Do Growth Spurts Increase Injury Risk

Do Growth Spurts Increase Injury Risk?

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Take Home Points on Do Growth Spurts Increase Injury Risk?
  1. It seems the injury rate increases during growth spurts, but research is very limited. 
Growing pains are common in children, yet the cause and treatment of growing pains are not well known. Some hypothesize growing pains occur from muscles pulling on bones creating discomfort. Others believe the increase in bone size simply increases discomfort from an increase in mechanical pressure.
Growing pains are one type of “injury” during growth spurts. Specific adolescent injuries also exist, which I commonly see for Physical Therapy:

Adolescent Injuries

  1. Osgood-Schlatter’s Disease: is a painful swelling of the bump on the upper part of the shinbone, just below the knee. This bump is called the anterior tibial tubercle. It is believed to occur in active children who’s patella tendon pulls on the tibial tubercle.
  2. Sever’s Disease: inflammation of the growth plate in the heel of growing children, typically adolescents. The condition presents as pain in the heel and is caused by repetitive stress to the heel and is thus particularly common in active children. It usually resolves once the bone has completed growth or activity is lessened.
  3. These are just a few common musculoskeletal injuries affecting children. Many other injuries can occur during growth spurts and parents for decades believe children have a higher injury risk during a growth spurt. Combine this injury risk with chronic poor posture from computers/electronics and early sports specialization and you’ve got a high injury risk for child…scary!

Growth Spurts and Injuries

Now, before we jump to conclusions about the injury incidence and growth spurts, we should consult the limited literature:

Yukutake (2014) had 654 baseball players aged 6-12 years, all male, complete an original questionnaire that included items assessing demographic data, developmental factors (increase in height and increase in weight over the preceding 12 months), and baseball related factors. Multiple regression analysis was used to identify the risk factors for elbow pain during the 12 months prior to the study.
The data collected for 392 players without omissions or blank answers were submitted to statistical analysis. The results found that 19.1% of Little League baseball players had experienced elbow pain in the 12 months leading up to the study. The analysis revealed that height and increase in height were risk factors that increased the risk of elbow pain after adjustment for demographic data, developmental data, and baseball related factors.
Wild (2012) looked at ACL injury rates in adolescent boys and girls, noting girls have a higher ACL injury rate from:
  1. The effects of changes in estrogen levels on the metabolic and mechanical properties of the ACL
  2. Changes in musculoskeletal structure and function that occur during puberty, including changes in knee laxity, and lower limb flexibility and strength.
  3. How these hormonal and musculoskeletal changes impact upon the landing technique displayed by pubescent girls.With limited research, limited conclusions are possible.

However, the risk of injury increases during periods of growth. Unfortunately, recommendations now are purely theoretical. Some would suggest decreasing activity during maturation, but these are the peak years of motor learning. Instead, decreasing training volume and varying activities may be the best solution. In the Swimmers Shoulder System, I brought up the idea of a “swim stroke count”, similar to a pitch for baseball. However, swim stroke counts may not be effective nor practical as many other factors influence musculosketetal stress on maturing bodies. Looks like we need more research on maturing athletic children!

References:
  1. Yukutake T, Nagai K, Yamada M, Aoyama T. Risk factors for elbow pain in Little League baseball players: a cross-sectional study focusing on anthropometric characteristics. J Sports Med Phys Fitness. 2014 Apr 9.
  2. Wild CY, Steele JR, Munro BJ. Why do girls sustain more anterior cruciate ligament injuries than boys?: a review of the changes in estrogen and musculoskeletal structure and function during puberty. Sports Med. 2012 Sep 1;42(9):733-49. doi: 10.2165/11632800-000000000-00000. Review.

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