Injuries to Children – Overuse Injuries to the Growth Plate

Children’s bones are still growing making them prone to injuries to the areas in the bone known as the epiphysis and apophysis. These are the areas on the growing bone that contain growth cartilage. This is the area of the bone that produces new bone cells that allow children to grow.

These injuries are common and if left unattended may result in time off sport.

The most common of these are Severs Syndrome and Osgood Schlatters Syndrome. These are injuries to the apophysis. The apophysis is as a bony lump, which the tendons attach to. It is softer in children than in adults.

Severs Syndrome occurs through overstress of the attachment of the Achilles tendon at the back of the heel. The age of occurrence is usually between 10 to 12 years of age. The child complains of heel pain. The condition will usually resolve over the next year or so as the growth plate matures. Factors such as flat feet and tight calves can contribute to its onset and if these are addressed will usually aid recovery. Activity modification is sometimes necessary.

Osgood Schlatters Syndrome is caused through overstress on the attachment of the patella tendo on the front of the leg below the knee. The condition will usually resolve over the next year or so as the growth plate matures. Stretches to the quadriceps, correction of biomechanics (such as using orthotics) and activity modification will usually aid recovery.

These injuries always self resolve but may be indicative of poor biomechanics, overtraining or unsuitability for an activity. They respond well to advice and in some cases corrective exercises. Load management is crucial. Sometimes a period of relative rest from the sport is required.

A professional assessment is essential. Early diagnosis leads to good early treatment and can have a huge impact on the speed of recovery and may even prevent longer-term problems.