[Eccentric Training after a Traumatic Apophysis Fracture at the Spina Iliaca Anterior Inferior: Case Study of a Junior Football Player].

Eccentric training is an established training method in competitive sports. It has been used effectively to improve muscle strength during rehabilitation after cruciate ligament reconstruction. However, it is still uncertain whether or not eccentric training contributes to successful rehabilitation after apophysis fractures. A fourteen-year-old soccer player, forward position, presents with an apophysis avulsion located at the right spina iliaca anterior inferior. After completing an early rehabilitation phase and isokinetic concentric strength development, the patient starts an eccentric training programme eight weeks after the injury, including training on an isokinetic dynamometer (Biodex) for four weeks, followed by a four-week eccentric ergometer training (Eccentron). Before and after each eccentric training phase, isokinetic maximum strength tests of the knee extensors and flexors are performed with angular velocities of 60 degrees per second (°/sec.), 180°/sec. and 240°/sec. In response to the eight-week eccentric rehabilitation program, maximum torque increases in all angular velocities in the injured (60°/sec. + 14.4 %; 180°/sec. + 8.8 %; 240°/sec. + 6.3 %) and the uninjured leg (60°/sec. + 15.6 %; 180°/sec. + 1.9 %; 240°/sec. + 8.1 %) between the first and the last test. Furthermore, neuromuscular coordination has improved during the eccentric training sessions. This case study demonstrates that controlled eccentric training in the open and closed kinetic chain increases coordination and strength of the trained muscles and therefore should be regarded as a valuable contribution toward a safe return to sport after apophysis fractures.