As winter sports return, we often see a rise in young athletes presenting with heel or knee pain. Sports like soccer, netball, AFL, basketball and rugby all ramp up again .. . and so do conditions linked to growing bodies under increasing load.
Two of most common causes of pain in active kids during this time are Sever’s disease and Osgood-Schlatter’s disease. Both fall under a broader category called apophysitis.
What is Apophysitis?
Apophysitis refers to irritation or inflammation at a growth plate where a tendon attaches to bone. In growing children, these areas are naturally weaker because the bone is still developing. When strong muscles repeatedly pulll on these developing areas durign sport, the attachment site can become irritated and painful.
A key factor is that bones and muscles don’t always grow at the same rate. During growth spurts, bone may lengthen quickly while muscles and tendons temporarily become tighter. This increase tension places more stress on the attachment points .
When sport volumes increases, like at the start of a season, these areas can become overloaded.
Sever’s Disease (heel pain)
Sever’s disease affects the back of the heel, where the calf muscles attach via the Achilles tendon. It commonly occurs in children aged 8-12 years, particularly those involved in running and jumping sports.
Common signs include:
– Heel pain during or after sport
– Tenderness at the back or sides
– Limping or discomfort walking after activity
– Pain with running, jumping or calf raises
Osgood-Schlatter’s Disease
Osgood-Schlatter disease affects just below the kneecap, where the patella tendon attaches to the shin bone. It typically occurs in children aged 10-16 years, especially during periods of rapid growth.
Common signs include:
– Pain or swelling just below the kneecap
– Tenderness at the tibial tuberosity (the bony bump below the knee)
– Pain when running, jumping, kneeling or squatting
– Pain worsens with sport
Why We See More Cases at the Start of Sports Seasons
At the beginning of winter sports seasons, young athletes often experience:
– A sudden increase in training load
– Multiple sports or training sessions per week
– Growth spurts
– Reduced recovery between activities
These factors together can increase stress on developing growth plates.
The Good News – Kids Can Usually Keep Moving
These conditions are very common and often managed well. In most cases, young athletes don’t need to stop sport complete. Instead, management usually focuses on:
– Adjusting training load
– Managing symptoms
– Improving strength and flexibility
– Supporting a gradual return to full activity
With the right approach, kids can stay active while allowing the irritated area to settle.
A Quick but Important Note
While Sever’s disease and Osgood-Schlatter disease are common causes of heel and knee pain in growing athletes, similar symptoms can sometimes be caused by other conditions or injuries. Because of this, it’s always best to have ongoing pain assessed by a physiotherapist who can help differentiate the cause and guide the most appropriate treatment and return-to-sport plan.
When to Seek Advice
If your child is experiencing ongoing heel or knee pain with sport, it’s worth having it assessed early. Appropriate guidance can help manage symptoms, prevent flare-ups, and keep kids participating in the activities they enjoy.
At our clinic, we work with young athletes and their families to identify the cause of pain, guide treatment, and support a safe return to sport for growing bodies
