Osteopathic care for apophysitis

Your child is between 9 and 16 years old ? He practices sport regularly and consistently complain about knee or heel pain while exercising, climbing stairs or kneeling ? Your child might suffer from an apophysitis. The most common apophysitis are :

• Osgood-Schlatter Disease (OSD) (upper part of the tibia),
• Sinding-Larsen Disease (lower part of the patella)
• Sever’s Disease (heel), usually of a ration Boy/Girl of 3/1.

During childhood and teenagehood, the bone is not completely ossified, part of it is still fibrous, leaving space for growing. Those part of the bone are called secondary ossification centers, more resilient than ossified bone. Those cartilage areas are sensitive to regular excessive activity and trauma. Therefore, they can be subject to inflammation, even avulsion fractures in the worst case (tibia tuberculosis separating from the tibia in case of OSD). Thus, can be a terrain for other pain in the body : backache, neck pain sometimes even headaches. Can be a terrain for a bad body posture (adaptation to the pain), especially in the pelvis and the spine.

Diagnosis is made based on signs and symptoms but can be infirmed or confirmed by ultrasonography or X-ray.

Prevention of apophysitis is muscle stretching. Hamstring and quadriceps for OSD and SLD, calf and tibial muscles for Sever’s disease.

In conclusion, in addition to reducing (sometimes stopping) sport activity during the healing process from inflammation, an osteopathic treatment can prevent future misalignment and dysfunctional movement of other parts of the body (pelvis and spine are the main adaptative areas for this symptoms). The body, already subject to a lot of tension and pain during growth can benefit greatly from an osteopathic treatment. Of course, management of this particular pathologies demands from the patients some commitments into advices than the osteopath is giving (icing, stretching, rest).