Growth Plate Injuries
by Melinda Burris

This article discusses growth plate injuries and how young athletes’ treatment for injury must be conducted bearing in mind the fact that their bodies are still growing and immature. Failure to do so could cause long-term negative effects.

A scientific study published in 2014 investigated the rising number of athletic-related injuries among young children and teens. The cause of this increase was attributed to a growing participation rate in organized sports starting with children as young as five.¹ This is seen as a good sign as our society has become more sedentary. ¹ However, with younger children taking part in activities that put them at risk for injury, it is important to discuss the unique challenges of treating pediatric patients.

It must be remembered that the bones in young people are still growing and have not yet reached maturity. Children and adolescents are vulnerable to sustaining a shearing injury to the growth plates and this can result in growth plate fractures. Youth are also at risk of apophyses to traction, which is an injury to the cartilage and bony attachment of tendons. These are typically overuse injuries.¹ Researchers point out that reconstruction of the anterior cruciate ligament (ACL) in pediatric patients who still have a significant amount of growing to do is high risk because it can cause growth plate injury and actually disrupt growth.¹ This is noteworthy because ACL tears are common in many sports including soccer and track and field.

Growth plates are found at each end of young bones and are responsible for adolescents reaching their full height and arm span or reach. Growth plates are made up of layers of cartilage and as a child grows the cartilage cells divide and are eventually replaced by bone as the child reaches maturity.² Growth plates are susceptible to injury because they are weaker than bone. As Pediatric Sports Medicine Specialist Dr. Aubrey Armento explains, “Plus, with all that rapid growth, tendons and ligaments can get extra tight. Sometimes if there’s a forceful contraction, the muscle or tendon can actually pull bone away from the growth plate. A soccer player going in for a big kick and feeling a sudden sharp pain in the hip, for example.”² This type of injury is an avulsion fracture. Other areas prone to growth plate injuries include the foot, knee, shoulder, and wrist.²

The Children’s Hospital of Philadelphia notes, “The growth plate is the weakest part of your child’s growing skeleton. It is weaker than nearby ligaments and tendons that connect bones to other bones and muscles.” This weakness leaves the growth plate more susceptible to injury.³

The growing body of a child or adolescent is different than that of a fully grown adult. For instance, the same injury could occur to an adult and a child and would probably only cause a sprain in the adult. However, the child is likely to sustain a bone fracture from the same injury because of the weakness of the growth plate.³

It is interesting to note that boys are twice as likely to sustain growth plate injuries than girls. Since girls mature faster than boys, strong bone replaces their growth plates at a younger age.³

Growth Plate Injury Protection

While some injuries are going to happen when you are active in sports or athletic activity, there are steps you can take to avoid risks. Always stretching as part of your warmup routine before playing any sport or beginning any form of serious exercise is important for everyone. It is particularly important for children and adolescents as it has been established that they can be prone to having tight tendons and muscles as they are still in the growth process.^1,2 If a new season is about to start and you haven’t stayed in shape during the break, it is important to focus on conditioning your body, so you are physically and mentally prepared.

Incorporate strength training and focusing on good form into your regular training sessions. Doing so will help reduce the risk of repetitive use injuries.²

Treatment for Growth Plate Injuries

When growth plate injuries do occur, they are characterized by inflammation and joint pain. Make sure the injury is looked at promptly by a healthcare professional, preferably someone who specializes in pediatric sports medicine and has experience with growth plate injuries to ensure the injury is properly diagnosed and treated.²

Dr. Armento emphasizes this is not a situation where a ‘play through the pain’ mentality is wise. If these injuries are not treated early and correctly, they can lead to chronic injury and have lasting effects on growth. By consulting a knowledgeable pediatric sports medicine specialist, the injury can be dealt with appropriately, bringing in a physical therapist if needed to help facilitate recovery and aid in pain management.²

Conclusion

There are two key takeaways here: children and adolescents are still growing and are susceptible to different types of injuries than adults and this should be taken into account when treating any injuries, they may incur. Secondly, prevention and preparation are key to injury prevention throughout your life. Staying in condition between seasons and doing proper warmups including a stretching routine to make the body more limber is key to avoiding injury.

You have one body to last you your entire life. Though it may sound trite, the truth is your body can only be as good to you as you are to it. Though you can recover from injuries, some leave you unable to compete at the level you once did. Remember this next time you feel bored at the thought of doing the same warmups and stretches again before starting training or competition. Prevention can save you pain and regret especially if you plan to play any sport competitively for the long haul!

References:

1. Caine, D., Purcell, L., and Maffulli, N. (2014) The Child and Adolescent Athlete: A Review of Three Potentially Serious Injuries.
2. Children’s Hospital Colorado. (2023). Why Growth Plate Injuries are a Risk for Young Athletes.
3. Children’s Hospital of Philadelphia. (n.d.). Growth Plate Injuries.