Growth Plate Injuries: What Are They and How Are They Treated?

by Gabby Haugh, PT, DPT, SCS, CSCS, USAWL1

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Young soccer player injury growth plate injuries

Picture this: your child is a competitive athlete who tells you that their knee has started hurting. They did not have a moment of injury, but they have been playing an increasing amount of their sport and you also remember that they have been growing a lot recently. You take your child to the pediatrician who diagnoses them with apophysitis. Now what?

Anatomy Background

The apophysis, more commonly known as the growth plate, is a secondary ossification center located on certain bones throughout the body that lengthen as a child’s body grows. These sites also serve as an attachment point for muscle tendons associated with the joint. In the lower body, there are eight primary apophyses: the iliac crest, anterior superior iliac spine, ischial tuberosity, inferior portion of the patella, tibial tuberosity, calcaneus, and the base of 5th metatarsal. In the upper body, there are two primary apophyses: the humeral head and the medial epicondyle of the elbow. Just like any structure in the body, these sites are susceptible to injury.

Apophysitisoverview growth plate injuries

What Are Growth Plate Injuries?

There are different types of growth plate injuries, but the most common is apophysitis. Apophysitis occurs due to repetitive traction, causing microtrauma, to the growth plate. When children are growing and are active, the growth plate is the weakest part of the joint. Often, these kids’ muscles are stronger than their bones! As this site becomes inflamed, it can cause pain, swelling, and changes in movement. Apophysitis most commonly occurs due to overuse, rather than a specific injury. Additionally, these injuries are more likely if a child is also going through a growth spurt, as this can add additional stress to the growth plate. At first, kids will only report pain after physical activity or sports, but it will continue to progress to constant pain if left untreated. 

Little league shoulder growth plate injuries

The most common sites of apophysitis in the lower body are at the tibial tuberosity (also known as Osgood-Schlatter Disease) and calcaneus (also known as Sever’s Disease). In the upper body, we can see both humeral head and medial epicondyle apophysitis, more commonly known as Little Leaguer’s Shoulder and Elbow, respectively. Depending on your child’s activity or sport, any of the growth plates in the body can become injured. 

Osgood schlatters disease scaled 1 growth plate injuries

How Do We Treat Growth Plate Injuries?

If your child begins to report pain in a joint that seems to be gradually worsening despite ice, pain relievers, and other treatments, see a physician. A pediatrician is a good place to start or a pediatric sports medicine physician. At this visit, they will take x-rays to evaluate the status of the growth plate. If apophysitis is diagnosed, your child will need to rest from the painful activities to allow for the inflammation to decrease. During this time of rest, your child should see a physical therapist to help improve their flexibility, strength, and movement control in order to off-load the injured growth plate so they can return to your sport as soon as possible.

Worried your child may have a growth plate injury? Call to schedule an evaluation with us today!

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