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Growing Pains

There are several guidelines athletes who are still growing should abide by to help prevent injuries associated with this life stage.

Published October 26, 2011 05:20

Growing Pains


You can still be physically growing into your young adult (early 20s) years?

Athletes whose bodies are still growing are at risk of unique injuries associated with physical growth and of overuse injuries?

If you are the owner of an athletic body that is still growing; your training or doubles partner is still maturing; or if you are the parent, coach or fitness trainer of a young growing athletes, then you need to pay attention to some important guidelines to help prevent injuries associated with this life stage.


A wrist X-ray can determine if you are still growing. If the growth (epiphyseal) plate (a cartilage that promotes bone maturation located at the end of the bones) is still visible, it means your skeleton is still growing. When you stop growing, the growth plate closes and is replaced by solid bone. The growth process relating to bone length stops in early adulthood (your early 20s) while bone thickness may continue to increase in response to muscle activity and participation in sports.

Your bone growth is influenced by a number of factors:
• GENES: The biological code material you inherit from your parents. You are genetically programmed to become a certain height, size and shape.
• HORMONES: Growth hormone (from the pituitary gland), thyroxin (from the thyroid gland) and the reproductive or sex hormones (androgens and estrogens), all stimulate human growth.
• NUTRITION: Poor dietary habits, restrictive eating practices and disordered eating are major factors that contribute to reduced growth and delayed skeletal maturation.
• TRAINING LOAD: Intense training can delay skeletal maturation in some female athletes, especially when combined with poor nutritional practices.

Over-training in frequency and/or intensity, such as practicing twice a day before the player is 12 years, can:
• Cause irreversible (lifelong) damage
• Close growth plates early and result in decreased adult size
• Contribute to injuries later on during the player's professional career


The risk of injury for young athletes is related to many factors. Specific factors related to immature tissues of the musculoskeletal system include:
• The growth cartilage, a type of dense connective tissue, is at higher risk of injury with repetitive stress and load. This special cartilage is found at the growth plate, the cartilage inside joints, and at sites where a tendon attaches into a bone (called apophyses).
• With rapid change in bone length, there may be a mismatch between the bone length and that of the muscle-tendon unit. Joint tightness can develop when bones lengthen faster than the muscle-tendon units, creating relative lack of flexibility and muscle imbalances, which can lead to injury.
• Increased load and force at the apophyses can also cause injuries in the young player, especially at the knee, ankle and elbow.


are common in young athletes. Studies indicate that up to 60% of injuries sustained during adolescence (between 12 - 24 years old) relate to overuse.
• These injuries happen when the tissue is repeatedly, gradually loaded.
• Fatigue of the loaded tissue (e.g. muscle, tendon or bone) occurs.
• Without adequate recovery time to allow tissues to adapt between training sessions, this causes trauma that rises over time, eventually resulting in tissue breakdown and injury.

BIOMECHANICS: Body alignment and muscle imbalances are common in tennis players due to the repeated use of some muscles and the one-sided loading that occurs in tennis strokes. They can lead to tennis injuries for ANY player.
• You can correct alignment problems with improved postural control and dynamic stability.
• A Primary Health Care Provider or Athletic Trainer can help you with corrective and preventative exercise programs.
• When appropriate, the Primary Health Care Provider or Athletic Trainer may recommend using tape or devices like orthotics to improve alignment.

PSYCHOLOGY: Pressure from others, especially adults leading the training process such as parents, coaches and fitness trainers, plays a critical role and can lead to injuries.
• Excessive intensity and "no pain, no gain" and/or "win at all costs" philosophies are very detrimental to health.
• Expecting players to value winning over the joy of competing can be physically and emotionally abusive and contributes to injuries.

TRAINING LOAD: Varying intensity, frequency and length of training sessions all help performance.
• So do REST and RECOVERY. Sudden increases in training without proper rest and recovery will cause injury.
• Young athletes require individual programs due to vast differences in physical, mental and emotional maturity.


Prevention of injuries is important for the long-term physical and tennis development of young players. Start good health habits early and prevent career interrupting injuries at any stage of your career. Some basic principles include:
• Annual physical - identifies at risk areas
• Periodize - lighter training during rapid growth
• Gradual increased training load: The "10% rule" = total training (amount, time & intensity) to increase slowly by 10% over time
• Intensity of training - young players (under 24) cannot cope with the same intensity as a mature adult
• For more information about injury prevention, speak to a Primary Health Care Provider and your Medical Practitioner

The contents of the Health site are for informational purposes only and should not be treated as medical, psychiatric, psychological, health care or health management advice. The materials herein are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this site. Reliance on any information provided herein is solely at your own risk.

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