Massage therapy · Kitchener–WaterlooSlipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis (SCFE), also called slipped upper femoral epiphysis (SUFE), is a hip disorder affecting adolescents. It is the most common hip disorder in this age group (AAOS, n.d.). For reasons that experts do not fully understand, the ball at the top of the thigh bone (femur) slips down and backwards off the neck of the bone, through the growth plate, which is a weaker area of bone that is still developing (AAOS, n.d.; West Suffolk NHS Foundation Trust, 2021). It usually develops during periods of rapid growth, shortly after puberty begins, most often between 12 and 16 in boys and 10 and 14 in girls (AAOS, n.d.).

The condition is diagnosed from a careful history, watching how the young person walks, a physical examination and X-rays of the hip. An X-ray confirms the diagnosis by showing the head of the femur slipping off the neck of the bone (AAOS, n.d.).

Slipped Capital Femoral Epiphysis Anatomy

The hip is a ball and socket joint connecting the thigh bone (femur) to the socket in the pelvis. The femur grows at each end around an area of developing cartilage called the growth plate. The part of the bone above the growth plate at the top of the femur (the epiphysis) eventually becomes the ball of the hip (the femoral head). Once growth finishes and the growth plate closes, no further slipping can occur (AAOS, n.d.).

Symptoms

• Pain in the groin, hip, thigh and/or knee, often for weeks or months and worse with activity (AAOS, n.d.)
• Pain may be felt only in the knee, which can mean the hip problem is missed (East Sussex Healthcare NHS Trust, 2022)
• A limp, and the leg or foot turning outwards (AAOS, n.d.)

Treatments you may want to discuss with your medical team or family doctor or nurse practitioner

Tips

• SCFE is more common in boys than girls (AAOS, n.d.).
• Being overweight is a risk factor (AAOS, n.d.; East Sussex Healthcare NHS Trust, 2022). Your family doctor or nurse practitioner can support your family with healthy weight.
• In most cases the slip happens slowly and gradually over weeks or months (AAOS, n.d.).
• However, a minor fall or injury can make it come on suddenly (AAOS, n.d.).
• SCFE can later affect the other hip, usually within 18 months (AAOS, n.d.).
• When the condition is treated early and well, the long-term outcome for the hip is very good (AAOS, n.d.).

With a slipped capital femoral epiphysis, surgery comes first and your child's surgical team leads the care. They decide how much weight your child can put through the leg, whether crutches are needed and when sport can restart. Massage can't change the hip itself, but once the surgeon has cleared hands-on treatment, I can help your child get their movement, strength and confidence back, within the team's limits.

Please bring any X-ray or scan reports and notes from your child's medical team to the first visit. They're an important part of planning safe treatment for your child.

I check what your child has been cleared to do, then assess how they walk and move. Parents are welcome to sit in, with your child's agreement. Work around the hip and buttock needs informed consent and a signed consent form.

Early On, After Surgery

• Gentle hands-on work for the low back, the other leg, and the shoulders if they're on crutches
• Scar work once the wound has fully healed
• Crutch set-up and walking practice within the team's weight-bearing limits
• Gentle hip, knee and ankle exercises, as the team allows

Building Back Up

1. American Academy of Orthopaedic Surgeons (n.d.) Slipped capital femoral epiphysis. OrthoInfo. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/slipped-capital-femoral-epiphysis-scfe/ (Accessed: 7 October 2026).
2. West Suffolk NHS Foundation Trust (2021) Slipped upper femoral epiphysis (SUFE). Patient information leaflet. Available at: https://www.wsh.nhs.uk/CMS-Documents/Patient-leaflets/TraumaandOrthopaedics/6273-1-Slipped-Upper-Femoral-Epiphysis-(SUFE).pdf (Accessed: 7 October 2026).
3. East Sussex Healthcare NHS Trust (2022) Slipped capital femoral epiphysis (SCFE). Physiotherapy patient information leaflet. Available at: https://www.esht.nhs.uk/wp-content/uploads/2022/12/1040.pdf (Accessed: 7 October 2026).