fully weight-bear for a while, around six weeks, and require crutches or a wheelchair. Once the growth plate has fused, you can usually have the screws removed.
Rest from intense activities such as running and contact sports will be required to allow the growth plate to fuse. Once the growth plate is stable, your return to loaded activities can begin.
Your physiotherapist can assist in recovery after the operation. They can provide:
- Advice and education on appropriate post-operative activity
- Hip mobility exercises
- Progressive hip stability and strengthening exercises
- Assist with a return to sport
The physiotherapists at PhysioWorks can help get your child back on track following surgery. If you have any questions or would like your child to start a rehabilitation program, please contact us.
Common Causes of Hip & Groin Pain
Hip Joint Pain
- Hip Arthritis - Hip Osteoarthritis
- Hip Labral Tear
- Hip Pointer
- Femoroacetabular Impingement - FAI
- Perthes Disease
- Slipped Femoral Capital Epiphysis
- Stress Fracture
- Avascular Necrosis of the Femoral Head
Lateral Hip Pain
Adductor-Related Groin Pain
Pubic-Related Groin Pain
Inguinal-Related Groin Pain
- Inguinal hernia
- Sportsman's hernia
Iliopsoas-Related Groin Pain
- Hip Flexor Strain
Other Muscle-Related Pain
- Piriformis Syndrome
- Muscle Pain -Muscle Strain
- Poor Hip Core
- DOMS -Delayed Onset Muscle Soreness
- Core Stability Deficiency
Hip Pain Treatment
A thorough analysis of WHY you are suffering hip pain from a movement, posture, or a control aspect, is vital to solving your hip pain.
Only an accurate diagnosis of the source of your hip pain can solve the pain, quickly improve your day to day function, prevent a future recurrence, or improve your athletic performance.
The first choice of short-term therapy has been symptomatic hip treatment. This approach could include local chemical modalities such as cortisone injections or painkillers. Ice or heat could also assist along with some gentle stretching or exercise.
However, persisting hip problems will require additional investigations to assess your joint integrity or range of motion, muscle length, strength, endurance, power, contraction timing and dynamic stability control.
You should consult a healthcare practitioner who has a particular interest in hip pain and injury management to thoroughly assess your hip, groin, pelvis, lower limb and spine. Due to the kinetic chain, they all impact, especially at the high athletic performance end. A quality practitioner will educate you on your condition and combine it with exercise and manual therapy as per the Clinical Practice Guidelines. (Cibulka et al., 2017) Hip pain education should also include teaching you specific activity modification, individualised exercises, weight-loss advice (if required), and methods to unload any arthritic joints.
Recent research evidence-backed approaches have modernised physiotherapy treatment approaches to effectively managing hip pain. Together with a thorough hip assessment, your hip treatment can progress quickly to restore you to a pain-free hip and perform your regular sport or daily activities in the shortest time possible.
For specific rehabilitation advice regarding your hip pain, seek the professional advice of high quality and up-to-date physiotherapists experienced in the assessment, treatment, prevention and optimisation of hip pain and related conditions. After assessing you, they will individually prescribe therapeutic activities based on your specific needs for daily living, values, and functional activities or point you in the direction of the most suitable healthcare practitioner for you and your hip condition.
Hip Pain Treatment Options
Your hip physiotherapist may consider an extensive range of treatment options, including manual joint therapy to improve your joint mobility, muscle stretches or supportive taping. Your physiotherapist is also likely to add strengthening and hip joint control exercises as they deem appropriate for your specific functional and sporting needs. Please consult with them for advice.
Acute Injury Signs
Acute Injury Management.
Here are some warning signs that you have an injury. While some injuries are immediately evident, others can creep up slowly and progressively get worse. If you don't pay attention to both types of injuries, chronic problems can develop.
For detailed information on specific injuries, check out the injury by body part section.
Don't Ignore these Injury Warning Signs
Joint pain, particularly in the knee, ankle, elbow, and wrist joints, should never be ignored. Because these joints are not covered by muscle, pain here is rarely of muscular origin. Joint pain that lasts more than 48 hours requires a professional diagnosis.
If you can elicit pain at a specific point in a bone, muscle, or joint, you may have a significant injury by pressing your finger into it. If the same spot on the other side of the body does not produce the same pain, you should probably see your health professional.
Nearly all sports or musculoskeletal injuries cause swelling. Swelling is usually quite obvious and can be seen, but occasionally you may feel as though something is swollen or "full" even though it looks normal. Swelling usually goes along with pain, redness and heat.
Reduced Range of Motion
If the swelling isn't obvious, you can usually find it by checking for a reduced range of motion in a joint. If there is significant swelling within a joint, you will lose range of motion. Compare one side of the body with the other to identify major differences. If there are any, you probably have an injury that needs attention.
Compare sides for weakness by performing the same task. One way to tell is to lift the same weight with the right and left sides and look at the result. Or try to place body weight on one leg and then the other. A difference in your ability to support your weight is another suggestion of an injury that requires attention.
Immediate Injury Treatment: Step-by-Step Guidelines
- Stop the activity immediately.
- Wrap the injured part in a compression bandage.
- Apply ice to the injured part (use a bag of crushed ice or a bag of frozen vegetables).
- Elevate the injured part to reduce swelling.
- Consult your health practitioner for a proper diagnosis of any serious injury.
- Rehabilitate your injury under professional guidance.
- Seek a second opinion if you are not improving.