If your child or teenager has been complaining of pain near their heels or knees, especially after playing sports or being active, then they may be experiencing a growth plate injury. These types of injuries are common during growth spurts and can often affect young athletes. In this blog, we’ll help you understand what growth plates are, why they’re vulnerable, and explore two common conditions we often see in young athletes: Sever’s Disease and Osgood-Schlatter’s Disease.

What Are Growth Plates?

Growth plates (also known as epiphyseal plates) are areas of developing cartilage located near the ends of long bones in children and adolescents. These plates allow bones to lengthen as kids grow.

Because growth plates are softer and more vulnerable than mature bone, they’re more susceptible to injury—especially when placed under repeated stress or during a rapid phase of growth. (Circi, Atalay & Beyzadeoglu, 2017).

Why Do Growth Plate Injuries Happen?

Growth plate injuries typically occur due to:

• Overuse from sports or activity
• Sudden increases in training load or intensity
• Muscle tightness pulling on growing bones
• Imbalances between strength and flexibility
• Trauma or impact injuries

Young athletes involved in running, jumping, or high-impact sports like soccer, rugby, gymnastics, netball, and athletics are particularly at risk.

Common Growth Plate Injuries:

1. Sever’s Disease (Calcaneal Apophysitis)

Sever’s Disease is a growth-related condition affecting the heel bone (calcaneus). It occurs when the Achilles tendon pulls on the growth plate at the back of the heel, causing irritation and inflammation.

Who Gets It?

Typically seen in children aged 8–14, especially those who are active in running and jumping sports (James, Williams & Haines, 2013).

Symptoms:

• Pain at the back of the heel (often in both heels)
• Pain worsens during or after activity
• Tenderness when squeezing the heel
• Limping or walking on toes to avoid heel contact

Risk Factors:

• Growth spurts
• Tight calf muscles or Achilles tendon
• High activity levels, especially in cleated shoes or on hard surfaces

2. Osgood-Schlatter’s Disease

Osgood-Schlatter’s Disease affects the tibial tuberosity, the bony bump just below the kneecap. Repeated pulling by the quadriceps muscle via the patellar tendon causes inflammation and sometimes a visible bony lump.

Who gets it?

Most common in children aged 10–15, especially those who play sports with running, kicking, and jumping (like soccer, basketball, or hockey).

Symptoms:

• Pain just below the kneecap
• Swelling or a prominent bump at the top of the shin
• Pain worsens with activity, especially squatting, jumping, or going up stairs
• Tenderness to touch over the shin bone

Risk Factors:

• Periods of rapid growth
• More common in boys
• Tight quadriceps or hamstrings
• Poor biomechanics or muscle imbalances
• High-impact activity with little rest

How Physiotherapy Can Help

Both Sever’s Disease and Osgood-Schlatter’s Disease are self-limiting conditions, meaning they will often resolve with time as growth slows. However, physiotherapy plays an important role in managing symptoms and keeping kids active, safely.

Our Approach Includes:

• Accurate Assessment & Diagnosis
• Activity Modification: helping your child stay active while reducing aggravating movements
• Stretching Program: targeting tight muscles like the calves, quads, and hamstrings
• Strengthening Exercises: to support surrounding joints and improve biomechanics
• Manual Therapy: gentle techniques to reduce muscle tension
• Education & Load Management: guidance for return to sport and prevention of recurrence

Tips for Parents & Coaches

• Encourage proper warm-up and cool-down routines
• Ensure kids wear supportive, well-fitting footwear
• Avoid sudden spikes in training load
• Listen to pain, if it’s persistent or affects movement, seek help
• Don’t push through pain: rest and rehab are crucial

When to See a Physio

If your child is struggling with heel or knee pain that interferes with daily activities or sports, it’s a good idea to see a physiotherapist. Early intervention can help manage symptoms, prevent further irritation, and ensure a safe return to activity.

At Pretto Physio, we work with young athletes and growing kids to keep them moving and pain-free. Whether it’s Sever’s Disease or Osgood-Schlatter’s we’re here to help get them back to doing what they love.

Reference List

Circi, E., Atalay, Y. & Beyzadeoglu, T. (2017) ‘Treatment of Osgood–Schlatter disease: review of the literature’, Musculoskeletal Surgery, 101(3), pp. 195–200. doi:10.1007/s12306-017-0479-7.

Hernandez-Lucas, P., Leirós-Rodríguez, R., García-Liñeira, J. & Diez-Buil, H. (2024) ‘Conservative Treatment of Sever’s Disease: A Systematic Review’, Journal of Clinical Medicine, 13(5), 1391. doi:10.3390/jcm13051391.

James, A. M., Williams, C. M. & Haines, T. P. (2013) ‘Effectiveness of interventions in reducing pain and maintaining physical activity in children and adolescents with calcaneal apophysitis (Sever’s disease): a systematic review’, Journal of Foot and Ankle Research, 6, 16. doi:10.1186/1757-1146-6-16.

StatPearls (2025) Osgood-Schlatter disease. StatPearls Publishing, 2025. Available at: (Accessed: 11 August 2025).