Growing Pains

Osgood Schlatters, Severs and Sinding Larsen Johansson diseases are common adolescent conditions that people think of when they hear of injuries affecting young rapidly growing athletes. However, traumatic injuries, such as ACL tears and overuse injuries, such as stress fractures, are also more prevelant during the adolescent growth spurt. Many adolescent athletes are specializing in sport earlier and are engaging in year round training. How can you make sure that your young athletes can continue to train during this vulnerable stage of development without suffering from injury?

Physiological changes during the Adolescent Growth Spurt

  • Hormonal changes, such as an increase in estrogen in girls, has been shown to potentially lead to increases in ligament laxity, and therefore decrease joint stability;
  • The bones are growing faster than the muscles can adapt in terms of flexibility and strength, which puts a lot of stress on the muscle-tendon junctions, bone-tendon junctions, ligaments and growth cartilage;
  • Increased risk of growth plate injury due to decreased physeal strength during this time;
  • Increases in height lead to a higher center of mass, which makes muscular control of the body and balance more challenging;
  • Bone mineralization lags behind bone linear growth, which makes the bone more fragile to injury;
  •  “Adolescent Awkardness”, whereby growth is occurring at different rates and there is now an imbalance in strength, flexibility and coordination;
  • Altered landing biomechanics in response to growth and development (i.e., increased knee valgus);
  • Sensorimotor function is not fully mature by the time children reach adolescence.

Injury Prevention Strategies

  1. Stay flexible by keeping the muscles at an optimal length as the bones grow, with particular focus on the hamstrings, quadriceps and lower back (which have all been shown to be excessively tight during the adolescent growth spurt).
  2. Strengthening key muscles (i.e., core/hips, etc.) to prevent imbalance.
  3. Focus on exercises that develop neuromuscular control, proprioception and postural stability, especially for young female athletes.
  4. Proper technique in landing and jumping, since this is one of the main mechanisms of injury in this age group.
  5. Careful monitoring of training workload during this vulnerable period, especially if the athlete is showing early signs of an injury.

If you are the parent, coach or trainer of a young growing athlete, be proactive and chat with one of the therapists at Sheddon Physiotherapy and Sports Medicine on injury prevention strategies. If your child is already showing signs of injury, book them in for an assessment to help alleviate pain and return to sport healthy.