Apophysitis

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What is apophysitis?
An apophysis is a type of a growth plate at the end of the bone which a tendon or ligament attaches to. The apophysis, as well as other growth plates, are the weakest link in the musculoskeletal system and are prone to injury from direct trauma or repetitive stress. Apophysitis, which means inflammation of the growth plate, develops in children due to chronic traction of a tendon at its insertion onto the growth plate. It is most common during rapid growth in conjunction with a high amount or increase in activity level. Common sites of apophysitis include the heel (Severs Disease), foot (Iselin’s Disease), knee (Sinding Larson Johansson and Osgood-Schlatter Disease), elbow (Medial Epicondyle Apophysitis, also known as Little League Elbow), and shoulder (Proximal humeral apophysitis, also known as Little League Shoulder).

Management
All types of apophyseal injuries are treated with a period of rest, activity modification, ice, and potentially physical therapy, depending on the severity of the condition. Patients with Osgood-Schlatter disease may benefit from a knee strap or knee pad for comfort. Children with Severs disease can be treated with full length heel cushions to decrease impact on the growth plate. Children with Iselin’s disease can be treated with an ankle brace for comfort and stabilization. The length of treatment varies from case to case. Some patients heal within a few days whereas others may take weeks to months, even with the appropriate treatment. Healing time largely depends on patient compliance. Children who allow their injuries to heal with rest and activity modification, avoiding painful and/or inciting activities, tend to heal at a more rapid rate.