Understanding Traction Apophysitis in Adolescents: A Guide for Parents and Young Athletes

As a physiotherapist, I’ve seen firsthand how injuries in young athletes can shape their physical and emotional journeys. One common yet often misunderstood condition in adolescents is traction apophysitis—a fancy term for inflammation or irritation where growing tendons pull on the soft, developing bone. This happens during growth spurts when bones, muscles, and tendons are all trying to keep up with each other. For parents, coaches, and young athletes, understanding this condition can mean the difference between a thriving sports experience and a cycle of pain and setbacks.

What Is Traction Apophysitis?

Traction apophysitis occurs at the growth plates—soft areas of cartilage at the ends of bones where growth happens. In active kids, repetitive pulling from strong tendons during sports like running, jumping, or kicking can irritate these spots. It’s most common between ages 8 and 15, when growth is rapid and kids are pushing their bodies hard.

Some of the most well-known types include:

• Osgood-Schlatter's: Pain just below the knee where the patellar tendon attaches to the shinbone. It’s a classic in sports like soccer or basketball.

• Sever’s: Heel pain where the Achilles tendon meets the heel bone, often seen in runners or gymnasts.

Then there are less common ones, like:

• Sinding-Larsen-Johansson Syndrome: Pain at the bottom of the kneecap, linked to jumping or climbing.

These conditions might sound scary, but they’re manageable with the right approach. The catch? About 80% of managing them comes down to load—how much stress you put on the body through activity.

The First Injury: A Fork in the Road

Picture this: Your 12-year-old soccer star comes home limping after practice, clutching their knee. It’s their first real injury—maybe Osgood-Schlatter’s flaring up. This moment is critical. If handled well, it’s a bump in the road. If mismanaged, it can snowball into bigger problems, both physically and mentally.

Physically, pushing through pain can worsen the irritation, prolong healing, and even set the stage for mismanagement of future injuries. Psychologically, it’s just as heavy. Adolescents’ brains are wired to either survive or thrive. A survival mindset kicks in when fear takes over—fear of missing out on the team, fear of letting the coach down, fear they’re not good enough. I’ve seen kids grit their teeth through pain, not because they’re tough, but because they’re scared to stop. That’s a story of survival, not strength.

Load Management: The Key to Recovery

Here’s the good news: traction apophysitis doesn’t have to derail your child’s love for sport. The trick is managing load—the total amount of running, jumping, and training they do. As a physiotherapist, I’d say 80% of the battle is figuring out the right balance. Too much load keeps the injury angry; too little, and your kid feels left out or loses fitness.

This isn’t a solo job—it’s a team effort. Parents, coaches, and the athlete need to work together, with a physiotherapist guiding the plan. We might tweak training schedules, swap high-impact drills for low-impact skills, or build in rest days. The goal? Keep them in the game without making things worse. If load isn’t managed early, pain lingers, and eventually, you’re looking at longer breaks from sport—weeks or even months. No one wants that.

Teaching Kids to Test & 'Rest', Not Tough It Out

One of the biggest lessons I teach young athletes is to test their injuries & then rest from those activities that exacerbate them, not ignore them. Pain isn’t a badge of honor—it’s a signal. Playing through it might feel brave in the moment, but it can lead to a cycle of injury that steals the joy from sport. Instead, we teach them to listen to their bodies. For example:

• With Osgood-Schlatter’s, can they kneel without sharp pain? If not, we adjust.

• With Sever’s, does a quick jog hurt the heel? Time to ease off.

This isn’t about coddling—it’s about empowering them. When kids learn to manage injuries smartly, they set themselves up for a lifetime of sport, not a string of setbacks. Remember, 'rest' doesn't mean, sit on the lounge and do nothing. Here at Up N Adam Performance Training & Physiotherapy, we strive to find the appropriate load & the appropriate activities that enable your child to continue moving & staying strong whilst the traction apophysitis pain settles.

A Path to Thriving

Imagine your child back on the field, pain-free, grinning ear to ear. That’s the goal. Traction apophysitis doesn’t have to be a villain in their story. With the right team approach—led by a physiotherapist—and a focus on load management, they can thrive, not just survive. They’ll build resilience, confidence, and a love for sport that lasts.

So, if your young athlete starts limping or complaining, don’t brush it off. Get it checked. Teach them that resting now means running later. Together, we can turn that first injury into a lesson in strength—not a step toward struggle.

This is APA Sports Physiotherapist, Darren Glendenning, signing off for now!

You can book an appointment with Darren or Newcastle Knights Physiotherapists Katie or Hayd'n at www.upnadamptphysio.com

Bookings also available on our website for:

• Dietitian - weight-loss or to optimise your training nutrition / fueling

• VO2 Max testing - to discover more effective ways to train efficiently

• Strength & Conditioning Programs - contact us via the website or email us at upnadamptphysio@gmail.com

• Remedial Massage - to relieve accumulative muscle tension & keep you training well.