By Dominic Worsowicz DPT
Apophysitis is an inflammation or injury where a tendon attaches to a growth plate. It is most relevant in growing children and adolescents, but why is it so common in young athletes?
- Children go through growth spurts where the bones grow quickly. Sometimes there has not been time for the muscles to grow and adapt. Therefore, children and adolescents have shortened muscles which increases the stress at the muscles respective attachment site.
- In these age groups, the children’s bones are not fully developed and not as strong. Bones are not equipped to handle the tendon’s repeated pulling on the bone with large amounts of force, which can be caused by activities like running, jumping or throwing.
Apophysitis is usually caused by repetitive stress to the area (running, jumping, throwing), but it can also be caused by an acute injury (fall, impact).
- Pain, swelling, and tenderness around the area where tendon attaches to a growth plate.
- Increased pain with activity and decreased pain with rest.
- Occasionally a bump can be seen or felt in the area of the pain.
Most common types of Apiphysitis
- Shoulder (Little League Shoulder*).
- Elbow (Little League Elbow*).
- Knee (Osgood Schlatter’s Disease*).
- Hip/pelvis (Iliac crest apophysitis*).
- Foot (Iselin’s disease*).
* The names are more specific names for apophysitis in their specific areas.
To be diagnosed with apophysitis, you would have to see a Sports Medicine Physician. The physician would perform a physical examination along with ordering an x-ray to help rule in or out apophysitis or other diagnoses.
Prevention of Apophysitis
Things you or your child can do to try to prevent apophysitis is paying attention to your child’s symptoms. If the child or adolescent is experiencing pain, let the child rest until the pain has resolved.
Another important thing you can do is make sure the child or adolescent maintains and continues to improve their flexibility as they are growing. This will decrease stress on the areas of growth plates and help decrease range of motion deficiencies that can cause injuries down the line.
The third thing you can do is not letting your children specialize in a sport until later in life like high school and college. Letting the child participate in a variety of sports instead of one sport year around helps decrease the time the child spends in that aggravating activity. Also playing multiple sports increases a variety of physical skills that they learn and helps them become a better all-round athlete.
Injured athletes affected with apophysitis should utilize the RICE protocol:
Other forms of treatment may include the following:
- NSAID’s (Non-steroidal anti-inflammatory) medication to control pain and reduce inflammation.
- Physical Therapy: Physical therapy can be essential for the recovery from apophysitis. As mentioned above, one of the issues that can occur is the bone grows too quickly for the muscle and the muscle is short and tighter now. A physical therapist can help the child or adolescent stretch properly to improve flexibility as well as decrease tissues restrictions around the area. Physical therapy can also address strength deficits as the surrounding musculature can be too weak and the inflamed tendon is taking the brunt of the work. Exercises learned can also help strengthen the affected musculature as it may not be strong enough to take on the demands of the activity the child or adolescent enjoys participating in.
- Medical equipment: The doctor may prescribe or recommend a brace, strap, or shoe that either offers more support to that area or helps transfer the stress of jumping, running, or throwing to a different area that is better equipped for those stresses.
JOI Physicians and Rehab are currently offering ASAP fracture and injury care. This is a new option for patients who would like to avoid the emergency room if they have suffered a fracture or soft tissue injury. To learn more about this service, read this article about fracture and injury care. Make an appointment by calling (904)JOI-2000.
If your child is suffering from apophysitis, call JOI-2000 to schedule an appointment with one of our physicians.