The number of children participating in youth sports is growing each year and so is the number of sports related injuries. Research indicates that injuries in children make up approximately 5% of all visits to medical doctors. During adolescence (ages 10 to 19), the number jumps to 10% with more boys than girls affected. Most injuries to young athletes are related to overuse and occur gradually over time, when an athletic activity is repeated so often that the affected areas of the body do not have enough time to heal between activities.
Why the increase. Prior to puberty, sports injuries are not very common. But just before, during and after puberty, there are significant changes in muscles and bones that can increase the risk of injury. With the onset of puberty, bone length grows at a faster rate than muscles and tendons. Bones increase in length; muscles increase in size. Because bone length is increasing at a faster rate than muscle and tendon length, the muscles become tight which, in turn, reduces flexibility. An increase in muscle tightness (lack of flexibility) can also increase the pulling force on the growth plate of bones at the attachment site and can cause pain and inflammation. If the situation is not treated and/or the athlete continues to train and play, does not improve flexibility and does not give the apophysis time to heal, the pain will increase. In the worst cases, the cartilage can be pulled away from the bone resulting in an avulsion fracture.
Muscles attach to bones by tendons. In young athletes, the sites of attachment are called apophysis. These sites are growth plates made of cartilage that is weaker than bones and muscles. When a muscle contracts to move a bone, it tugs on the apophysis (growth plate). When these tugs occur repeatedly, with too much force or with bad mechanics, they can, over time, injure the cartilage and cause, inflammation, swelling and pain (apophysitis).
Many sports medicine specialists believe that the increasing number of sports injuries in young athletes is attributed to early specialization and year-round participation in sports. In the past, children changed sports with the seasons. Today it is common for some children to play on more than one team at the same time while others participate in a single sport, all year long. This repetitive use of the same muscle groups places unchanging stress to specific areas of the body, leading to muscle imbalances that, when combined with overtraining and inadequate rest periods, can put young athletes at serious risk for overuse injuries.
What are the signs and symptoms of apophysitis? Common signs and symptoms include:
- Pain, swelling and tenderness over a growth plate where a muscle tendon attaches that often increases with activity, and can’t be tied to an acute injury, such as from a collision or fall
- Pain that typically worsens with activity, improves with rest and sometimes causes a limp
- Changes in running, throwing, jumping form or technique
Who gets apophysitis? Young athletes who are involved in sports that require repetitive action of the same joint or joints are most susceptible, especially those involved in throwing sports like baseball, jumping in basketball and running in track and soccer.
