Growth-Related Conditions.
Why growth-related conditions develop
The pre-teen and teenage years are a period of rapid skeletal growth — and with that growth comes a specific window of vulnerability to a group of conditions that are almost exclusively seen during this developmental phase. Growth-related conditions are medical conditions that affect the growth and development of children and teenagers. These conditions can be caused by a variety of factors, including genetic disorders, hormonal imbalances, injuries, and other underlying health problems.
The key anatomical reason most growth-related conditions develop during adolescence is the growth plate — the area of cartilage at the ends of long bones where new bone tissue is produced. Growth plates are significantly weaker than mature bone, and the tendons and muscles that attach to them are put under increasing tensile stress as bones lengthen rapidly during growth spurts. This creates a window during which repetitive loading from sport, activity or simply rapid growth can produce characteristic apophysitis — inflammation at the growth plate — at specific anatomical sites throughout the body.
The good news for parents: these conditions are self-limiting. They resolve when the growth plate closes and the apophysis fuses to the adjacent bone — typically between 14 and 18 years depending on the site and the individual. The challenge is managing symptoms and maintaining activity participation until that point. This is exactly where physiotherapy makes the most meaningful contribution — not by curing the underlying growth process, but by managing load, building supporting strength, and keeping young athletes active and in the sport they love.
Conditions we treat
Osgood-Schlatter disease — the most common growth-related condition in our clinic — involves traction stress at the tibial tuberosity, where the patellar tendon attaches to the shinbone. It produces the characteristic painful lump just below the kneecap in active adolescents aged 10 to 15, particularly those in running and jumping sports. Load management, quadriceps and hip strengthening, and patellar taping are the primary physiotherapy interventions.
Sever's disease — the heel equivalent of Osgood-Schlatter — involves traction stress at the calcaneal apophysis, where the Achilles tendon attaches to the developing heel bone. It is the most common cause of heel pain in children aged 8 to 14 and is particularly prevalent in football, rugby, basketball and running sports. Calf stretching, heel cups and load management are the mainstays of treatment.
Sinding-Larsen-Johansson syndrome — a traction apophysitis at the inferior pole of the patella (the bottom of the kneecap) — produces anterior knee pain at a slightly different location to Osgood-Schlatter and affects a similar age group. Management follows the same principles.
Scheuermann's disease — structural kyphosis (rounded upper back) developing during adolescent growth due to abnormal vertebral end plate development — produces thoracic pain and progressive forward posture in teenagers. Physiotherapy addresses thoracic mobility, postural strengthening and pain management, and in more significant cases works alongside medical and surgical assessment.
Scoliosis — lateral curvature of the spine — most commonly develops or progresses during the adolescent growth spurt. Physiotherapy monitors curve progression, addresses postural and muscular contributors, and provides specific scoliosis exercise programs. Significant curves require medical and orthopaedic co-management.
Stress fractures — bone stress injuries from training load exceeding skeletal adaptation capacity — are more common in adolescents than adults, particularly in young female athletes where relative energy deficiency in sport (RED-S) reduces bone density and increases fracture risk. The metatarsals, tibia and pars interarticularis (lumbar stress fracture in young fast bowlers and gymnasts) are the most common sites.
Hypermobility and joint hypermobility spectrum disorders — generalised joint laxity that becomes symptomatic during the adolescent growth phase as increasing body weight and training demands exceed the capacity of loose joints and connective tissue. Hypermobility in adolescents is common in the dance population and requires specific physiotherapy that builds dynamic stability without restricting the range of motion that defines performance.
Hip and groin conditions in adolescent athletes — including femoroacetabular impingement and hip labral tears — are increasingly recognised in young athletes, particularly in sports requiring extreme hip range of motion or repetitive hip loading.
Postural conditions — forward head posture, thoracic kyphosis and hyperlordosis that develop or worsen during adolescence from a combination of growth, screen use and reduced physical activity — are increasingly common presentations in school-aged children.
Managing growth-related conditions — the physiotherapy approach
The management of growth-related conditions shares common principles regardless of the specific site. Load management — reducing the activities most provocative of symptoms while maintaining as much participation as possible through less aggravating alternatives — is the primary intervention. The complete rest approach is rarely necessary and often counterproductive in active adolescents.
Strengthening of the muscles around the affected site reduces the tensile stress on the vulnerable growth plate. For Osgood-Schlatter, this means quadriceps and hip strengthening. For Sever's, calf and hip strengthening. For spinal growth conditions, thoracic extension, core and postural strengthening.
Flexibility work — calf and quadriceps stretching for lower limb apophysitis — reduces the resting tension in the muscles transmitting force to the growth plate. Bracing and padding — heel cups for Sever's, patellar strapping for Osgood-Schlatter — provide symptomatic relief and allow greater activity participation during the most symptomatic phase.
Parent and coach education is an essential component — understanding what these conditions are, why complete rest is rarely the answer, and how to use symptom response to guide training decisions, reduces anxiety and enables better shared decision-making about training loads and competition participation.
Clinical Pilates adapted for adolescents provides a controlled, low-impact strengthening environment that is particularly useful for dancers and gymnasts with growth-related conditions where the exercise environment needs to be compatible with their training context.
Our physiotherapists Mauricio Bara, Bethany Kippen and Emma Cameron all have experience in adolescent musculoskeletal conditions and are members of the Australian Physiotherapy Association. Eliane's doctoral research in lower limb biomechanics is directly relevant to the loading assessment and rehabilitation of lower limb growth-related conditions. Emma's experience in dance physiotherapy and pre-pointe assessment gives her specific expertise in growth-related conditions in the dance population.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
The pre-teen and teenage years are a period of rapid skeletal growth — and with that growth comes a specific window of vulnerability to a group of conditions that are almost exclusively seen during this developmental phase. Growth-related conditions are medical conditions that affect the growth and development of children and teenagers. These conditions can be caused by a variety of factors, including genetic disorders, hormonal imbalances, injuries, and other underlying health problems.
The key anatomical reason most growth-related conditions develop during adolescence is the growth plate — the area of cartilage at the ends of long bones where new bone tissue is produced. Growth plates are significantly weaker than mature bone, and the tendons and muscles that attach to them are put under increasing tensile stress as bones lengthen rapidly during growth spurts. This creates a window during which repetitive loading from sport, activity or simply rapid growth can produce characteristic apophysitis — inflammation at the growth plate — at specific anatomical sites throughout the body.
The good news for parents: these conditions are self-limiting. They resolve when the growth plate closes and the apophysis fuses to the adjacent bone — typically between 14 and 18 years depending on the site and the individual. The challenge is managing symptoms and maintaining activity participation until that point. This is exactly where physiotherapy makes the most meaningful contribution — not by curing the underlying growth process, but by managing load, building supporting strength, and keeping young athletes active and in the sport they love.
Conditions we treat
Osgood-Schlatter disease — the most common growth-related condition in our clinic — involves traction stress at the tibial tuberosity, where the patellar tendon attaches to the shinbone. It produces the characteristic painful lump just below the kneecap in active adolescents aged 10 to 15, particularly those in running and jumping sports. Load management, quadriceps and hip strengthening, and patellar taping are the primary physiotherapy interventions.
Sever's disease — the heel equivalent of Osgood-Schlatter — involves traction stress at the calcaneal apophysis, where the Achilles tendon attaches to the developing heel bone. It is the most common cause of heel pain in children aged 8 to 14 and is particularly prevalent in football, rugby, basketball and running sports. Calf stretching, heel cups and load management are the mainstays of treatment.
Sinding-Larsen-Johansson syndrome — a traction apophysitis at the inferior pole of the patella (the bottom of the kneecap) — produces anterior knee pain at a slightly different location to Osgood-Schlatter and affects a similar age group. Management follows the same principles.
Scheuermann's disease — structural kyphosis (rounded upper back) developing during adolescent growth due to abnormal vertebral end plate development — produces thoracic pain and progressive forward posture in teenagers. Physiotherapy addresses thoracic mobility, postural strengthening and pain management, and in more significant cases works alongside medical and surgical assessment.
Scoliosis — lateral curvature of the spine — most commonly develops or progresses during the adolescent growth spurt. Physiotherapy monitors curve progression, addresses postural and muscular contributors, and provides specific scoliosis exercise programs. Significant curves require medical and orthopaedic co-management.
Stress fractures — bone stress injuries from training load exceeding skeletal adaptation capacity — are more common in adolescents than adults, particularly in young female athletes where relative energy deficiency in sport (RED-S) reduces bone density and increases fracture risk. The metatarsals, tibia and pars interarticularis (lumbar stress fracture in young fast bowlers and gymnasts) are the most common sites.
Hypermobility and joint hypermobility spectrum disorders — generalised joint laxity that becomes symptomatic during the adolescent growth phase as increasing body weight and training demands exceed the capacity of loose joints and connective tissue. Hypermobility in adolescents is common in the dance population and requires specific physiotherapy that builds dynamic stability without restricting the range of motion that defines performance.
Hip and groin conditions in adolescent athletes — including femoroacetabular impingement and hip labral tears — are increasingly recognised in young athletes, particularly in sports requiring extreme hip range of motion or repetitive hip loading.
Postural conditions — forward head posture, thoracic kyphosis and hyperlordosis that develop or worsen during adolescence from a combination of growth, screen use and reduced physical activity — are increasingly common presentations in school-aged children.
Managing growth-related conditions — the physiotherapy approach
The management of growth-related conditions shares common principles regardless of the specific site. Load management — reducing the activities most provocative of symptoms while maintaining as much participation as possible through less aggravating alternatives — is the primary intervention. The complete rest approach is rarely necessary and often counterproductive in active adolescents.
Strengthening of the muscles around the affected site reduces the tensile stress on the vulnerable growth plate. For Osgood-Schlatter, this means quadriceps and hip strengthening. For Sever's, calf and hip strengthening. For spinal growth conditions, thoracic extension, core and postural strengthening.
Flexibility work — calf and quadriceps stretching for lower limb apophysitis — reduces the resting tension in the muscles transmitting force to the growth plate. Bracing and padding — heel cups for Sever's, patellar strapping for Osgood-Schlatter — provide symptomatic relief and allow greater activity participation during the most symptomatic phase.
Parent and coach education is an essential component — understanding what these conditions are, why complete rest is rarely the answer, and how to use symptom response to guide training decisions, reduces anxiety and enables better shared decision-making about training loads and competition participation.
Clinical Pilates adapted for adolescents provides a controlled, low-impact strengthening environment that is particularly useful for dancers and gymnasts with growth-related conditions where the exercise environment needs to be compatible with their training context.
Our physiotherapists Mauricio Bara, Bethany Kippen and Emma Cameron all have experience in adolescent musculoskeletal conditions and are members of the Australian Physiotherapy Association. Eliane's doctoral research in lower limb biomechanics is directly relevant to the loading assessment and rehabilitation of lower limb growth-related conditions. Emma's experience in dance physiotherapy and pre-pointe assessment gives her specific expertise in growth-related conditions in the dance population.
To book or find out more, call us on 07 3706 3407 or book online below. We see patients from across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt.
Who to book in with:
If you are unsure about which appointment type is right for you, please don't hesitate to get in touch with our friendly reception staff by calling 07 3706 3407 or emailing [email protected].