Physeal (Growth Plate) Injuries in Children and Adolescents

Children and adolescents are constantly growing, and their bones are still developing. While activity is essential for healthy growth, it also comes with unique risks not seen in adults. One of these is a physeal injury, which involves the growth plate of a bone.

What is the Physis?

The physis, commonly referred to as the growth plate, is an area of developing cartilage located near the ends of long bones. It’s responsible for bone lengthening during childhood and adolescence. Because the physis is softer and less dense than mature bone, it’s more vulnerable to injury from stress, impact, or overuse.

Once skeletal maturity is reached (typically in the mid-to-late teenage years), the growth plates close and harden into solid bone. Until then, protecting the physis is critical to avoid long-term effects on bone growth.

Common Types of Physeal Injuries

• Salter-Harris Fractures: Fractures involving the physis, classified by severity and location, which may affect future growth if not managed properly.

• Osgood-Schlatter Disease: Irritation at the tibial tubercle’s growth plate, often from repetitive jumping or running.

• Sever’s Disease: Inflammation at the calcaneal (heel) growth plate, common during rapid growth spurts in young athletes.

• Overuse-Related Physeal Stress Injuries: Caused by repetitive movements in sports like baseball, gymnastics, or soccer.

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Signs & Symptoms to Watch For

• Persistent pain near a joint after activity

• Localized swelling or tenderness at the bone’s end

• Noticeable deformity or misalignment of the limb

• Difficulty bearing weight or limited joint movement

• Pain that doesn’t improve with rest

Prompt evaluation is important. Early diagnosis and treatment help prevent long-term complications, such as altered limb length or joint mechanics.

How Physical Therapy Supports Recovery

Physical therapy is a key part of rehabilitating a physeal injury while ensuring protection of the developing bone:

• Pain and Inflammation Management: Using safe modalities, gentle exercises, and activity modification.

• Restoring Mobility: Guided stretching and range-of-motion work to prevent stiffness.

• Targeted Strengthening: Building stability in surrounding muscles to protect the injured site.

• Gait and Movement Retraining: Correcting compensations to restore natural movement patterns.

• Gradual Return to Sport: Progressing activity in a controlled way to reduce re-injury risk.

  
  

Prevention Strategies for Youth Athletes

• Increase training intensity gradually.

• Cross-train to reduce repetitive stress on one area.

• Prioritize rest days for proper recovery.

• Ensure proper footwear and sport-specific support.

• Teach correct form and movement techniques early.

  
  

Physeal injuries are a unique concern for growing children and teens, but with early recognition, proper care, and a tailored rehabilitation plan, young athletes can safely return to the activities they enjoy. Physical therapists are uniquely positioned to guide recovery while promoting healthy development.