Chiropractic Care for Adolescents and Teens in Joondalup: Supporting Growing Bodies Through Sport
Load management and targeted rehab can help teens work through growth related knee and heel pain and stay involved in the sport they love.
The teenage growth spurt is hard enough without pain getting in the way of sport. We see a lot of growth related knee and heel pain in active teens across Joondalup and Perth’s northern suburbs, most commonly Osgood-Schlatter disease, Sever’s disease and Sinding-Larsen-Johansson disease, all linked to rapid growth combined with high training loads.
What Are Osgood-Schlatter, Sever’s and Sinding-Larsen-Johansson Disease?
All three conditions are what’s known as traction apophysitis, irritation at a growth plate where a tendon attaches to bone, caused by repetitive pulling during activities like running and jumping.
Osgood-Schlatter affects the growth plate at the top of the shin bone, just below the kneecap, where the patellar tendon attaches.
Sinding-Larsen-Johansson affects the opposite end of the same tendon, at the bottom of the kneecap itself, and is often described as Osgood-Schlatter’s close cousin.
Sever’s disease affects the growth plate at the back of the heel, where the Achilles tendon attaches.
All three are common in growing, physically active adolescents and generally resolve once the growth plate matures, though that can take some time.
Symptoms
- Pain and tenderness at the top of the shin bone, just below the kneecap (Osgood-Schlatter)
- Pain and tenderness at the bottom of the kneecap itself, just above where the patellar tendon starts (Sinding-Larsen-Johansson)
- Pain at the back or underside of the heel, often worse with running or jumping (Sever’s)
- Pain that builds during and after sport, particularly running, jumping or kicking sports
- A small, tender bump that can develop below the kneecap over time
- Discomfort easing with rest, then flaring again once training resumes
What Causes These Conditions
- A growth spurt, where bones lengthen faster than the surrounding muscles and tendons can adapt
- High training loads, particularly in running, jumping or kicking sports
- A sudden increase in training volume, such as pre-season
- Tightness through the quadriceps or calf muscles, increasing pull on the growth plate
What the Research Shows
A structured approach of activity modification and strengthening is the evidence backed way to manage Osgood-Schlatter.
A systematic review by Neuhaus et al. (2021) reviewed conservative treatment options for Osgood-Schlatter disease and found that programs combining activity modification with knee strengthening exercises were associated with the most consistent improvements in pain and function.
Sinding-Larsen-Johansson generally responds well to the same conservative approach, usually within a matter of months.
A 2024 scoping review by Wilczyński et al. (2024) consolidated the available research on Sinding-Larsen-Johansson disease and found that conservative treatment, centred on activity modification alongside rest, stretching and gradual strengthening, produced positive outcomes within two to eight months in physically active adolescents.
Conservative, load-focused care is also the standard approach for Sever’s disease.
A systematic review by Hernandez-Lucas et al. (2024) assessed conservative treatments for Sever’s disease and found that interventions including activity modification, stretching, taping and foot orthoses were commonly used and generally well tolerated, supporting an individualised, load-managed approach.
How We Can Help
Because all three conditions are about managing load on a growth plate that will settle with time, treatment focuses on keeping your teen as active as possible while it heals. This might include:
A structured activity modification and strengthening program for the quadriceps or calf, in line with the strongest evidence across all three conditions.
Hands on work to ease tightness in the quadriceps or calf muscles, reducing pull through the affected growth plate.
Used to address tight, overworked muscles in the quadriceps or calf contributing to ongoing pull through the growth plate.
Taping to help manage load and discomfort at the knee or heel during a graded return to sport.
A low-load option that can help manage pain at the growth plate without adding to the load it’s already under.
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References
- Neuhaus C, Appenzeller-Herzog C, Faude O. A systematic review on conservative treatment options for OSGOOD-Schlatter disease. Physical Therapy in Sport. 2021;49:178-187. PMID 33744766
- Wilczyński B, Taraszkiewicz M, de Tillier K, Biały M, Zorena K. Sinding-Larsen-Johansson disease. Clinical features, imaging findings, conservative treatments and research perspectives: a scoping review. PeerJ. 2024;12:e17996. PMID 39346060
- Hernandez-Lucas P, Leirós-Rodríguez R, García-Liñeira J, Diez-Buil H. Conservative Treatment of Sever’s Disease: A Systematic Review. Journal of Clinical Medicine. 2024;13(5):1391. PMID 38592198
Disclaimer: This page is intended as general information only and does not replace individual assessment and advice from a qualified health professional. If you're dealing with growth related knee or heel pain in an active teenager, book an appointment with our team so we can assess your specific situation and recommend an appropriate treatment plan.
Location Details
| Day | Hours |
|---|---|
| Sunday | 9:00 AM - 4:00 PM |
| Monday | 9:00 AM - 7:00 PM |
| Tuesday | 8:00 AM - 7:00 PM |
| Wednesday | 8:00 AM - 7:00 PM |
| Thursday | 8:00 AM - 7:00 PM |
| Friday | 8:00 AM - 7:00 PM |
| Saturday | 8:00 AM - 4:00 PM |
