Growing Pains or a Sports Injury? Understanding Heel and Knee Pain in Active Kids (Apophysitis)

Annie Chappell, PhD | June, 2025  
 
As a parent in the South West, watching your active child suddenly limp off the sports field with heel or knee pain can be worrying. You might wonder if it’s just 'growing pains' or something more. Often, the cause is a common and treatable condition called apophysitis, which affects the growth plates in children and teenagers. In this post, our expert paediatric physiotherapy team explains what it is, what to look for, and how we can help your child get back to the activities they love. 

What is Apophysitis? 

Children are not little adults, and their injuries are not adult injuries. Pain after activity in growing children may be due to apophysitis, which does not occur in adults whose bones have stopped growing. The term apophysitis refers to irritation of a bony bump next to a growth plate. It is often caused by muscles pulling strongly on the bone of an active, growing child. 

Common Types of Apophysitis 

Apophysitis has been called different things depending on its location, for example: 

• Sever’s – at the heel 

• Osgood-Schlatter’s – at the knee 

• Sinding-Larsen-Johanssen’s – at the kneecap 

• Iselin’s – on the outside of the foot 

• Little league elbow 

• Little league shoulder 

How Paediatric Physiotherapy Can Help 

Treatment for apophysitis generally involves: 

• stretching tight muscles near the site of the pain 

• improving biomechanics 

• relative rest / modification of sport schedules 

• offloading the tendon which attaches to the painful site 

• icing after activity 

• limited use of nonsteroidal anti-inflammatory drugs 

Managing apophysitis effectively is about finding the right balance between rest and activity to allow the irritation to settle while addressing the underlying causes, like muscle tightness or biomechanics. With the right guidance, your child can typically continue with their sport in a modified way and return to full activity feeling strong and confident. 

Your Local Support for Children's Sports Injuries 

If you're in Busselton, Bunbury, Dunsborough, Margaret River, or Katanning and are concerned about your child's pain after activity, our dedicated paediatric physiotherapists are here to help. We provide a comprehensive assessment and a personalised plan to empower your child to get back on their feet, pain-free.  

Contact us today to book a consultation and get a clear plan for your child's recovery 

References  

Achar, Suraj, and Jarrod Yamanaka. "Apophysitis and osteochondrosis: common causes of pain in growing bones." American family physician 99.10 (2019): 610-618.