The Running Doctor: Recognizing children's growth plate injuries

As more children play more sports, they appear to be complaining of more aches and pains. And the more they play, the more stress and strain is put on the joints, especially the growth plates in the feet.

Long-term complications may exist as the young athletes gets older. The foot has growth plates in the toes, metatarsal bones, behind the toes, the midfoot and the heel. At the age of 16 years, growth plates are still fusing. If there is an injury it can effect the bone growth, due to the needed blood supply to the growing bone tissue.

One of the more common growth plate injuries is Sever’s disease. As the child runs, it puts more stress on the Achilles tendon behind the heel bone where it inserts, and creates a constant pulling of the heel. This, in turn, leads to inflammation of the actual growth plate of the back of the heel bone.

Treatment is directed toward the cause and effect of the condition, which is usually poor shoe gear with the lack of shock abortion, stretching and strengthening exercises, or conditioning programs. Ice therapy and biomechanical orthotics shoe inserts will control the motion and supply cushioning for increased shock absorption. Parents should look for tell-tale signs to help prevent child growth plate injuries, and thereby avoid adulthood problems.

Dr.Robert F. Weiss is a podiatrist. He was a former member of the Medical Advisory Committee of the Olympic Marathon Trials. Dr. Weiss is a veteran of 35 Marathons. For more information go to