Teens’ growth-plate injuries need early care

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Injuries to the bones’ growth plates are fairly common in adolescent athletes, but prompt attention is required to keep these injuries from becoming serious, according to a research review.

Growth plates are areas of softer, growing tissue at the ends of the long bones in children and teenagers. Because these areas are weaker than solid bone—and even the ligaments and tendons that surround the bones—they are relatively vulnerable to injury.

About half of children’s growth plate injuries occur during competitive sports, such as football, basketball and gymnastics, or recreational activities like skateboarding and skiing.

In the new study, published in the journal Sports Health, researchers analyzed 75 previous studies on growth plate injuries in adolescent athletes. They found that teenagers seem to be particularly vulnerable overuse injuries that cause fractures in the growth plates in the wrist, elbow, foot and knee.

The most frequent overuse injury in teen athletes is Osgood-Schlatter disease, which causes painful swelling just below the front of the knee.

The elbow is another common site for growth plate injuries, including “Little League elbow,” pain in the inner aspect of the elbow caused by too much throwing with too little rest. Similarly, pitchers and gymnasts may develop osteochondritis dissecans, in which tiny fragments of bone or cartilage at the outer elbow break lose, causing pain and stiffness.

“Parents should be aware that if their children have pain associated with sporting activity, it may not be simply due to muscle strains or ‘growing pains,’” said Dr. Todd Frush, the lead author of the review and an orthopedic surgeon at Cincinnati Sports Medicine Research and Education Foundation.

Most growth plate injuries heal without complications. But early diagnosis and treatment are important, since some injuries can lead to long-term problems, like improper growth of the bone and chronic pain.

“Some athletic injuries may have long-term consequences if not treated early,” Frush told Reuters Health, citing osteochondritis dissecans as an example.

Treatment of growth plate injuries depends on the severity. But Frush and colleague Dr. Thomas N. Lindenfeld found that teen athletes generally recovered and got back in the game most quickly if they were diagnosed early and had the injury immobilized in a cast or brace until they were pain-free—usually about four weeks.

“The concept of ‘no pain, no gain’ should not apply to children,”

Frush stressed. “Pain is a symptom of damage that is occurring. Mild soreness that occurs with conditioning for sporting activity is normal, but chronic pain should be investigated.”

This is especially true, he added, if the pain persists when a child is inactive.

SOURCE: Sports Health, May/June 2009.

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Thanks for this information. More and more we are hearing about kids having to get “Tommy John” surgery in baseball. They no longer play one spring season, today’s kid plays winter ball, fall ball, summer ball, spring ball, and often for 2 or more teams. It is important for the parents to monitor the kid and the coaches not to abuse their arms. Thanks for the article!

posted by The Little League Coach on 05/15/2009 at 5:00 am -08:00