Tuesday, January 27, 2009

Growth Plates and Sports - The Weakest Link

In years past, sports were kid games. Kids gathered in vacant lots to play baseball and football. School teams existed but weren't taken nearly as seriously as today. Strengthening and conditioning usually consisted of "how many push ups and sit ups could you do". An exercise machine was a rusty bar and a few weights covered in dust in the corner. Sometimes they were even used but rarely taken seriously.



Today, strength training with weights has become all important. Field houses across the country have vast forests of shiny imposing machines designed to push human strength to the limit. Beginning in middle school (and sometimes earlier) kids begin to try and enhance their strength to become the biggest and baddest, generally with encouragement from coaches and parents. There are 15 year old kids out there that are stronger than most full grown men; able to lift amazing poundage. However, there is a catch.



The problem with loading our bodies with heavy weight at a young age is that the growth plates are still open and not solid bone. No matter how strong you are, you can't put heavy weight onto your skeleton and spine without the real potential of damaging these growth plates.



Growth Plates are what allow our skeleton to grow. Most of us have heard, for example, about the kid that broke his leg "at the growth plate" and now that leg is shorter than the other one. This can change the way bones mature and is a prime concern in juvenile fractures.



Growth Plates are the expandable actively growing regions within bones that are made of cartilage. In the long bones (like legs and arms) these plates are near the ends of the bones close to the joints. In other bones like the spine, pelvis and ankles, these growth areas tend to begin in small focal regions and slowly harden into bone while becoming larger. Once these plates grow together and disappeared, we quit getting bigger and the bones become generally stronger and harder; making damage less likely. Almost any growing bone therefore is susceptible to injury.



These cartilaginous growth areas are the underlying weakness in several types of sports type injuries when we are young. A common example is Osgood Slaughters knee. This is when there is damage to the growth plate of the Tibial Tuberosity. This is just below the knee cap on the front of the upper shin bone. This bony area is where the heavy tendons and ligaments from the large Quadratus Femoris (thigh) muscles or "Quads" attach. This bony attachment area on the upper shin has a growth plate behind. When a youngster overuses the thigh muscle, damage to this growth plate can occur. It is very painful and can limit activity until it becomes mature and fuses. If the damage is substantial it can leave this area enlarged and knobby; not too pretty if you are a young lady.



The spinal vertebrae also have growth plates and tend to mature and ossify around 18-20 years old. They are susceptible to damage up to that time. When youngsters load their spine with heavy weight bearing exercises: squats, over head presses, dead lifts and weighted lunges for example, the chances of damage to the spinal growth plates is real. The ends of the vertebrae above and below the discs can be compressed (like squeezing a marshmallow). The discs themselves can also be injured and inflamed. Damage of this nature tends to lead to scarring and inflexibility. Over time this damage accelerates degenerative arthritis. This becomes most apparent usually around 35-45 years old when we begin to have back problems and the x-rays show wearing that looks like someone decades older.



Don't get me wrong, exercise is critical and sports definitely build character. The benefits are too numerous to cover in this article. It's my opinion though, that we stay away from the heavy weights at a young age. There are many great exercises that can be done with our body weight; push ups, sit ups, running, pull ups and dips are all examples of excellent exercises to build strength and endurance without compromising growing bones.

When we are older and look fondly back on our High School sports days, it would be nice to not still be paying for damage we did off the field. It's possible to have fun without paying for it the rest of our lives.