These changes related to rapid growth and bony changes can cause a range of injuries unique to the adolescent group including:

• Avulsion Fracture Injuries
• Apophysitis
• Osteochondritis Dissecans

Avulsion Fractures:
A small chip of bone is pulled off by a relatively stronger muscle during a sudden, forceful muscle contraction during sports or activity. These injuries are often managed conservatively and respond well to physiotherapy, strengthening exercises and a gradual return to sport.

Apophysitis:
The apophysis describes the part of a bone where major tendons and ligaments attach. Apophysitis is an irritation and inflammation of this bony attachment point and is most often an overuse injury, with the adolescent completing high training loads or repetitive movements in their sport. Common sites for apophysitis are the knee (oschgood schlatters), heel (severs disease) and at multiple locations around the hip.

Osteochondritis dissecans:
Osteochondritis dissecans is a joint disorder, where break-down of bone and the overlying cartilage occurs. This damage can cause small pieces of bone to separate and create pain and swelling in the joint. The exact cause of this disorder is not known, but it is thought that repetitive stress or small traumas during sporting activities may affect blood supply to the bone thus creating the bony damage.

Early diagnosis and treatment is key for better long-term outcomes. Many adolescents can be managed conservatively, with activity restriction and reduced loads through the affected joint (often with the use of braces and/or crutches). Sometimes surgery is required to help promote bony healing. After surgery, these adolescents will require physiotherapy rehabilitation to improve strength and mobility and a guided return to activities.