DISTURBANCES IN THE GROWTH PLATES AS A RE SULT OF SPORTS STRESS

Besides the positive physiological, psychological and social aspects, sports activities in adolescents bear the risk of injuries and overuse of the locomotor system. Previous examinations have shown that increa sed stress to the growth plates by sports activities, in relation to t he intensity of strain during growth spurts, can influence normal grow th. In female gymnasts, hormonal changes can decrease the growth speed and long-term growth. On the other hand, during more intensive phases of growth the column cartilage of the growth plate is the weakest par t of the locomotor system because of the influence of somatotropin and low levels of testosterone. This can cause subchondral stress fractur es in the growing cartilage that later on, if missed or not sufficient ly treated, can cause osteochondrosis dissecans. The apophysis of tend ons of big muscle groups can show loosening of the apophysis caused by increased muscle strength and acute or chronic microtrauma. Male adol escents show an incidence of lesions in the relation of 9:1 to female adolescents. The therapy for apophyseal lesions is generally nonoperat ive. Due to the persistent growth possibility, pseudotumors can occur, which can cause problems in differential diagnosis among skeletal tum ors. Too high pressure, pushing and tearing forces can influence growt h. Later examinations of previous high-level sportsmen and patients wi th coxarthrosis with and without a sports history show that blockage o f the rotation of the foot during growth, for example caused by soccer shoes, can cause high pushing forces on the femoral epiphysis, which can lead to epiphyseolysis cap. fem. lenta and thereby to prearthrotic deformities. This is overcorrection of the ''physiological'' epiphyse olysis, described by Morscher. Knowledge of the reduced strength of th e growth plate indicates better adaptation of training and supervision of the adolescent high-level sportsman. A regular check-up of the gro wing athlete and a reduction in sports intensity during the growth spu rts, prohibition of negative training parts and sometimes even prohibi tion of sports at all, if there is a lesion of the growth plate or hor monal disorders, are sometimes necessary to minimize late defects. In addition to this, a reduction of strain in some sports and, for exampl e, prohibition of rotation-blocking soccer shoes in the adolescent soc cer player is necessary.