Growth Plate Closure: Concerns for Your Son's Height

The growth plates in my son's bones are closing rapidly?

Hello Doctor, my son just started ninth grade this year, and this semester he has only grown 1 cm (currently 171 cm).
During the summer, we took him for a bone age assessment, and the doctor said he has entered stage four of sexual maturity.
The X-ray indicated that his growth plates are closing quickly, with no gaps at the finger joints and only a little space remaining at the wrist.
The doctor estimated that he has about a year and a half left to grow, but this growth will be slow, with a maximum of 3 to 4 cm in a year, or even less.

My husband and I calculated that the average height should be around 175 cm.
In sixth grade, he grew 10.5 cm, in seventh grade 7.5 cm, in eighth grade 6.1 cm, and this semester he has only grown 1.2 cm.
He has had a normal lifestyle since childhood; even in junior high, he goes to bed before 10 PM, has a good appetite, and is not picky with food.
He currently drinks 240 cc of fresh milk daily and skips rope for 800 times.
We thought reaching over 175 cm would not be a problem, but the doctor mentioned that his growth plates are closing quickly.

Now, every junior high student seems to be very tall, and I am worried that he may not even reach 175 cm.
Is there any way to help my son maximize his growth potential before his growth plates fuse? He hopes to reach 178 cm, but with only 1.2 cm of growth this semester, will the future growth really be as slow or even less, as the doctor suggested? Below is my son's height record for the past four years: fifth grade first semester 142 cm, fifth grade second semester 146 cm, sixth grade first semester 152 cm, sixth grade second semester 156.5 cm, seventh grade first semester 160.5 cm, seventh grade second semester 164 cm, eighth grade first semester 167.7 cm, eighth grade second semester 170.1 cm, and ninth grade first semester 171.3 cm.

Finally, thank you for your patient response, Doctor! Thank you!!

xin ji ru wen de ma ma, 10~19 year old female. Ask Date: 2016/09/20

Dr. Lin Yishou reply Pediatrics

Dear Parents,
According to your letter, your child's bone age is nearing closure, and the annual growth rate is gradually declining.
Indeed, there is only 1-2 years left for growth.
Any form of exercise is beneficial, so jumping rope is certainly one of the options.
However, the effects of exercise must be initiated early in life to accumulate noticeable results over time.

As for the average height of boys in Taiwan, the latest statistics indicate it is 172 cm.
Therefore, your child's height has already reached a normal level.
Of course, being slightly taller is preferable for boys, but this is more related to aesthetics or personal and parental expectations rather than physical health.
From a Western medical perspective, there are medications available that may promote growth.
Parents can refer to the information provided on Dr.
Lin's website at http://www.ishoulin.com/cms1-cat1.html.
However, to understand the effectiveness of these treatments, parents should discuss in detail with a physician.
The key point is that if you are considering medication treatment, given your child's situation, a prompt decision is essential, as there is limited space left in the growth plates.
Thank you for your letter.

Reply Date: 2016/09/20

More Info

Understanding the growth plate and its role in height development is crucial, especially for parents concerned about their child's growth trajectory. Your son, currently in the ninth grade and measuring 171 cm, has shown a significant slowdown in growth, with only 1 cm gained this semester. Given that he has entered stage four of sexual maturity, as indicated by the bone age assessment, it is important to understand what this means for his potential height.

The growth plates, or epiphyseal plates, are areas of developing cartilage tissue located at the ends of long bones. They are responsible for the lengthening of bones during childhood and adolescence. As a child matures, these plates gradually close, which signifies the end of vertical growth. In boys, this process typically occurs around the ages of 16 to 18, although it can vary based on individual development and genetic factors.

From the information provided, it appears that your son has experienced a significant growth spurt in earlier years, particularly in sixth grade, where he grew 10.5 cm. However, the recent growth rate of 1.2 cm in the past semester suggests that he may be nearing the end of his growth potential. The doctor’s estimate of an additional 3 to 4 cm over the next year and a half aligns with typical growth patterns observed in adolescents who are approaching skeletal maturity.

While genetics plays a significant role in determining height, environmental factors such as nutrition, physical activity, and sleep also contribute. It is commendable that your son maintains a healthy diet, consumes dairy for calcium, and engages in physical activity like jump rope. These factors are essential for supporting bone health and overall growth. However, it is important to note that no specific exercise or dietary change can guarantee an increase in height once the growth plates are close to closing.

To maximize his growth potential, consider the following recommendations:
1. Nutrition: Ensure that your son’s diet is well-balanced and rich in essential nutrients. This includes adequate protein, calcium, vitamin D, and other vitamins and minerals that support bone health. Foods like lean meats, dairy products, leafy greens, nuts, and whole grains should be staples in his diet.

2. Physical Activity: Encourage regular physical activity, which can promote overall health and well-being. While exercises like jump rope are beneficial, incorporating a variety of activities, including strength training and flexibility exercises, can be advantageous. Activities that promote good posture and spinal alignment, such as swimming or yoga, may also be beneficial.

3. Sleep: Adequate sleep is crucial for growth hormone production. Ensure that your son maintains a consistent sleep schedule, aiming for 8-10 hours of quality sleep each night.

4. Regular Check-ups: Continue to monitor his growth with regular check-ups. If there are any concerns about his growth or development, consulting with a pediatric endocrinologist may provide additional insights and options.

5. Realistic Expectations: While it’s natural to hope for a specific height, it’s important to set realistic expectations based on genetic potential and current growth patterns. Encourage your son to focus on his overall health and well-being rather than solely on height.

In conclusion, while there may be limited opportunities for significant height increases as your son approaches skeletal maturity, maintaining a healthy lifestyle can support his overall growth and development. It’s essential to foster a positive body image and self-esteem, regardless of height, as these factors play a crucial role in his overall well-being.

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