What it is

Growth plate injuries around the shoulder include proximal humeral physeal fractures and distal clavicle physeal injuries. They follow falls, tackles, or awkward landings. Early diagnosis protects growth and joint surfaces.

Treatment respects biology. Protection is followed by a staged plan to restore range, strength, and confidence.

What happens when it occurs

Shear and rotational forces injure the growth cartilage. Some patterns carry a risk of growth disturbance if not managed well. Precise imaging and early protection lead to excellent results.

Common causes and risk factors

  • Falls from bikes or playground equipment
  • Tackles in football codes
  • Skateboard and scooter incidents
  • Relative stiffness during growth spurts

Who is most affected

School-age children and early adolescents. Dominant arm injuries are common in sports.

Typical symptoms

  • Shoulder or collarbone pain and swelling after a fall or tackle
  • Pain with lifting the arm and tenderness over the growth plate
  • Bruising and reduced range

When to seek care

Seek urgent assessment when pain follows a fall and lifting the arm is difficult. Early review protects alignment and growth.

How we diagnose

Clinical examination and X-ray. Ultrasound is used selectively. Classification follows Salter-Harris types for planning.

Management

  • Sling or immobilisation based on the pattern
  • Gradual range and strength once pain settles
  • Return to throwing and contact after criteria are met
  • Surgical care for displaced or high-risk patterns

Rehabilitation milestones

Phase 1 weeks 0 to 3: protection, swelling control, hand and elbow movement.

Phase 2 weeks 3 to 6: shoulder range and light strength, bike and pool.

Phase 3 weeks 6 to 12: progressive strength, return to non-contact drills.

Phase 4 months 3 to 6: throwing, contact readiness, and testing.

Readiness to progress

  • Pain-free shoulder elevation
  • Range within 90 per cent of the other side
  • Strength and control targets met

Prevention

  • Protective skills for falls in contact sports
  • Progress returns after time off
  • Monitor training spikes during growth spurts

Australia snapshot

  • Common in school sports and cycling incidents
  • Most recover fully with a timely diagnosis and a staged programme
  • Follow-up imaging is used when growth disturbance is a concern

Latest insights

Respect the plate. Protection first, then clear milestones toward throwing and contact.

Function and comfort guide return more than the calendar.

Frequently Asked Questions

Children often injure the growth plate rather than the ligaments. X-rays help decide the plan.

Most do not when managed well. High-risk patterns are monitored until growth finishes.

When range, strength, and control targets are met, and testing is clear.

Common early. The plan transitions to movement as comfort improves.

Healing follows biology. You can optimise swelling control, strength, and a graded plan.