Growth plates are the area of new bone growth in children and teenagers. Before a child reaches “skeletal maturity,” they have at least one growth plate (epiphyseal plate) on each end of their long bones. These are areas of cartilage, which will eventually calcify as they age to add length to their bones until they stop growing.
These areas can be vulnerable to injury as they are the weakest part of a child’s growing bones. Growth plates are even weaker than nearby tendons and ligaments, leaving them susceptible to excessive force and strain.
Growth plate injuries most often occur in long bones, which are bones that are longer than they are wide, such as leg bones (femur, tibia, fibula), arm bones (humerus, radius, ulna), foot bones (metatarsals), finger and hand bones (phalanges, metacarpals), etc. Injuries to these regions are significant as they can lead to pain and disability in children. In severe cases, injury can also lead to early closure of the growth plate meaning the bone growth stops.
Injuries to growth plates most often occur due to two main factors: acute injuries and chronic injuries.
Acute injuries are also known as fractures. These types of growth plate injuries are usually caused by a traumatic event such as a fall or sports injury.
The two main types of chronic growth plate injuries are inflammation of the growth plate (apophysitis) and rapid growth spurts.
Apophysitis usually results from repetitive movements or overuse, which is often caused by early sports specialization in children such as ball throwing (Little League Elbow, Little League Shoulder) or jumping and running sports (basketball, track and field).
Rapid growth spurts occur when bones grow faster than the surrounding muscles can accommodate, resulting in tight muscles with limited flexibility. Rapid growth spurts create pulling of the muscle-tendon against the bone where the growth plate resides. Common areas include the knee cap (Osgood-Schlatter’s or Sindig Larsen) and the back of the heel (Sever’s Disease).
Depending on the severity of your child’s growth plate injury, a medical doctor/pediatrician may first immobilize the area with a cast or boot to allow the tissue to heal. Immobilization time is, on average, 3 to 6 weeks. After immobilization, or if your child’s doctor deems immobilization unnecessary, the next step is to work with a physical therapist.
As growth plate injuries are often related to overuse, a physical therapist will first address how to modify the manner and frequency of your child’s use of the injured area to enable your child to stay active without pain.
After activity management, a physical therapist will address your child’s flexibility in the injured area. Light stretching and foam rolling will improve muscle mobility and flexibility, helping to decrease tension caused by muscles pulling on bones, which subsequently pull on growth plates.
Finally, a physical therapist will look at your child’s movement and coordination to address motor control and associated muscle weakness to ensure your child is moving in an optimal way that prevents future injury.
At Maven, we have years of experience helping children who have sustained significant growth plate injuries get back to playing, being active and having fun. We will educate both you and your child on the nature of their injury and will work with you both to devise an effective recovery plan.
Our Doctors of Physical Therapy will create a personalized exercise and stretching program to improve your child’s strength and mobility. Throughout the treatment, your child’s movement and activity load will be continuously assessed to assist with recovery and prevent future injury.