"Growth Plate Injuries in the Youth Athlete" By: Steven Lyon, PT, MPT
Jul. 30, 2010
What is a growth plate
injury?
Growth plate injuries occur at the ends of a child or
adolescent's long bones where developing cartilage is laying down
the framework for increased bone length and shape. As the
child reaches full maturity, these growth plates are replaced by
solid bone structure. Common sites of growth plate injuries
include the shoulder, elbow, wrist, hip, knee and ankle
joints. The growth plates are at high risk for injury in the
young athlete due to their relative weakness compared to the rest
of the bone, ligaments, surrounding musculature and tendon
insertions to the bone. This inherent weakness results in
injury with great stresses placed on these regions by developing
young athletes, especially with throwing, jumping, squatting,
kneeling and running. Injuries can also occur due to
overuse. Growth plate fractures consist of 15-30% of all
childhood bone breaks.
How to help identify a growth plate
injury?
Recognizing signs that your child may be at risk for, or may
already have a growth plate injury will help with early treatment
and prevention with this problem. A common sign of this
injury is complaints of persistent pain at the sites associated
with these growth plates (i.e. - below the knee cap (Osgood
Schlatters), the heel (Sever's), outside of shoulder (Little
leaguer's shoulder), etc.). If a child is unable to
participate in their respective sport because of any discomfort in
motion, it is possible that overuse has resulted in a growth plate
injury. Any deformities noted at the growth plate regions should be
addressed quickly. There can be long term consequences
associated with injuries to the growth plate such as chronic pain
and limb length discrepancies, so early intervention is a
must.
Treatment options
Depending on the severity of the injury, doctors may prescribe a
period of rest followed by a strengthening and stretching regimen
implemented by a physical therapist, or in more severe cases
immobilization to restore the integrity of the growth plate and
formation of the bone prior to starting rehab. Manual therapy
to surrounding muscle and tendons will help alleviate stresses to
the growth plate.
Prevention
Through proper diet, strength and conditioning training, and
correct warm-up strategies these types of injuries can be
avoided. Children should avoid aggressive static stretching
prior to participation in their sport, and would benefit from a
dynamic warm-up stretching program that would enhance their
performance level and protect growth plates from over-pulling at
the tendon insertions. They should also be aware that
strength training or participation in their sport with the presence
of pain is not a desired outcome. Reproducible pain or point
tenderness that does not improve with rest should be addressed
quickly by seeing a physician or physical therapist.