Growth Plate Injuries

Where bones grow

Growth plates are areas of cartilage near the ends of your long bones. They're the last part of your bones to harden, and they're where your bones get longer as you grow.

The weak spot in kids

In kids and teens, growth plates can be 2 to 5 times weaker than the ligaments and tendons around them. So a twist or fall that would sprain an adult's ankle can injure a kid's growth plate instead.

Myth or fact?

• Adults can't get growth plate injuries because their growth plates have closed. Fact. Once growth plates turn into solid bone, there's no growth plate left to hurt. Adults tend to hurt ligaments and tendons instead.

Growth plate fractures

A fall or a hard twist can break a bone right through the growth plate. These fractures happen most in the fingers, and they're also common in the forearm and lower leg bones. Boys get them about twice as often as girls, because girls finish growing earlier.

Overuse injuries

Doing the same motion again and again can irritate a growth plate where a strong tendon pulls on it. You've already met a few in other lessons.

Growth spurts

During a growth spurt, bones can grow faster than muscles, which pulls the muscles tight. That's when overuse injuries like Osgood-Schlatter and Sever's show up most often.

One sport, all year

Playing one sport all year stresses the same body parts over and over with no break. The AAP recommends trying different sports and taking time off from each one.

Myth or fact?

• Gymnasts, pitchers, and kids in running and jumping sports are more likely to get overuse growth plate injuries. Fact. Their sports repeat the same motions over and over, which stresses the same growth plates.

Days off and months off

The AAP says kids shouldn't train more than 5 to 6 days a week. They should also take at least 2 to 3 months off from each sport during the year, split into breaks of about a month.

Follow the limits

Pitch counts, rest days after pitching, and not adding more than 10 to 20% to your training each week all help protect growing bodies. Stretching tight muscles helps too.

Myth or fact?

• Pain that keeps coming back in the same spot near a joint is normal for young athletes. Myth. Pain or swelling that keeps coming back near a joint can be a growth plate problem. Tell an adult and get it checked by a doctor.

Get it checked

Any injury near the end of a bone that's swollen, crooked, or too painful to use should be checked by a doctor right away. The doctor may order an X-ray, but some growth plate breaks don't show up on X-rays, so the exam matters too.

How they heal

Most growth plate fractures heal well, often with a cast. Some need surgery. Doctors often keep checking for at least a year to make sure the bone keeps growing normally.

Overuse injuries calm down with rest

Overuse injuries like Sever's and Osgood-Schlatter usually get better with rest from the activity that hurts, stretching, and strength work. The pain goes away once you finish growing, though an Osgood-Schlatter bump can stay.

Myth or fact?

• Playing through growth plate pain helps the bone get tougher. Myth. Pain is a warning sign, not a way to get tougher. With injuries like Little League elbow, playing through pain can make things much worse. Tell an adult and get the right care.