Peak Height Velocity (The Growth Spurt)

When do kids begin their growth spurt?

  • Girls around 12 years old (10-13)
  • Boys around 14 years old (12-15)

Important physiological changes occur during the growth spurt in multiple tissues. In particular, bone, cartilage, and muscles/tendons undergo significant changes during this time, which puts them at risk for injury.

The following injuries should be kept in mind for the adolescent running athlete:

  • Apophyseal injuries (an apophysis is a bump or knob of bone that extends beyond the normal bone contour; it functions as an attachment site for ligaments and tendons).
    • Apophysitis, at the following sites:
      • Pelvis (ischial tuberosity, ASIS, AIIS)
      • Knee (Osgood-Schlatter’s disease)
      • Heel (Sever’s disease)
      • Fifth metatarsal
    • Avulsion injuries
  • Lower extremity tendon injuries
    • Patellar
    • Achilles
    • Posterior tibialis
  • Bone injuries
    • Medial tibial stress syndrome
    • Stress fracture
    • Osteochondritis dissecans

Prevention & Management

For an introduction to some running basics, check out this previous post. Optimal management of the above injuries includes a team of practitioners working together to provide the best care for the individual!


Krabak, B., Snitily, B., & Milani, C. (2016). Running injuries during adolescence and childhood. Phys Med Rehabil Clin N Am, 27, 179-202