Children's Hospital Colorado

Why Growth Plate Injuries Are a Risk for Young Athletes

Growth plates do an important job. Situated at either end of young long bones, they crank out height and reach — and during adolescence, they’re going full swing.

“You can imagine a layering process,” explains pediatric sports medicine specialist Aubrey Armento, MD. “They’re basically areas of cartilage, and the cartilage cells divide and eventually are replaced by bone. Over time that process adds more and more length to the bone shaft.”

Why growth plates are susceptible to injury

Growth plates close up as teens reach skeletal maturity, anywhere from 14 to 20 years, meaning adults don’t have them. But teens certainly do, and especially during the peak growth years of adolescence, they’re susceptible to injury.

“Growth plates are structurally weaker than the rest of the bone,” says Dr. Armento. “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.”

That’s called an avulsion fracture, but growth plate injuries come in many kinds. They’re particularly likely to occur in the knee, shoulder, wrist and foot.

Types of growth plate injury

Some growth plate injuries are acute, or sudden — like a fracture after a collision or a hard hit — but many more are chronic, meaning the growth plate gets inflamed over time. Inflammation of a growth plate where a tendon inserts at the bone is called “apophysitis.”

Sports medicine specialists like Dr. Armento diagnose growth plate injuries by completing a physical exam, getting information about how the injury occurred, and looking at X-rays from several angles. Since growth plates are specific to growing kids and teens, a pediatric specialist will know what to look for.

And Dr. Armento sees chronic growth plate injuries often, a pattern she says could be related to the rise of sports specialization for young athletes. They’re generally known as “overuse injuries” resulting from repetitive movements like pitching or swinging a racket. Little League elbow is a classic example.

How to prevent growth plate injuries

To some extent, growth plate injuries are just a risk of being young and playing sports. They happen. But there are some things young athletes can do to minimize the risk.

Especially during growth spurts, a good stretching routine can help tendons and muscles loosen up and adapt to the growing bone, and good form and strength training for repeated movements is essential. If you’ve been away from a sport, during the summer, for example, build back up to it and get conditioned before jumping right back in.

Growth plate injury treatment

If you do feel the telltale inflammation and joint pain of a chronic growth plate injury, get it checked out — preferably by a pediatric sports medicine specialist like the ones at Children’s Colorado’s Sports Medicine Center, who will know how to diagnose and treat growth plate injuries. That’s especially important for acute growth plate injuries like fractures, which can affect the way the bone grows over time. It’s important with chronic ones, too.

“As pediatric specialists who understand chronic growth plate injuries, we can work with the athlete to ideally allow them to continue play, as long as we can control the pain,” says Dr. Armento. “We have athletes work with an athletic trainer or a physical therapist to modify activities that aggravate or cause pain, and work on flexibility and strength to treat and prevent future injuries.”

But, she cautions, early treatment is key. Don’t play through the pain.

“If you keep going hard, growth plate injuries can become so painful you ultimately have to scale back or stop sport to allow it to heal,” Dr. Armento says. “The sooner we can catch it, the shorter the recovery is hopefully going to be.”

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