Growth plates, also known as epiphyseal plates, are areas of cartilage located at the ends of long bones in children and adolescents. The growth plates are responsible for the lengthwise growth of bones. However, at the end of puberty, which occurs around ages 16-18 in girls and 18-21 in boys, the growth plates ossify (harden into bone), stunting further longitudinal growth. While many mistakenly believe growth plates fuse completely at this time, some evidence suggests growth plates may still have some capacity for growth even after initial ossification. This has led some people to explore methods of re-activating growth plates to regain some height later in adulthood.
Can growth plates be re-activated after initial ossification?
Some preliminary studies in animal models have suggested that growth plates retain some capacity for growth even after the initial ossification process that occurs at puberty.
One study in New Zealand white rabbits found that initially ossified growth plates could be induced to resume growth when put under constant tension from staples or distraction osteogenesis devices. While under tension, cracks and gaps were observed in the ossified growth plates, indicating the bone was still responding to mechanical stress. When tension was released, new bone formation was seen filling the gaps. This provides evidence that growth plates may maintain some mechanosensitivity even after puberty.
Other preliminary studies in rats have shown growth plate chondrocytes remain metabolically active even after initial ossification. When injected with growth promoting substances like growth hormone or thyroid hormone, initially ossified growth plates showed evidence of cell proliferation and production of new cartilage matrix. However, the amount of regenerated cartilage was quite limited.
Overall, the animal studies to date suggest growth plates may maintain some potential for growth after initial ossification at puberty. However, the capacity appears limited compared to wide open growth plates in juveniles. Much more cartilage regeneration would likely need to occur to translate into any substantial increase in height. Unfortunately, these animal studies have not yet led to viable therapies to substantially reopen growth plates in humans.
Challenges of re-activating growth plates in humans
While animal models provide some hope, there are significant challenges to translating growth plate reactivation into increased height in humans:
– Limited remaining growth potential – The amount of height that could theoretically be gained by reopening growth plates later in adulthood is limited. Growth slows markedly in the final years before growth plate closure, so reactivating growth several years post-closure may only add a small amount of height.
– Need for constant mechanical tension – The animal studies required constant tension across the growth plate via distraction devices to stimulate new growth. It is unclear how such tension could be safely applied constantly across human growth plates to see results.
– Unknown efficacy and safety of chemical stimulants – Growth hormones, thyroid hormones, and other potential chemical stimulants have shown minimal effects in animal studies. Much higher doses would likely be needed to produce noticeable growth in humans, increasing safety concerns.
– Potential for abnormal bone growth – Regenerating significant cartilage in closed growth plates could lead to excessive or abnormal bone growth. There are risks of developing bowleggedness, disproportionate limbs, or misaligned joints.
– Only longitudinal growth – Growth plates determine longitudinal growth, not transverse bone width. Reopening growth plates could lead to disproportionately long limbs compared to width.
– Unethical human trials – Controlled human trials have not and likely would never be conducted due to major ethical concerns. The unknown efficacy and safety profile prohibits deliberately trying to reopen growth plates in children or teenagers.
For these reasons, while scientifically intriguing, deliberately re-activating growth plates to increase height remains safely out of reach for now, especially for adults well past the initial closure of their growth plates.
What influences growth plate closure?
Although re-activating closed growth plates is not feasible, understanding the biology controlling growth plate closure may provide insights into maximizing growth potential before growth stops. Multiple factors contribute to eventual ossification of growth plates at the end of puberty:
– **Estrogen** – Rising estrogen levels in girls and boys at the onset of puberty initiate the beginning phases of growth plate closure. High estrogen signals bones to start ossifying.
– **Testosterone** – Rising testosterone levels in boys contribute to growth plate ossification by the late teens. Testosterone rises later in boys than estrogen does in girls, leading to boys typically having later growth plate closure.
– **Growth hormones** – Growth hormone and related factors, like IGF-1, stimulate growth plates to grow. As growth hormone declines in late puberty, growth slows and eventual closure occurs.
– **Thyroid hormones** – Thyroid hormones also play a role in stimulating growth plate chondrocytes. Decreased thyroid hormone signaling can trigger earlier growth plate closure.
– **Glucocorticoids** – Glucocorticoids like cortisol counteract the effects of growth-promoting hormones. Increased glucocorticoid exposure prematurely slows growth velocity and initiates closure.
– **Nutrition** – Poor nutrition leads to growth retardation and earlier growth plate closure. Adequate nutrition helps maximize growth potential.
– **Mechanical forces** – Compressive forces on growth plates from weight bearing activities help drive chondrocyte proliferation and cartilage expansion. Lack of mechanical load causes growth plates to thin and close sooner.
These systemic and local factors work in concert to carefully regulate growth plate activity over childhood development. Disruptions to endocrine signaling or biomechanical forces during critical growth periods can prematurely deplete growth plates, leading to loss of height potential.
Strategies to maximize growth before plate closure
While growth plate reactivation is not currently possible, the following strategies may help maximize growth potential before plate closure occurs:
– Get adequate nutrition with sufficient calories, protein, minerals, and vitamins to support growth.
– Treat endocrine disorders like growth hormone deficiency, hypothyroidism, or premature adrenarche early to minimize their growth-limiting effects.
– Limit exposure to medications like glucocorticoids that can impair growth. Use alternative medications when possible.
– Engage in regular weight-bearing exercise to stimulate growth plates via mechanical forces. Sports like basketball, gymnastics, tennis, and swimming provide compressive and tensile forces.
– Avoid smoking, excessive alcohol, and reproductive steroid abuse, as these can accelerate growth plate closure.
– Get adequate sleep, as growth hormone is secreted during deep sleep phases. Lack of sleep reduces growth hormone release.
– For late bloomers, delaying epiphyseal closure through foregoing hormone replacement therapy and maintaining mechanical loading may allow more growth. However, this delay comes with social and emotional challenges.
– Seek guidance from an endocrinologist if growth concerns arise to develop a specialized treatment plan. Annual height measurements can track growth velocity.
While the window of opportunity is finite, focusing on maximizing growth potential in the critical pre-closure years provides the best opportunity for achieving one’s genetic height potential.
Non-surgical methods that do NOT increase height by reopening growth plates
Some non-surgical methods advertised online as ways to increase height in adults do not actually work by reopening growth plates. These unproven, ineffective, or potentially dangerous methods include:
– **Supplements** – Supplements like human growth hormone, growth factors, or amino acids claim to boost IGF-1 levels and stimulate bone growth. But taken orally, these molecules cannot cross gut epithelium or growth plate cartilage matrix to reach chondrocytes and stimulate new growth. Clinically, these supplements do not increase height.
– **Stretching exercises** – Static stretches and inverted positions like gravity boots aim to decompress the spine and elongate the body. But they do not stimulate growth plate chondrocytes to produce new cartilage and lack evidence in increasing height.
– **Spinal traction devices** – Mechanical traction devices that pull on the spine also do not stimulate cartilage growth at epiphyseal plates. They will not increase overall height beyond possibly a few millimeters.
– **Hanging** – Hanging from a bar to decompress and stretch the spine has no effect on growth plates and cannot increase height beyond temporary spinal lengthening. The force is applied in the wrong direction.
– **Growth stimulators** – Electrical or ultrasonic devices that allegedly stimulate chondrocytes have shown no convincing evidence that they can regenerate enough cartilage matrix to increase height.
– **Milk or vitamin overdose** – Overdosing on ordinary foods like milk or vitamins well beyond the recommended dietary allowance does not further stimulate growth plates and can actually cause health problems.
– **Osteopathic manipulation** – Techniques like craniosacral therapy cannot stimulate meaningful new chondrocyte activity or cartilage regeneration in ossified growth plates.
– **Acupuncture** – No evidence supports acupuncture as a way to reach ossified growth plates and reactivate their function. Needling areas around Growth Plates cannot increase height.
Why these methods do not work
These non-surgical methods fail to increase height in adults because they cannot truly reopen growth plates and stimulate significant new cartilage growth. Reasons these methods lack evidence include:
– Cannot physically reach closed growth plates to stimulate chondrocytes
– Do not recreate proper biochemical environment for cartilage growth
– Do not apply appropriate direction or magnitude of mechanical forces
– Limited remaining chondrocyte potential for proliferation
– Safety concerns with overdosing on supplements, hormones, vitamins
Rather than unproven height increase methods, people dissatisfied with their height should focus on embracing their body and optimizing their health through proper nutrition, exercise, sleep, social support, and self-acceptance. Height is just one aspect of health and does not define human worth or potential.
Surgical leg-lengthening procedures
The only proven methods to increase height as an adult involve surgical lengthening of the femur or tibia bones in the legs. These invasive procedures have been performed for decades to correct limb length discrepancies. When performed for purely cosmetic height increase, the procedures remain controversial due to high costs and risks of complications.
The two main techniques are:
– **Distraction osteogenesis** – The surgeon breaks the femur or tibia in half, inserts a telescopic rod, and gradually distracts the rod over months to stimulate new bone growth at the gap. Once the desired height is reached, the new bone solidifies and the rod is removed.
– **Epiphysiodesis** – Metal plates are surgically implanted across open growth plates to temporarily stunt growth. At skeletal maturity, the plates are removed, allowing some catch-up growth. This technique cannot reopen closed plates in adults.
Outcomes of leg lengthening procedures
When performed correctly, these procedures can increase height by 3-6 inches. However, patients must consider many potential drawbacks:
– High out-of-pocket costs – $40,000 to $100,000 in the U.S. since insurance does not cover cosmetic procedures.
– Extended recovery – Patients require months of challenging physical therapy to remodel the new bone and regain joint mobility. Work/school often needs to be put on hold.
– Risk of complications – Approximately 30% of patients experience complications like infections, delayed bone healing, joint stiffness, fracture, nerve damage, and chronic pain.
– Appearance changes – The procedures can leave visible scars and an unnatural elongated appearance to the legs and feet.
– No guarantee – A few people still fail to get their desired height, go through difficult recoveries, and regret the permanent changes from surgery.
Considering these factors, interested individuals must carefully weigh if the potential height gain is worth the physical and financial costs and reflects realistic expectations. Thorough psychological screening helps determine appropriate candidates. For most, learning to accept height through counseling proves safer.
Conclusion
While some limited growth potential may remain in closed growth plates, current science does not enable regenerating enough new cartilage to substantially increase height as an adult. Non-surgical methods advertised for height gain lack an evidence basis and largely prey on body insecurities without delivering results. Surgical leg lengthening procedures remain controversial and involve significant risks and burdens that may outweigh limited rewards. Learning to embrace one’s natural height through building confidence and self-esteem often proves more beneficial than pursuing unsafe or unrealistic height increase gimmicks. Focusing inward on positivity and outward on making a difference in the world can help overcome dissatisfaction with appearance. With mindfulness and dedication, people can achieve their human potential at any height.