Traction apophysitis: The Alex

Traction apophysitis is a term used for a group of ‘conditions’ that tends to affect children who are having a ‘growth spurt’.

The two most common conditions are:

• Osgood-Schlatter Disease (Tibial apophysitis).
• Severs Disease (Calcaneal apophysitis).

This tends to affect children aged 11- 15 and is more common in boys. The main symptom is pain just below the front of the knee; sometimes there is also a tender lump.

Often, the pain is noticed after a high level of physical activity but with rest it tends to settle.

Osgood-Schlatter disease is probably the result of rapid growth and pulling of the quadriceps tendon around the growth plate of the knee.

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This tends to affect children aged 7 - 12 and is more common in boys. The main symptom is heel pain where the Achilles tendon joins the heel bone.

Often, the pain is noticed after a high level of physical activity but with rest it tends to settle.

Severs disease is probably the result of rapid growth and pulling of the Achilles tendon around the growth plate of the heel.

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These conditions will get better on their own as your child rests. However, pain may start again with a high level of physical activity and possibly take weeks or months to settle completely. Traction apophysitis conditions are not the cause of any long term problems like arthritis.

If the symptoms are causing a lot of pain, it may be wise to stop the activities which cause the pain. However, your child may be allowed to continue sporting activities if they are willing to put up with the discomfort caused by the activity.

If symptoms are mild, then treatment may not be needed.

Clinician comments:

Our aim is to provide information that will help you understand your child’s injury and enable the appropriate after-care.

There are lots of useful injury leaflets to download at the Royal Alexandra website; use the QR code below or follow the link: bsuh.nhs.uk/alex/services/accident-and-emergency/

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Useful numbers:

NHS 111 - 24hr advice line.
Practice Plus (Brighton walk-in Centre) 0333 321 0946.
Practice Plus GP – 0300 130 3333 8am/8pm - 7 days a week.

This information is intended for patients receiving care in Brighton & Hove or Haywards Heath.

The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.