An increase in physical activity stimulates musculoskeletal growth and repetitive stress can stimulate positive adaptive responses in musculoskeletal structures. However, excessive stress or overload can lead to tissue breakdown and injury. To realize maximum gains, athletes must correctly identify and train just below the threshold for injury. Because of the potential for long-term growth disturbances, injuries to epiphyseal growth centers are a particular concern for young athletes. Because the physeal plate may be weaker than surrounding ligamentous structures, external stress may disrupt a growth plate rather than damaging a ligament or related soft-tissue structure.
Physeal fractures can result in growth arrest or deformity of long bones.
Fortunately, there is no evidence that epiphyseal fractures or growth complications caused by epiphyseal injuries are seen disproportionately in children who participate in organized sports or higher levels of competition. The long-term effects of repetitive microtrauma to the epiphysis is still under investigation. Damage to the distal radial epiphysis with subsequent alterations in radial-ulnar growth has been described in highly competitive gymnasts. Similarly, cross-sectional and longitudinal studies describing growth in child athletes indicate that size and rate of growth of athletes are not negatively influenced by intensive training and competition. 11 Short stature in gymnasts has been considered most likely a consequence of genetic and physique preselection rather than a result of training, although some have concluded that training starting before and maintained throughout puberty can alter growth rates.