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Why Teen Athletes Get Hurt During Growth Spurts: Training Load, Recovery, and the Awkward Phase

Princeton Sports and Family Medicine, P.C. Blog Why Teen Athletes Get Hurt During Growth Spurts: Training Load, Recovery, and the Awkward Phase

There is a period in many young athletes’ lives when everything seems to change at once.

They grow taller. Their limbs look longer. Their stride changes. Their coordination may look different. They may feel tight, awkward, tired, or less explosive. A movement that used to look smooth may suddenly look clunky. A player who was always durable may start complaining of heel pain, knee pain, back pain, shin pain, or soreness that does not go away as quickly.

Parents often ask: “Is this just growing pains?”

Sometimes growth is part of the story. But pain during a growth spurt should not automatically be dismissed.

A growth spurt can temporarily change how a teen athlete moves, absorbs force, and tolerates training. At the same time, many athletes are increasing practice demands, playing for multiple teams, specializing earlier, lifting harder, attending showcases, and sleeping less.

That combination can create the perfect setup for overuse injuries.

For athletes in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County, the goal is not to fear growth. The goal is to understand how growth changes the athlete’s body and how to support safe, confident development.

Quick Takeaways

What Happens During a Growth Spurt?

During a growth spurt, bones lengthen quickly. Muscles, tendons, coordination, and strength may need time to catch up.

This can change how an athlete moves.

A teen may suddenly feel:

This does not mean the athlete is doing anything wrong. It means the body is changing quickly.

The problem is that sports demands usually do not slow down just because growth is happening. Practices, games, tournaments, showcases, and strength training often continue at the same pace or increase.

Why Growth Can Increase Injury Risk

Growth itself is not an injury. But rapid growth can change the athlete’s load tolerance.

Load tolerance means how much stress the body can handle before symptoms develop. Running, jumping, cutting, throwing, lifting, and contact all create load. A growing athlete may temporarily tolerate less of that load than before.

Several factors can contribute:

This is why an athlete can get hurt even without a single traumatic event.

The pain may appear gradually because the body is being asked to handle more than it is ready for.

The Awkward Phase Is Real

Parents and coaches often notice an “awkward phase” during adolescence.

A player who used to be quick may look slow. A runner’s stride may look uneven. A basketball player may struggle with footwork. A soccer player may look less coordinated when cutting. A pitcher may lose command. A gymnast or dancer may feel that timing is off.

This can be frustrating for athletes.

They may feel like they are getting worse even though they are developing normally.

This is where adults need to be careful. Criticizing effort or toughness may miss the real issue. The athlete may be working hard while the body is adjusting to a new size and movement system.

The awkward phase often improves with time, patience, strength, coordination work, and appropriate training.

Common Growth-Related Pain Patterns

Growing athletes can develop pain in several common areas.

Heel Pain

Heel pain in active kids and teens is often related to irritation near the heel growth area. This is common in running and jumping sports such as soccer, basketball, field hockey, lacrosse, and track.

Athletes may complain of pain with running, jumping, cleats, or the first steps after activity.

Knee Pain Below the Kneecap

Pain at the bump below the kneecap can be related to Osgood-Schlatter disease. This often affects athletes who run, jump, sprint, squat, or change direction frequently.

The athlete may have tenderness, swelling, or a painful bump at the top of the shin.

Pain Around the Kneecap

Some athletes develop front-of-knee pain as training load increases. This may be related to patellofemoral pain, strength deficits, mechanics, or rapid changes in activity.

Shin Pain

Shin pain may be a sign of overload. Sometimes it is shin splints. Sometimes it may be a bone stress injury. Pain that becomes focal, worsens with running, or hurts with walking should be evaluated.

Back Pain

Back pain in a teen athlete should be taken seriously, especially if it persists, worsens with extension, or affects sport. Gymnasts, rowers, football players, dancers, wrestlers, and athletes doing repetitive extension or loading may be at risk for specific spine-related issues.

Shoulder or Elbow Pain

Throwing athletes may develop shoulder or elbow pain when growth, throwing volume, mechanics, and strength are not well matched. Elbow pain in a growing thrower should not be dismissed as simple soreness.

“Growing Pains” vs. Sports Injury

The phrase “growing pains” can be misleading.

Classic growing pains are usually vague aches, often at night, often in both legs, and not clearly tied to sports performance. They typically do not cause limping, swelling, focal tenderness, or pain during activity.

Sports-related pain is different.

A sports injury is more likely when pain:

When pain behaves like an injury, it should be treated like one.

Training Load: The Missing Piece

Many growth-related injuries are really growth plus load problems.

Training load includes everything the athlete’s body has to handle:

Parents and coaches often underestimate total load. Each adult may see only one piece of the schedule. The athlete feels all of it.

A middle school or high school athlete may be playing for a school team, club team, and trainer at the same time. Add rapid growth, homework, poor sleep, and skipped meals, and the body may struggle to adapt.

Why Specialization Can Add Risk

Early specialization means focusing heavily on one sport, often year-round, with limited breaks or other movement patterns.

Specialization is common in competitive youth sports. Families may feel pressure to keep up with peers, maintain roster spots, attend showcases, or chase recruiting opportunities.

But repeating the same sport motions all year can increase overload risk. Throwers throw. Runners run. Soccer players cut and kick. Basketball players jump and land. Dancers and gymnasts load the same positions repeatedly.

Growing athletes often benefit from variety. Different sports and movement patterns can build broader athleticism and reduce repetitive stress.

This does not mean every athlete must play multiple sports. But it does mean year-round single-sport load should be monitored carefully.

Recovery Is Training

Teen athletes often think recovery is what happens when they are not training.

That is only partly true.

Recovery is when the body adapts. Bones, muscles, tendons, and the nervous system need time and resources to respond to training.

Key recovery factors include:

A teenager who is growing, training hard, sleeping five or six hours, skipping breakfast, and playing every weekend may not be recovering enough.

Recovery is not laziness. It is part of development.

Sleep Matters More Than Most Athletes Think

Sleep is one of the most powerful recovery tools.

During adolescence, sleep supports growth, learning, mood, reaction time, immune function, and tissue repair. Yet many teen athletes are chronically sleep-deprived because of early school start times, homework, phones, travel, late practices, and stress.

Poor sleep can affect:

When a teen athlete is in a growth spurt, sleep becomes even more important.

A practical question for parents: if your athlete is hurt, tired, irritable, and not recovering, how much sleep are they actually getting?

Nutrition and Energy Availability

Growth requires energy. Sports require energy. Recovery requires energy.

If an athlete is not eating enough to support all three, problems can develop.

Underfueling may show up as:

This is not just a weight issue. Athletes of any body size can underfuel.

A growing athlete needs adequate calories, protein, carbohydrates, fats, vitamins, minerals, calcium, vitamin D, and hydration. Restrictive eating during growth and heavy training can create real health risks.

Strength Training During Growth Spurts

Strength training can be very helpful for teen athletes when it is appropriate, supervised, and progressive.

The goal is not to load a growing athlete like a professional adult. The goal is to build control, coordination, strength, balance, and confidence.

A good program may include:

Strength training should support the athlete’s development, not add excessive stress on top of an already overloaded schedule.

When Pain Should Be Evaluated

A teen athlete should be evaluated if pain:

It is better to evaluate early than to wait until the athlete is forced to stop.

Early care often means a shorter, more manageable plan.

How Parents Can Help

Parents can help by noticing patterns and asking better questions.

Instead of only asking, “Does it hurt?” try:

These questions help separate normal soreness from a developing injury.

What Coaches Should Watch

Coaches can also play an important role.

Signs an athlete may be struggling include:

A coach who recognizes the awkward phase can help the athlete adapt rather than simply pushing harder.

Growth-Spurt Injury Care Near Princeton, NJ

Teen athletes in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County are often balancing school teams, club sports, camps, strength training, and academic stress.

That makes growth-spurt injuries common.

The best plan usually starts with understanding what changed. Did the athlete grow? Did practice intensity increase? Did the athlete add a second team? Did sleep decrease? Did pain begin after a tournament? Did the athlete change shoes, surfaces, or training volume?

The answer is often in the timeline.

How PSFM Can Help

At Princeton Sports and Family Medicine, care for teen athletes focuses on diagnosis, development, and safe return to activity.

Sports Medicine Services can help evaluate growth-related pain, overuse injuries, bone stress concerns, concussion history, and return-to-sport questions.

Physical Therapy can help athletes improve strength, mobility, balance, movement control, and confidence.

For runners and field athletes with recurring lower-extremity symptoms, the Run Stride & Performance Evaluation can help assess mechanics and loading patterns.

PSFM Wellness can support healthy fitness habits, recovery, and long-term wellness.

Fuse Sports Performance can help athletes build strength, speed, durability, and performance capacity in a structured environment.

The goal is not simply to get the athlete through the next game. The goal is to support long-term development.

How to Adjust Training During a Growth Spurt

During rapid growth, athletes may need temporary adjustments.

That may include:

These changes do not mean the athlete is weak. They mean the training plan is adapting to the athlete’s body.

That is what good coaching and good sports medicine should do.

Related Pages

FAQs

Why do teen athletes get hurt during growth spurts?

Growth spurts can temporarily change coordination, flexibility, strength, and tissue tolerance. If training load increases at the same time, the athlete may be more vulnerable to overuse injuries.

Are growth-spurt injuries just growing pains?

Not always. Pain that occurs during sports, causes limping, worsens with activity, or is located in one specific spot should be evaluated as a possible injury.

What injuries are common during growth spurts?

Common problems include heel pain, Osgood-Schlatter symptoms, knee pain, shin pain, stress injuries, back pain, tendon irritation, and throwing-related shoulder or elbow pain.

Should my athlete stop sports during a growth spurt?

Not necessarily. Many athletes can continue with modifications. The plan depends on symptoms, diagnosis, training load, and sport demands.

Is strength training safe during puberty?

Appropriate, supervised, technique-focused strength training can be helpful. The program should be progressive and matched to the athlete’s development and training load.

How much pain is okay for a growing athlete?

Mild soreness that improves and does not change mechanics may be acceptable. Pain that worsens, causes limping, persists, or limits activity should be evaluated.

Can poor sleep increase injury risk?

Poor sleep can affect recovery, coordination, mood, reaction time, and pain sensitivity. Teen athletes need sleep to support growth and training adaptation.

Where can I get a teen sports injury evaluated near Princeton, NJ?

Princeton Sports and Family Medicine evaluates teen athletes with growth-related pain, overuse injuries, and return-to-sport concerns in Princeton, Lawrenceville, and surrounding Mercer County communities.

The Bottom Line

Growth spurts are normal. The awkward phase is normal. But persistent pain is not something athletes should simply push through.

Teen athletes often get hurt during growth spurts because their bodies are changing at the same time training demands are rising. The solution is not panic or complete rest for every ache. The solution is smart load management, recovery, strength, nutrition, sleep, and early evaluation when symptoms are concerning.

If your athlete is dealing with heel pain, knee pain, shin pain, back pain, throwing pain, or recurring soreness during a growth spurt, request an appointment with Princeton Sports and Family Medicine.

This content is educational only and is not a substitute for individualized medical advice. If an athlete has severe pain, rapidly worsening symptoms, inability to bear weight, significant swelling, night pain, fever, numbness, weakness, chest pain, fainting, major trauma, or other concerning symptoms, seek urgent medical evaluation.

Author
Peter Wenger, MD Peter C. Wenger, MD, is an orthopedic and non-operative sports injury specialist at Princeton Sports and Family Medicine, P.C., in Lawrenceville, New Jersey. He is board certified in both family medicine and sports medicine. Dr. Wenger brings a unique approach to sports medicine care with his comprehensive understanding of family medicine, sports medicine, and surgery. As a multisport athlete himself, he understands a patient’s desire to safely return to their sport.

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