What you can and cannot control
Growth timing, growth rate and the temporary vulnerability of growth plates are not modifiable. What is modifiable is how much impact the athlete absorbs each week, how quickly that changes, and how strong and coordinated they are when they absorb it.
That is not a consolation prize. Across youth sport, structured prevention programmes reduce injury rates meaningfully, the effect size is larger than almost any treatment applied after an injury has already happened.
1. Strength train, all year
Two 20–30 minute sessions a week are enough for most young athletes. The goal is not lifting heavy; it is building the calves, quadriceps, glutes, hamstrings and trunk so the tissues pulling on growth plates are tolerant of the demands of sport.
Crucially, this should run year-round rather than being started when pain appears. Capacity built in advance is prevention; capacity built after a flare is rehab.
2. Warm up properly
- Use a structured neuromuscular warm-up rather than a lap and a static stretch.
- Include hopping, bounding, landing and deceleration in every warm-up.
- Add balance and single-leg control work, 5–10 minutes is enough.
- Do it before every session, not just matches.
3. Watch the weekly total
- Count all organised sport - school, club, county, district, PE, in one number.
- Keep weekly hours of organised sport at or below the athlete's age in years as a rough ceiling.
- Avoid week-on-week increases of more than roughly 30%.
- Take one full day off organised sport each week.
- Plan one to two months a year away from the main sport.
4. Track growth
Measure standing height monthly, barefoot, at the same time of day. An increase above roughly half a centimetre a month indicates an active growth phase. During those months, hold training volume steady rather than progressing it, keep strength work going, and expect a temporary dip in coordination and flexibility.
Rapidly outgrowing boots and trainers is the same signal by another route, and worn or too-small footwear is itself a contributor to heel and knee pain.
5. Protect sleep and fuelling
Adolescent athletes need 8–10 hours of sleep. Consistently getting less is associated with higher injury rates, and it is often the easiest variable to improve in a busy household.
Under-fuelling matters just as much. A growing athlete training six or more hours a week has substantial energy needs; chronically eating too little impairs bone health, recovery and adaptation, and raises injury risk. Regular meals, carbohydrate around training, and adequate calcium and vitamin D are the basics.
6. Keep sport varied
Playing more than one sport through to mid-adolescence spreads the load across different tissues and movement patterns, and is consistently linked with fewer overuse injuries and lower dropout. It also does not compromise long-term performance in most sports, the majority of senior elite athletes played multiple sports as children.