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The Role Of growth plates in Growth of Long bones

 

The role played by growth plates in bone growth and their closure is misunderstood by many so may be this topic deserves a mention.

what exactly are growth plates?epiphyseal

Simply put, the epiphyseal / growth plates are thin layers of cartilage disc entrapped at the distal ends of long bones between the epiphysis (head ) and metaphysis  .

Most long bones in the body have at least two growth plates, including one at each end.

 

Parts of the body with growth Plates

Growth plates are found in the long bones of the body—the bones that are longer than they are wide. Examples of long bones include the femur (thighbone), the radius and ulna in the forearm, as well as the metacarpal bones in the hands.

 

X – ray showing open and Closed plates.

growth plate

Open growth plates

 

 

How Growth takes place at the Epiphyseal Plate.

skeletal growth at the epiphyseal plate is an active and dynamic process.
The epiphyseal growth plate is made of several key aspects including cartilaginous, bony, and fibrous components, which act together to achieve longitudinal bone growth

Growth plates consist of special cells called chondrocytes, which make a cartilage template for the bone to be formed on.

Immature (stem-like) chondrocytes first start proliferating; then maturing (differentiate and enlarge); and finally die, allowing new bone tissue to be formed on the remaining cartilage matrix.

The epiphyseal growth plate, being a highly specialized layer of cartilage where chondrocytes proliferate and differentiate, brings forth longitudinal bone growth.

The exact mechanism of epiphyseal fusion is still not completely understood and experimental studies are complicated by the fact that there is a species difference between humans and rabbits that do fuse their growth plates and rodents that do not.

 

How about Flat Bones? How do they grow?

The growing skull,  jaw  and collar bone do not have a cartilage stage. They form directly from osteoblasts (cells that make bone  by producing a matrix that then becomes mineralized.) .

A layer of cells which can differentiate into the osteoblasts lines the bone, with a special concentration between the bones of the skull.

These precursor cells turn into osteoblasts which secrete collagen in a haphazard pattern called woven bone. Later osteoclasts resorb (dissolve) the woven bone and new osteoblasts form the mature, lamellar (layered) bone.

 

Theories Regarding  Growth plate maturation and fusion

A nowadays generally accepted hypothesis is that terminally overgrown chondrocytes die by undergoing apoptosis (A form of cell death in which a programmed sequence of events leads to the elimination of cells ) leaving behind a scaffold of cartilage matrix for cells that make bones (osteoblasts) that invade and lay down bone resulting in growth plate fusion.

In specific disorders, timing of epiphyseal fusion is advanced or delayed; for example, in patients with estrogen deficiency it is delayed and in patients with precocious puberty it is advanced.

In case of Precocious puberty, a child’s body begins changing into that of an adult (puberty) too soon.

Puberty that begins before age 8 in girls and before age 9 in boys is considered precocious puberty.

Puberty includes rapid growth of bones and muscles, changes in body shape and size, and development of the body’s ability to reproduce.

Men with a disruptive mutation in the oestrogen resistance gene
or in the aromatase deÆciency gene (estrogen deficiency) who have no pubertal growth spurt may continue to
grow into adulthood due to lack of epiphyseal fusion.

 

Timing of Growth Plates closure or fusion

According  Andre C. Grant, MD an orthopaedic surgeon at Duke Orthopaedics of Raleigh,  It is difficult to predict exactly when each growth plate will close because different bones stop growing at different times.

But there is an average time when the growth plates in the long bones should close.

Most children grow an average of two years after they have completed their pubertal growth spurt.

The age at which puberty starts is quite variable depending on many factors including race, gender, and body habitus. On average, females are done growing around age 12 to 14, and boys around age 14 to 16.

Obviously many children continue to gain some height into their late teen years, but the vast majority of growth is over by these ages

 

Role Played by Growth hormones and Estrogens

 

Growth Hormones

The balance between proliferation and differentiation in bone is  a crucial regulatory step controlled by various growth hormones acting in the endocrine pathways .

Growth hormone  and insulin-like growth factor-I have major effects on the chondrocytes of the growth plate and act upon all bone cells .

Growth hormone , mostly seen in action during the growth spurt in early adolescence, is considered to be the key hormone regulator of linear growth during childhood.

 

Estrogen
Estrogen action is indispensable for normal pubertal growth and growth plate fusion. Both estrogen receptors , ER-alpha and ER-beta, are expressed in the growth plate in boys and girls throughout pubertal development .

The rise in estrogen levels at menarche in girls is associated with a large reduction in bone turnover markers and reflects the closure of the epiphyseal growth plates, the reduction in periosteal apposition and endosteal resorption within cortical bone.

 

New Research regarding Bone growth, transformation and remodeling

From  above facts regarding growth  plates regulation of bone growth, it’s clear why doctors and researchers believe that growing taller after puberty is not possible once the epiphyseal plate is closed.

In contrast however, according to Los Alamos laboratory research, human bones are in fact dynamic organs  continually remodeling through processes that remove existing bone and deposit new bone, a young adult’s skeleton replaces one-fifth of its bone tissue each year.

This dynamic remodeling serves both to subtly adjust structure in response to changing stresses and to maintain the proper level of blood calcium, a mineral essential to the functioning of all cells.

Remodeling normally occurs during bone growth, in response to physico-chemical factors such as stresses from exercise, during repair of injuries such as fractures, and during hormonal changes.

Remodeling includes the sensing of environmental changes, the formation of new bone, and the removal of existing bone (“resorption”).

Limb lengthening surgery ( where a huge fracture is created by way of breaking the bone into two, Pins attached with a gap between the two broken parts then the two parts rejoin the gap forming a complete bone with increased length over a period of time )  is an excellent example to prove that bones remodel, re-build, grow, thicken, and lengthen throughout life.

Vigorous exercise and healthful diet with adequate calcium, protein, vitamin D, and supplements may replace the role of epiphyseal plate.

Thus, bone adaptation is forced to occur because stress is exerted and supplements & vitamins continuously supply nutrients and food for bones.

 For those  whose plates are closed should look to stress factors & vitamins & supplements.

According to J.S.R. Golding, an orthopaedic surgeon from the department of Surgery, University of the West Indies, Kingston, Jamaica

 The shape, strength, growth and form of a bone is determined not only by heredity but by the work it has to perform.

 

 

References And Further Reading

http://www.jocmr.org/index.php/JOCMR/article/view/477/281#16

http://www.nature.com/pr/journal/v52/n2/full/pr2002158a.html#bib39

https://www.lanl.gov/quarterly/q_w03/bones.shtml

https://www.fas.harvard.edu/~skeleton/pdfs/2004f.pdf

http://www.springer.com/cda/content/document/cda_downloaddocument/9780896038479-c2.pdf?SGWID=0-0-45-387574-p173728681

https://depts.washington.edu/bonebio/ASBMRed/growth.html

 

 

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  • zhou lee

    Sir ,I am 23 ,I am gonna follow your routine. Would going to bed without food be better? or what are the best foods before going to bed !please reply

    • Just avoid simple carbohydrate foods like soft drinks because they rapidly increase insulin levels in the blood and eat at least 2-4 hours before going to bed.

  • kawther

    Hi, im 14 and my growth pate closed, but will this work for me? is it possible to grow after growth plates closed?

  • bea

    Is this even for real.., im 5’6 19year old female. id like to grow at least one more inch taller…but I dont want to be scammed…there is a program called grow taller for idiots. Many ppl got fooled by it and tried the program but it didnt work…it is a scam. Honestly ppl are so twisted and vile these days 🙁

    • l Know exactly how you feel and i personally tried the prog. you mentioned but ended up chasing my tail. and that’s how i Created my personal routine. Basically what i share in the book and on the blog is hands on personal experience.

      • bea

        thanks.if i start this program, do u think it is okay for me not to eat meat? im a vegan, and i get my protein from oats,beans,and some leafy greens. there are studies showing that animal protein is not that good for the health. animal protein is a sulfer holding amino acid, which in turn makes the body more acidic(acidosis) the body does a mechanism where it takes out calcium from the bones to neutralize the acidic environment in our muscles. lots of vegan bodybuilders have actually improved their muscle mass by not eating animal protein but instead getting their protein from fruits veg, beans, oatmeal, rice etc…also i dont have a stationary bike at home but i can use a stationary bike at the gym…is it ok for me to bike ride instead? thanks

        • link to the Page about Nutrition in the Side bar of this page to Know more about role of meat. you may do cycling from a gym but doing it at home is more Convenient especially Since you have to do it everyday.

          • bea

            thanks..i am not sure weather i should do weight training or lifting weights…since i am 19 i am not sure weather i am done with puberty…it might have the opposite effect on my height and make me shorter? i think puberty ends llike at 21…not 19.

          • For males, puberty may stretch up to 25 but for females, chances are high that by 19 you are past puberty. You may ask more questions via email using the contact link above this page.

          • Zhang Zhen

            hello I am 20+ female and my growth pate closed. Do I still have chance to gain 2-3 inches heigh? Also my parent all tall people I even shorter 5 inches than my mom.

    • MrB’sSuperFunHappyHouseYAAAYYY

      I am not trying to stop you from trying height increase but you should know that your height is above average (At least for western countries like UK and the US), 5’6″ for a woman is about the equivalent of a 6’0″ male either way. I wish you luck though.

  • Jen

    hello I am 20+ female and my growth pate closed. Do I still have chance to gain 2-3 inches heigh? Also my parent all tall people I even shorter 5 inches than my mom.

  • JP

    Hi, I am looking into height increase and I had two questions:

    Were your growth plates in your legs confirmed closed before you began to pursue this height increasing routine? Gaining 7 inches in 3 years after growth plates close seems extremely difficult if not impossible. Do you think they may have still been open?

    Was it your pubertal growth spurt that initially brought you to 5’4″?

    Thanks

  • TSK

    Growing taller after puberty is possible. Answer is Chemicals. Knowing which chemical to use.

    • Do your best to keep away from chemicals.

      • TSK

        Chemical is the answer. I grown few inches using steroids and peptides.

  • Jade John

    I am 17 years old female and my growth plates are closed , my doctor said I can Still add 2 to 3 inches to my height is this true?

    • Sure!

      • Jade John

        My IGF-1 level is normal 270 . I run and do Hanging exercise , walk and jump can I increase my height 2 cm in five months If I continue with these exercise and I sleep 6-7 hours?

  • SS

    I’m 21 years old. My height is 5’6 and half. i wanted to add 2-3 inches to my height. I do stretching and cycling 5 times a week. Is there still a possibility for me to grow?
    Please do tell me what i need to do?
    I’ve gone through your entire article. I want to make sure how much time will it take to grow more for 2-3 inches?

  • Gaurav Sharma

    sir , i am 21 years old , my height is 5’4″ ….can i grow my height taller …?…my growth plates are fused…My father’s height is 5’4″ and my mother’s height is 5’2″ …

  • LNguyen

    This is impossible. I’ve tried similar methods on youtube like stretches, cycling, hanging, sleeping, nutrition stuff and after 4 months I did not gain a centimeter! guess I’ll just get use with my high rn..