In an extreme case, this bump tears off, says Dr. Gerbino. When this happens, surgery is needed to re-attach the bone. Associated with jumping and landing, medial tibial stress syndrome causes pain along the posterior medial border of the tibia. Almquist sees many athletes with medial compartment shin splints who are experiencing pain so intense that they literally jump of the table when the area is touched. Although not associated with a particular sport, apophysitis is a common overuse injury in junior high and high school athletes, says Dr. Gerbino.
Repetitive stress causes an outgrowth or projection from the bone that can tear off.
If a pitcher has an apophysitis that he ignores, and this happens at least twice a year at our clinic, it can pop off during a pitch. But surgery is the worst-case scenario. Most overuse injuries can be treated with relative rest and some alteration in activity. Hincapie starts with a thorough assessment of how the injury occurred and what motions cause pain. Injury simulation and advanced testing for neurological trouble also help pinpoint problem areas.