Pain and Injury in Children and Adolescents

What is growth and maturation?

Maturation of the human body does not proceed in concert with chronological age. Rather, it is generally governed by heredity (i.e., genes), the environment, and a combination of growth- and sex-related hormones. Thus, children of the same sex and age can demonstrate marked variance in maturity, with some individuals mature in advance or delay of others.

Why increased injury risk and pain during these times?

• During growth spurts, the growth plates of these bones are less resistant to tensile, shear and compressive forces compared to adult bones.

• Just prior to the onset of a growth spurt, there is a decrease in bone mineral density making the bone less resistant to load. 

• Tendons of muscles insert onto the bones around the growth plates causing irritability.

When is this most likely to happen?

• Changes in height of greater than 7cm per year.

• When a young person is between 88-92% of their predicted adult height.

• 2-3 years earlier in girls.

• Heel pain around the ages of 7-15 years.

• Knee pain around the ages of 10-12 (girls) and 13-15 (boys).

• Change in recent loading. Usually commencing a new sport or returning after the off-season.

Can this be assessed?

• Yes. Predictive equations and a detailed physical examination are performed to determine whether a young person is pre, during or post growth spurt. Each person can then be managed individually based on where they are at with their growth and maturation.

How are these symptoms managed?

• Reassurance and education of the athlete and parents. 

• Development of load management strategies to continue performing physical activity during periods of pain.

• Corrective and preventative strength and mobility exercises.

• Regular monitoring of growth and maturation.

The growth spurt is a normal process in which young athletes can be managed through. By identifying a child or adolescents’ stage of growth and maturation, optimal environments can then be established for their development and enjoyment. If you have any questions, or would like to book in for an assessment, give our All Stars a call on 3399 3318.

Aaron Hull

Physiotherapist

Certificate in Growth and Maturation for Youth Athletes