This is a result of severe contraction when either accelerating or kicking. The pain is exacerbated by resistance of hip flexion in extension and full knee flexion in a prone position. Players tend to be in their mid-teens. Typical x-ray appearance. This is a result of excessive running, especially in adolescents.
Repetitive strain is put upon the apophysis, compounded by tight hamstrings.
There is violent external rotation, with the leg in a widely abducted position. Well localised tenderness. A direct blow to the iliac crest in contact sports. Often associated with a broad pelvis, a large quadriceps angle and leg length discrepancies. There is pain over the lateral aspect of the thigh, when lying on the affected side.