Active Adolescents

August 12, 2019


Joe is currently part of a research team helping to create and test a questionnaire that will be used to help identify adolescent growth plate injuries. Here is a blog he prepared to help you understand these very common conditions.  


Calcaneal (Heel) Apophysitis (Growth Plate) and Tibial Tuberosity (top of shin bone) Apophysitis are very common conditions affecting around 10-15% of adolescents, with more boys experiencing pain than girls.


It affects children at different stages of their development, but generally adolescent heel pain occurs between 8 to 14 years of age, and adolescent top of shin pain occurs between 8 to 16 years of age.


Frustratingly, the kids that get struck down with this pain are the most active kids, and their pain may increase with physical activity or team sports and pain usually reduces with rest.


Getting the right diagnosis is key, so the project has established a set of questions that will be given to consumers and hopefully give them an idea of their likely diagnosis.


This is not designed to replace the clinician as parents may still want an assessment and confirmation of the diagnosis, but this tool gives the parent an idea of the likelihood of their child having one of these conditions. We are currently testing the questionnaire at our clinic and various clinics Australia wide.


Treatments can be, and often are, very simple. We can manage these conditions with activity modification, looking at how much sport your child is competing in, and considering subtle changes to footwear and possibly inexpensive shoe additions to help offload the area until it settles down and your child reaches skeletal maturity.


A very important factor in the treatment discussion is education; it's important to be aware that this may be your child's first painful experience, so a reduction in fear will help you and your child. Thinking back to the language we use, telling a 10-year-old they have a ‘disease’ can often leave them thinking this will stop them doing the sport they love for life. We need to make sure they feel safe doing physical activity.


You may be wondering why I haven't used some very common terminology, such as Severs “disease” or Osgood-Schlatters “disease”, when talking about these conditions. They are NOT diseases and thus should not be called a disease. Diseases strike fear into the hearts and minds of our little athletes. This is the furthest thing we need when getting them back to activity. 


We can confidently suggest that this problem is self-limiting; that means it should get better with time. Generally, this is when your child reaches skeletal maturity. Some factors may mean this condition is not self-limiting, but a true growth plate issue should resolve once growing stops and the growth plate fuses.


Don’t forget we can help manage symptoms in a cost-effective manner but knowing this pain will eventually reduce and not affect your little sports star’s long-term career can go a long way to helping them star on the weekend.

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