Overuse apophyseal injuries

Apophysitis is an injury secondary to overuse, seen in young, skeletally immature athletes. It is believed to result from repetitive microtrauma from forceful contractions by surrounding musculature. In the immature athlete, the area surrounding the growth plate, or apophysis, is relatively weak compared to attached tendons. Chronic tension from these attachments causes bony disruption, and may lead to avulsion of the secondary ossification centers. As this area continues to grow, ossify, and enlarge, fibrous nonunion or union with bony enlargement may result. These areas of bony disruption may become painful and persist during an athlete’s growing years. Pain will generally resolve after growth completes in an athlete; however, occasional individuals may complain of chronic pain into adulthood. Many areas of the body can be affected, and they are discussed separately in this chapter.