February 17, 2022

Understanding Growth Related Injuries & Peak Height Velocity

Understanding Growth Related Injuries & Peak Height Velocity

As part of the long-term athletic development (LTAD) pathway, it’s not always smooth sailing when keeping players fit. You might find some athletes are more prone to breaking down due to higher loads than others. It is also common to find some 14-year-old’s towering over other players in the same age group! This article will help to explain why this happens, what typical non-contact injuries players are susceptible to, and how to reduce the risk of these growth-related injuries.

Peak Height Velocity

Peak Height Velocity (PHV) is the period of time that teenagers/adolescents go through their biggest growth spurt.

PHV is the 2nd biggest growth spurt someone will undergo in their lifetime (1), which is why it is such an important period in the development of players for skills, movements and strength. This stage of PHV usually occurs at the ages of 12-13 in girls and 13-14 in boys. The rate at which girls grow is slightly lower than boys. On average, girls grow 7-9cm per year within this PHV stage, whilst boys on average grow between 8-10cm per year (2). Adolescents seem to reach max height around the age of 18, however some athletes might still be growing into their early 20’s. 

With this rapid period of growth, athletes may start to become a bit clumsier as they aren’t used to their longer limbs, affecting their coordination.

You may have heard people saying “Oh they’re just getting used to their bodies, give them some time to settle in”.

By challenging them with sport specific movements, this ‘settling in time’ should allow them to master these movements quicker and replicate the movements with real quality. This is exactly why practising these sport specific movements is vital for development and mastering movements in a key time of development and learning (3). For example, moving in a low position at speed which is replicating attacking a ball in the field as they get into awkward positions. Also, replicating awkward movements and positions when bowling and batting in isolation will help with stability, balance and execution of movements.

How can we help players through the PHV phase?

Mobility and stretching should be part of every player’s routine anyway.

Daily stretching and mobilisation around the key areas will relieve tightness and increase the range of motion, which will aid them in the growing process.

Tightness of muscles can trigger soft tissue injuries and growth-related injuries, which is why it is vital to stretch and have a good range of mobility around joints. 

Strengthening around the Knee, Ankle, Shoulders and Hips as a whole, will also help the athlete develop competent strength in order to cope with the demands of cricket. If we develop the athlete’s strength throughout this PHV stage, we are providing them a solid base of strength for them to build upon along the LTAD model (4). This base of strength allows them to control movements and accept load when decelerating faster.

By getting players to take part in a structured gym programme, the other benefits remain for life.

Picking up vital skills such as programming, lifting technique and general health and fitness tips to carry through life help to maintain a healthy lifestyle. Attending the gym and developing strength increases self-confidence (5). This regular exposure to gym-based activities will increase bone index, which is a measure of how healthy and strong your bones are. A good bone index will mean that the risk of getting bone related diseases like osteoporosis are significantly reduced. This is why gym work is important to carry out throughout all stages of life.

Growth Related Injuries

Sever’s Disease
Sever’s disease is an overload injury caused by repeated traction of the Achilles tendon on the calcaneal growth plate which causes inflammation in the area.

This can cause a large amount of pain by even doing the lightest of exercise such as generic walking which is why it’s important to understand the child’s pain and accept that the smallest of things can trigger large levels of discomfort. This usually occurs between the ages of 9-13.

Osgood-Schlatter disease
Osgood-schlatters disease (OSD) is an overuse injury that mostly appears in active adolescents typically during peak maturation periods.

The repetitive strain and impact results in irritations around the tibial tubercle at the front of the knee and in severe cases can ultimately cause an avulsion fracture in the same area. Osgood’s risk factors include poor flexibility of quadriceps and hamstrings, sudden growth spurts, gender (more likely in males) and repetitive activities in sport such as jumping and sprinting.

Sinding-Larsen Johansson syndrome
Sinding-Larsen Johansson Syndrome affects the extensor mechanisms of the knee and disturbs the area where the patellar tendon attaches just under the patella.

This one also appears during growth spurts around the ages of 10-14 and is associated with localised pain that gets worse with onset of exercise. Along with pain, tightness of surrounding muscles such as quadriceps, hamstrings and gastrocnemius also occurs, which would result in reduced flexibility at the knee joint.

This article leads into the video that Pete has made around growth related injuries and PHV which goes into more detail around the maturation process and growth-related injury prevention and treatment. Check it out below!


  1. Lloyd, R. S., & Oliver, J. L. (2012). The youth physical development model: A new approach to long-term athletic development. Strength & Conditioning Journal, 34(3), 61-72.
  1. Neinstein, L. S., & Kaufman, F. R. (2002). Chapter 1. Normal physical growth and development. Neinstein LS. Adolescent Health Care: A Practical Guide. 4th ed. Philadelphia: Lippincott Williams & Wilkins.
  1. Pichardo, A. W., Oliver, J. L., Harrison, C. B., Maulder, P. S., Lloyd, R. S., & Kandoi, R. (2019). The influence of maturity offset, strength, and movement competency on motor skill performance in adolescent males. Sports, 7(7), 168.
  1. Granacher, U., Lesinski, M., Büsch, D., Muehlbauer, T., Prieske, O., Puta, C., ... & Behm, D. G. (2016). Effects of resistance training in youth athletes on muscular fitness and athletic performance: a conceptual model for long-term athlete development. Frontiers in physiology, 7, 164.
  1. Rasmussen, M., & Laumann, K. (2013). The academic and psychological benefits of exercise in healthy children and adolescents. European Journal of Psychology of Education, 28(3), 945-962.