LIVINGSTON, NJ – The onset of puberty can make young athletes and dancers bigger and stronger—as well as clumsier, and thus more inclined toward a variety of injuries, according to SportsCare Institute, Inc., located in East Hanover, which manages a network of physical and occupational therapy centers.

Muscle mass increases significantly during puberty, while the body's center of gravity is altered. It's a period of rapid growth—the extremities and hands often grow more quickly than the rest of the body and, in some cases, boys gain nearly 12 inches of height in single year. And while these sudden changes are a natural part of human development, they do have a downside.

"With young athletes in the midst of puberty, a large number of injuries are the result of literally tripping over their own feet," said Certified Athletic Trainer at SportsCare Physical Therapy of Cedar Knolls 2 Jannel Arrieche. "These kids are playing the same games, but doing so in new, larger, and suddenly more awkward bodies. And, obviously, that can be a recipe for problems."

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“As we enter spring training for sports like baseball, it's important to remember that 20 percent of children ages eight-12 and 45 percent of children ages 13-14 will have arm pain during a single baseball season,” said Michael Rieber, MD, FACS, FAAOS, an orthopedic surgeon at Orthopaedics Unlimited, which is located at the Saint Barnabas Ambulatory Center in Livingston.

“The shoulder and elbow are at specific risk in baseball and can be left with permanent injuries to the growth centers of these joints” said Rieber, who is known by his patients as ‘Game Day Doc.’ “Parents and coaches should follow the rules and limit the number of innings pitched and pitches/game.”

“Proper techniques in stretching and strengthening should be taught and a curve ball should not be taught until after puberty,” said Rieber, who practices sports medicine and orthopedics. “During puberty a child should not play their sport all year long, and should be sure to focus on strength and flexibility. Improving muscle imbalance due to the rapid growth and hormonal changes is critical especially in the female athlete.”

Arrieche said that girls, for example, are more likely to suffer torn anterior cruciate ligaments once they begin puberty. Various factors contribute to this increased incidence of injury, including the natural widening of hips creating a more physically stressful "Q" (hip-knee-ankle) angle.

Another sports-related injury that's quite common during puberty is the "greenstick" bone fracture, which often happens when an adolescent extends a hand to avoid a fall. In most cases, this type of injury will heal appropriately through immobilization by a splint or cast, followed by physical therapy.

While there's no way to completely prevent puberty-related injuries in young athletes, Arrieche agrees with Rieber that strength training followed by frequent stretching does offer benefits. In addition, it's beneficial to be cognizant of—and avoid—any tendency toward replacing physical activity with primarily sedentary pastimes.

"Youngsters must remember to stretch," said Alexandra Scriffignano, director of SportsCare Physical Therapy of East Hanover, NJ. "Rapidly growing muscles are extremely prone to strain and such resultant injuries as Osgood-Schlatter disease and Sever's disease—particularly when they're also being exposed to repetitive stress, as is the case with athletes and dancers. Stretching at least allows for increased flexibility, and prevents muscles from becoming too tight."