Growth Spurts and Growing Pains: Sever’s & Osgood-Schlatter’s — What You Need to Know

Adolescent growth-related injuries aren’t just “growing pains.” Conditions like Sever’s disease (heel pain) and Osgood-Schlatter’s disease (knee pain) are common in active kids — especially during growth spurts. These injuries can limit sport participation and frustrate parents who want answers fast.

The good news? With the right education and physiotherapy, most kids recover fully — often without the need for imaging or long-term rest.

In this post, we’ll unpack what these conditions are, what doesn’t work, what does, and how our approach at Functional Xcellence helps families navigate these issues with confidence.

What’s Going On? The Basics of Growth-Related Injuries

When kids grow quickly, bones lengthen faster than muscles and tendons can adapt. This creates tension at the growth plates — areas of developing bone that are more vulnerable to stress.

Two common sites are:

• Sever’s Disease (Calcaneal Apophysitis): Pain at the back or underside of the heel, especially with running, jumping, or after sport.

• Osgood-Schlatter’s Disease (Tibial Tuberosity Apophysitis): Pain and a small bump just below the kneecap, worse with jumping, kneeling, or sprinting.

Common features include:

• Pain that worsens with activity, improves with rest

• Tenderness at the growth plate site (heel or shin)

• Often during peak growth (10–14 years old)

• No swelling, redness, or true “joint pain”

These are self-limiting conditions — meaning they resolve as the growth plates mature — but the right management shortens recovery and prevents frustration.

What Doesn’t Work (or Helps Less)

• Resting indefinitely — long breaks reduce fitness but don’t address load tolerance

• Over-reliance on imaging — X-rays or MRIs rarely change management for these conditions

• Pushing through pain — can delay recovery and worsen sensitivity

• Tight shoes or hard footwear — increase tension through the heel and knee

• Ignoring training load — sudden spikes in running, jumping, or new sports are major triggers

These approaches can create unnecessary worry, cost, and time away from sport.

What Does Work: Evidence-Based Rehab for Growing Athletes

1. Load Management & Smart Activity Modification

Find the sweet spot between total rest and overuse. Pain should guide activity, not stop it.

• Reduce high-impact or repetitive jumping temporarily

• Encourage cross-training (e.g. swimming, cycling)

• Gradually rebuild sport load as pain allows

2. Targeted Strength & Flexibility Work

Physio-guided exercise focuses on restoring balance between muscle and bone growth:

• Calf and hamstring strength to reduce traction forces

• Quads and glute control for knee alignment

• Gentle stretching (not aggressive pulling) for tight muscles during growth spurts

3. Footwear & Support

• Shock-absorbing shoes or gel heel cups for Sever’s

• Patellar straps or knee padding for Osgood-Schlatter’s if needed

4. Education for Parents & Athletes

Understanding that this is a growth-related, not structural injury helps reduce anxiety.

• Imaging is rarely needed unless red flags exist

• Pain does not mean damage

• Gradual load and patience = best long-term outcomes

Bottom Line & Take-Home Messages

• Growth-related injuries like Sever’s and Osgood-Schlatter’s are common, benign, and highly manageable with the right guidance.

• Early education and physiotherapy prevent unnecessary scans and rest periods.

• Smart load management and strength work help kids return to sport confidently and safely.

• Building trust between GPs, physiotherapists, and parents ensures consistent care and reassurance during these critical growth years.

At Functional Xcellence, we combine education, movement assessment, and progressive loading to help your young athlete stay active, informed, and pain-free — through every stage of growth.

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