# Lower Limb Osteochondrosis and Apopbysitis in Young Athletes--A Comprehensive Review
## 9 Future Directions  
Osteochondralosis and apopphysitis of the lower limbs are common in active children and young athletes. Participation in sport has been shown to significantly increase the incidence of traction apopphysitis of the lower limb [114]. A particularly important population group that should be specifically studied in future research is young football players. Participants in this sport are particularly susceptible to such changes in the developing skeleton due to the training load and the intense demands placed on the musculoskeletal system. In this regard, multi-club and multi-center studies must be carried out are to gain a comprehensive understanding of the extent of apopphysitis and osteochondosis of the lower limbs. Such studies would allow comparisons of training volume, training loads, and training intensity with the prevalence of these conditions.  
The overload disorders described in this review, via the musculoskeletal fascial networks and the phenomenon of tensegrity, influence changes in biomechanics and may contribute to potential pain symptoms throughout the body [115]. Future research should investigate the possible relationship between the tensegrity phenomenon and apophyseal inflammation focusing on whether the distribution of tension in the fascial and musculoskeletal networks influences the development or progression of apophyseal inflammation. Modern imaging techniques, such as musculoskeletal ultrasound and MRI, could be used to detect structural changes, inflammation, or fascial adhesions. Ultrasound elastography can also help to assess fascial stiffness and its role in the transmission of mechanical loads. Fur thermore, pain mapping tools, such as visual analogue scales (VAS) and pressure algometry, may help correlate fascial and apophyseal involvement with symptom distribution. Using these tools, future studies could clarify how the mechanisms associated with tensegrity contribute to inflammation, pain, and systemic biomechanical dysfunctions.  
It would also be beneficial for future studies to assess the knowledge base of coaches and healthcare professionals who treat these types of lower limb injuries in young populations. In this context, it would be valuable to investigate whether coaches from different sports disciplines exhibit varying levels of knowledge about these conditions, including their etiology, risk factors, and treatment approaches. This is an important area for future research, as coaches' knowledge may be one of the factors influencing the development of these conditions. Such research could facilitate the identification of knowledge gaps and inform the need to increase awareness and knowledge in this area.  
There is also an urgent need to improve our understanding of the optimal musculoskeletal loading strategies for athletes with osteochondrosis and apopysitis of the lower limbs. Further studies should be conducted to compare different loading strategies for young athletes with this type of injury. It would be beneficial to assess how the affected region responds during work in different ranges of motion of the joint or different lengths of muscle. In this context, biomechanical analyses (e.g., motion capture, force plates) and imaging studies (MRI, ultrasound) can elucidate safe thresholds and stress distribution along with structural responses. Moreover, it would be advantageous to undertake long-term studies which assess the influence of exercise regimens, such as eccentric or isometric training, on the outcomes of young athletes. These efforts would support the development of tailored protocols to accelerate recovery and reduce the risk of reinjury. This is an important issue for future research.  
Furthermore, it is of great importance to evaluate the therapeutic efficacy of novel rehabilitation techniques such as biofeedback training, neuromuscular re-education, and sport-specific training. These methods are likely to be effective, but their treatment potential should be checked in future studies, particularly randomized controlled trials.