Conditions We Treat
Growth plate injuries are among the most common causes of pain in active children and adolescents. They occur at the points where muscles and tendons attach to developing bone, and they tend to flare up during growth spurts when bones are lengthening faster than the soft tissues can adapt.
The medical term is apophysitis: inflammation at a growth plate (apophysis) caused by repetitive traction. These are overuse injuries, not sudden traumatic events. The two most common are Sever's disease (heel pain) and Osgood-Schlatter disease (knee pain below the kneecap). Other sites include the inferior pole of the kneecap (Sinding-Larsen-Johansson syndrome), the hip bone and the sit bone where the hamstrings attach.
A 2024 scoping review in the British Journal of Sports Medicine found that injury incidence increases with maturity status, and that more rapid growth of the lower limbs is associated with greater injury risk. Apophyseal injuries tend to follow a distal-to-proximal pattern: feet and ankles first, then knees and hips, which mirrors the way children grow.
What makes these conditions frustrating for families is that the child often looks fine. There is no swelling, no bruising and no obvious injury. But the pain is real, and it limits what they can do. The good news is that growth plate injuries respond well to conservative management, and most children can stay active through them with the right approach. Our parent's guide to growth plate injuries covers what you can do at home to help manage these conditions.
At our Sandton practice, we see these conditions regularly. Treatment is gentle, age-appropriate and focused on three things: reducing the traction on the affected growth plate, restoring normal joint movement in the surrounding areas and building the strength and flexibility needed to keep up with sport.
Growth plate injuries respond well to hands-on treatment combined with targeted stretching and strengthening. We use soft tissue work to reduce muscle tension and traction on the growth plate, joint mobilisation to restore normal movement at the ankle, knee and hip, and progressive exercises to build capacity in the muscles and tendons around the affected area.
Our Morningside practice is convenient for families across Sandton, Bryanston, Fourways, Midrand and greater Johannesburg.
Book an appointment at our Sandton practice. We will assess your child, explain what is going on and give you a clear plan to manage it.
Growing pains are typically vague, bilateral aches in the legs that occur at night and have no clear cause. Growth plate injuries (apophysitis) are specific, localised and reproducible. They hurt in a defined spot, are aggravated by activity and tender to touch. If your child has pain in a consistent location during or after sport, it is worth getting assessed.
Usually not. Most growth plate injuries can be managed with load modification rather than complete rest. The goal is to find a level of activity that does not significantly worsen symptoms while keeping your child active and maintaining fitness. Complete rest often leads to deconditioning, which makes the return to sport harder.
It depends on the condition and how early it is managed. Most children improve significantly within four to eight weeks with the right approach. The condition fully resolves once the growth plate closes, which happens at different ages depending on the location. Sever's disease typically resolves by age 14 to 15, while Osgood-Schlatter resolves by 16 to 18.
Yes. Chiropractors are trained to assess and manage musculoskeletal conditions in children. Treatment is gentle, age-appropriate and focused on reducing the load on the affected growth plate through soft tissue work, joint mobilisation and targeted strengthening. We also guide parents on activity modification and home exercises.
Many children develop a visible bump at the tibial tuberosity (the bony point below the kneecap). This is caused by the growth plate responding to repeated traction. In most cases the bump remains after the condition resolves but is painless and does not affect function.
