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Can the shoulder bones grow after the growth plates have fused?

Can the shoulder bones grow after the growth plates have fused?


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Body builders have broad shoulders. If one start lifting weights after one's growth plates have fused, can one still increase the width of one's shoulders? If yes, does that mean shoulder bones can grown longer?

Which bones, (if any) can grow longer after growth plates have fused without causing an abnormal condition like acromegaly?


Regardless of growth plates, exercise does not cause bones to get longer or wider than they would have without exercise.

Each bone is like a sponge, it grows to a predetermined size as regulated by your DNA. Exercise makes the bone more dense and stronger. The more you exercise, the more stress your bones are under. The bones respond by getting denser and stronger.

Like most organs/tissues, skeletal bone is constantly remodeling. Bone remodeling is a lifelong process where mature bone is removed (a process called resorption) and new bone is formed (called ossification). Cells called osteoclasts are responsible for the breakdown (resorption) while cells called osteoblasts handle new bone ossification. When we are young, we make new bone faster than we remove old bone and we increase our bone mass. Through our 20s this starts to shift, and we begin to lose bone mass faster than it is created. Source


The Quest for Height: Grow Taller | Increase Height | Bone Size

Here's a list of supplements by risk versus reward stated as benefit. The most beneficial supplements have the most validated effects, tend to always be beneficial without needing an equilibrium value, and the most pro-chondrogenic:

Most Beneficial: Milk(Cycle), Choindroitin, Hyaluronic Acid
Medium: LSJL, PEMF, LIPUS, Lovastatin, Creatine
Least Beneficial: Other(See LSJL supplement page)

First, the growth plate closing does not inhibit height increase from occuring. Their are still mesenchymal stem cells in the epiphyseal bone marrow. It's just that there are no chondrocytes proliferating and differentiating. If new stem cells proceeded to differentiate into chondrocytes then growth plate activity would be restored. This is what Lateral Synovial Joint Loading does, it encourages stem cells to differentiate into chondrocytes by altering intracellular calcium secretions via interstitial fluid flow and hydrostatic pressure.

The best supplements to increase height are hyaluronic acid and choindroitin. Their are countless studies that show the pro-chondrogenic effects of hyaluronic acid and choindroitin and their ability to induce chondrogenic differentiation. Their are even studies that show that Hyaluronic Acid supplementation does increase serum levels of HA.

LIPUS is also a potential way to grow taller for open plates as well as epiphysis with no active proliferating and differentiating chondrocytes. Their are countless studies that show the prochondrogenic effects of LIPUS. Unfortunately, the optimal setting has not been determined. An experimental routine is provided here.

Yet another way to increase height is anabolic(anabolic = increase cellular proliferation and differentiation) factors like IGF-1 and Insulin. Milk increases IGF-1 but needs to be cycled after age 5 . It would be better for somehow the milk to be lactose free as lactose enhances FGF21 signaling. I'm not sure how it should be cycled. Insulin is controversial as there is evidence that insulin resistance increases height. IGF-1 is pro-chondrogenic

Whether you still have active proliferating chondrocytes or not, what you want to do to achieve growth is pretty much the same. First, the most important thing to do is to inhibit myostatin. Myostatin is a regulator of stem cell proliferation and differentiation. Now that doesn't mean that you can't achieve extra stem cell proliferation and differentiation in the presence of myostatin. Compare it to muscle growth, it's easier if myostatin is inhibited but it's still possible if it's not. Creatine is a myostatin inhibitor that has other pro-chondrogenic effects as well.

Lovastatin which is in Red Yeast Rice may help increase height as well but it hasn't been well documented.

You would also want to find a way to enhance the amount of C-type nautriuretic peptides that you express. There's a product coming out that releases guanyl Cyclase B which enhances your expression of C-type nautriuretic peptides. CNP increases height by increasing chondrocyte hypertrophy and inhibits FGFR3 and keeps Sox9 in check when it wants to inhibit the cell cycle by inhibiting CyclinD

But even if you are doing LSJL to try to re-activate your growth plates you still ideally want both of these substances. You want your stem cells to proliferate and differentiate. You want your chondrocytes to proliferate or differentiate when the stem cells differentiate into them. The difference between growth plates open or not is that if your growth plates are "closed" you need to first initiate reform growth plates via mesenchymal condensation and chondrogenesis.

Another way to grow is to inhibit estrogen. There's an equilibrium quantity of estrogen however so you have to be careful not to go below this quantity. However, being at too high level of estrogen is more damaging to height than too low way.

The problem with this is negative feedback. Scientists have tried injecting extraneous HGH into children and only found an increase in growth rate but not final adult height. The reason that extraneous HGH doesn't work is negative feedback. Most of the causes of Gigantism involve an alteration in the bodies homeostatic mechanisms(like the pituitary gland). They have even found causes of Gigantism with low HGH levels due to an increase in tissue sensitivity to HGH. There is evidence that the genes related to HGH is involved in height growth but there's also a lot of evidence that HGH isn't the be-all/end-all to height growth.

Here are other supplements that may help.

So, pretty much everything you want to do to grow taller is pretty much the same whether you have existing chondrocytes proliferating and differentiating in the growth plate or not. The difference is getting new MSCs to differentiate into chondrocytes and form ectopic growth plates within bone in fused bone.


Chondrocyte injection in distraction epiphysiolysis (rabbit model).

"The purpose of this study was to determine if cultured chondrocytes could prevent premature closure of the physis after physeal distraction in a rabbit model. Epiphyseal distraction at the proximal tibial epiphysis was performed in 24 immature rabbits. Chondrocytes were harvested from the iliac apophysis. The animals were divided into three groups: A, epiphyseal distraction alone B, injection of phosphate buffered saline (PBS) after epiphyseal distraction and C, injection of cultured chondrocytes after epiphyseal distraction. After epiphyseal separation was noted radiographically, each animal was evaluated at routine intervals. At 2 to 4 weeks, significant tibial lengthening as compared to the contralateral tibia was noted in all three groups. At 10 weeks, lengthening was apparent only in group C in groups A and B, the operated tibia was shorter than the unoperated one. Histologic examination at 4 weeks revealed partial bony bridge formation with cell clustering in the fibrocartilaginous matrix in groups A and B. In group C, the matrix showed a typical hyaline aspect with cells organized in columns at the injection site. The zone of hypertrophic chondrocytes was enlarged. It appears that the injected cells differentiated into hypertrophic chondrocytes and delayed premature physeal closure. At 10 weeks after distraction of the physis, the width of the physis was restored to 75% of normal, but disordered chondrocyte growth with cell clustering was present in the cell-injected group."

"Physeal distraction is a relatively simple method of limb lengthening in which the epiphysis is pulled away from the metaphysis at a slow, controlled rate. The physis separates without osteotomy and distraction can be applied through an external fixator."

"the lengthening obtained often is lost by growth retardation caused by premature physeal closure after removal of the fixator."

"Skeletally immature, 6-week-old New Zealand white rabbits were ideal for study because these animals approach physeal closure (maturity) at 4 to 6 months."

"In group C, physeal defects were primarily filled with abundant hypertrophic cartilage. A few islands of calcified cartilage were seen in the separated defect in the lower portion of the separated physis at 4 weeks
The matrix showed a typical hyaline aspect with cells organizein columns at the injection site. Most of the cells were viable and exhibited a delimited nucleus. The cellularity of the repair tissue was greater than that of the adjacent normal cartilage. The injected cells seemed to attach to the bottom of the separated physis and incorporate as hypertrophic chondrocytes, thus delaying premature closure of the physis.At 10 weeks after initiation of distraction, the defect was filled primarily with mixed fibro-hyaline cartilage and the thickness of the physis was restored to 75% of normal, but chondrocyte growth remained disordered with cell clustering"

"Injected chondrocytes (group C) prevented bony bridge formation in all specimens, even in those
few where cell survival appeared to be minimal. Increased thickness of physeal cartilage produced by distraction was not due to increased cell proliferation in the physis. On the contrary, cell division appeared to be reduced with zonal separation. In 7 of 8 animals with injected chondrocytes, the cells continued to maintain a proteoglycan-rich cartilage matrix for the duration of the experimental period and in some cases showed ordered maturation. Evaluation at longer postoperative intervals showed an increase in vascularity at the distraction site, as fibrous stroma extending into the defects was replaced
with calcified tissue."

"the injected cells attached to the bottom of the separated physis and behaved as hypertrophic chondrocytes to delay premature physeal closure. The enlargement of the hypertrophic chondrocyte region was similar to that seen after slow distraction"

"this proliferation of hypertrophic chondrocytes is derived partly from the injected cells and partly from the tension effect on the physis."


Can the shoulder bones grow after the growth plates have fused? - Biology

HGH Therapy is the replacement of human growth hormone into the body when the production of this hormone begins to slow or stop altogether. It seems to be a reoccurring theme where adult patient ask if human growth hormone therapy can help them grow taller. This theme comes up again and again because the FDA, as well as many physicians, have used Pediatric HGH therapy to help children grow taller that have growth deficiency. With that in mind, many adults ask, if it works for children why won’t it work for me? The answer resides in our bones.

When we are in our adolescent years our bones grow by the signal of HGH and a secondary hormone product known as IGF-1. When HGH reaches a region at the ends of the long bones called growth plates or epiphyseal plates it stimulates new layers of bone to be added. When Layer after layer is put down our bones are lengthened which increases overall height. This is the exact mechanism that allows children to grow. With that stated if we add additional HGH to a child that is under developing it will help them grow to a normal height. But why can we not do this for adults wanting to gain height?

Adults that want to gain height cannot use Adult HGH Therapy in Hollywood to help stimulate their bones to lengthen. This is due to the fact that after puberty our growth plates begin to fuse with the bones they are associated with. When this fusion takes place there is no place for human growth hormone to stimulate new bone to be added. At this point in time, when the growth plates are closed, HGH therapy will not increase height. This typically is seen around the age of 18 when growth plate fusion is occurring or has finished.

For a young adult, roughly at the age of 18-24, there is still a slight chance their growth plates will be open. Premature birth or slow aging can lead to slowly developing bones. This slower than normal development will leave the growth plates unable to fuse for a longer period of time and allowing height to be achieved. A simple test can be done to see if the growth plates are still open called a bone age test. This is a simple x-ray of the wrists that will visually show the growth plates fused or unfused. But for the majority of cases after our adolescent years, an adult patient will not be able to use Pediatric HGH Therapy for height achievement. However, there are many benefits HGH therapy has for the adult population and those benefits should be explored.

For more information, regarding Hormone Therapy in Los Angeles check out this video below with Dr. Alex Martin.


How is Remaining Growth Estimated?

Your pediatrician likely has been monitoring your child’s height and weight on growth charts. You can estimate remaining growth based on these charts.

Orthopaedic surgeons also use different x-ray markers to better estimate the amount of growth a child has remaining, explains Robert Lark, MD, a pediatric spine specialist. A good rule of thumb is that once a child has reached the end stages of puberty, the growth plates are essentially closed.


What is Gigantism?

Definition of Gigantism:

Gigantism is the disorder in which excess amounts of growth hormone are secreted from the pituitary gland during a person’s childhood. It occurs before the epiphyseal (growth) plates of the bones have come together and fused.

Symptoms of Gigantism:

There is an unusual growth of muscles, organs, and bones so that a child is bigger, including taller than usual, for their developmental age. There can be symptoms such as blurred vision, delayed start of pubescent changes, double vision, very prominent forehead and jaw, increased sweat production, and large hands and feet. Patients may also feel very tired and their facial features may thicken.

Diagnosis and Causes of Gigantism:

The condition may be diagnosed in a child from a blood test where levels of growth hormone and insulin-like growth factor (IGF-1) are noted to be elevated. An MRI scan or CT scan can show if there is a pituitary adenoma (tumor) present. It is often caused by this benign non-cancerous tumor of the pituitary gland causing oversecretion of the growth hormone. Certain syndromes can also cause the condition, including McCune-Albright syndrome, and Carney complex. Neurofibromatosis and certain endocrine neoplasias can also cause the disorder.

Complications in Gigantism:

Treatment of the condition can lead to metabolic problems including with glucose and lipid metabolism. If not treated the heart can enlarge leading to cardiovascular problems later in life.

Treatment of Gigantism:

Gigantism is often treated by using medicine that helps reduce the overproduction of the growth hormone or blocks the receptors to which the hormone binds. The drug pegvisomant is sometimes used, as well as radiation therapy.


When Do Growth Plates Close?

As of now, it is extremely difficult to predict as to when do the growth plates in an individual close. This is because the different bones in the body take different times to stop growing and become mature.

Normally, the growth plate closes once the child has attained puberty. Thus for females, the normal age at which time the growth plate should close is between 12-14 years and for males the growth plates should close by the time the child is aged between 14-16 years.

Usually, a child continues to grow up to two years after attaining puberty. The age at which the growth plate closes depends on various factors like race, gender, and overall body habitus of the child. Some orthopedists make use of x-rays to estimate the amount of growth that a child is making and estimate a time as to when the growth plates may close for a particular child. However, the thumb rule is that the time when a child attains puberty, which is 12-14 years in girls and 14 to16 years in boys, is when the growth plates close.


How is osteochondroma diagnosed?

Your healthcare provider will review your medical history and do a physical exam. Other tests include:

  • X-ray. This test uses invisible electromagnetic energy beams to make images of tissues, bones, and organs.
  • CT scan. This test uses X-rays and computer technology to make images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • MRI. This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures in the body.

Stage 2: Maintaining A Straight Spine

Now that you’ve fixed the alignment of your spine, it is just as critical to keep your spine in the newly aligned position.

It is easy for your posture to go out of alignment, due to the nature of the tasks that we have to do in today’s day and age.

Thus, for you to master this stage of the process, you must focus on 2 sides of the coin:

A) Installing habits that allow you to maintain a straight posture easily, and

B) Avoiding habits that put your spine back out of proper alignment.

Let’s look at each aspect more in depth:


Understand concept of Height

Before using any ayurvedic home remedies to grow taller, first, we need to understand the concept of height. The human growth hormone is one of the solutions to the problem of how to increase height. The human growth hormone is produced in the anterior portion of the pituitary gland deep inside the brain. Production peaks at adolescence when accelerated growth occurs. But growth hormone levels fall steadily on reaching adulthood, and the body stops to increase height.


Manual of Human Embryology by Franz Keibel and Franklin P. Mall (1910)

Upper Limb

Table Of Ossification Of The Bones Of The Superior Extremity
Bone Centres Time of appearance of centre Union of primary and secondary centres remarks.
Clavicle Diaphysis 6th week There are two centres in the shaft, a medial and a lateral. These blend on the 45th day (Mall). Shaft and epiphysis unite between the 20th and 25th years.
Sternal epiphysis 18th to 20th year
Scapula Primary centres: The chief centre appears near the lateral angle. The subcoracoid centre appears at the base of the coracoid process and also gives rise to a part of the superior margin of the glenoid fossa. The coracoid process joins the body about the age of puberty. The acromial epiphysis centres (two or three in number) fuse with one another soon after their appearance and with the spine between the 22nd and 25th years (Quain) 20th year (Wilms). The subcoracoid and the epiphysis of the coracoid process, the glenoid fossa, the inferior angle, and the vertebral margin join between the 18th and 24th years in the order mentioned (Sappey).
1. That of the body, the spine, and the base of the glenoid cavity. 8th week (Mall) 1
2. Goraooid process 1st year
3. Subcoracoid 10th to 12th year
Epiphyses:
Acromial epiphyses 15th to 18th year
Epiphysis of the inferior angle. 16 to 18th year
Epiphyses of the vertebral border. 18th to 20th year
Epiphyses of upper surface of coracoid. 16th to 18th year.
Epiphysis of surface of glenoid fossa. 16th to 18th year.
Humerus Diaphysis 6th to 7th week (Mall) The epiphyses of the head, the tuberculum majus and the tuberculum minus (the last is inconstant) unite with one another in 4th-6th year and with the shaft in 20th-25th year. The epiphyses of the capitulum, lateral epicondyle, and trochlea unite with one another and then in the 16th-17th year join the shaft. The epiphysis of the medial epicondyle joins the shaft in the 18th year.
Epiphyses:
Head 1st to 2d year
Tuberculum majus 2d to 3d year
Tuberculum minus 3d to 5th year
Capitulum 2d to 3d year
Epioondylus med 5th to 8th year
Lateral margin of trochlea 11th to 12th year
Epicondylus lat 12th to 14th year
Radius Diaphysis 7th week (Mall) The superior epiphysis and shaft unite between the 17th and 20th years. The inferior epiphysis and shaft about the 21st year (Pryor) M 21st year, F 21st-25th year (Sappey). Sometimes an epiphysis is found m the tuberosity (R. and K.) and in the styloid process (Sappey).
Epiphyses:
Carpal end F 8th month - M 15th month (Pryor)
Humeral end 6th-7th year
Ulna Diaphysis 7th week The centre for the shaft of the ulna arises a few days later than that for the radius. The proximal epiphysis is united to the shaft about the 17th year the inferior epiphysis between the 18th and 20th years F 20th - 21st years, M 21st - 24th years (Sappey). There is sometimes an epiphysis in the styloid process (Sohwegel) and in the tip of the olecranon process (Sappey).
Epiphyses:
Carpal end F 6th-7th year - M 7th-8th year (Pryor)
Humeral end 10th year
Carpus Os capitatum F 3d-6th month M 4th-10th month The navicular sometimes has two centres of ossification (Serres. Rambaud and Renault). Serres and Pryor have described two centres of ossification in the lunatum. Debierre has described two centres in the pisiform, one in a girl of eleven, the other in a boy of twelve. The OS hamatum may have a special centre for the hamular process. Pryor has found two centres in the triquetrum. Pryor (1908), describes the centres of ossification of the carpal bones as assuming shapes characteristic of each bone at an early period.
Os hamatum F 5th-10th month M 6th-12th month
Os triquetrum F 2d-3d year M about 3 years
Os lunatum F 3rd-4th year M about 4 years
Os naviculare F at 4 years, or early in 5th year M about 5 years
Os mult. maj. F 4th-5th year M 5th-6th year
Osmult. min. F 4th-5th year M 6th-6th year
Os pisiforme F 9th-10th year M 12th-3th year
Metacarpals Diaphyses 9th week (Mall) The centres for the shafts of the second and third metacarpals are the first to appear. There may be a distal epiphysis for the first metacarpal and a proximal epiphysis for the second. Pryor (1906). found the distal epiphysis of the first metacarpal in about 6 per cent, of cases. It is a family characteristic. It arises before the 4th year and unites later. Pryor found the proximal epiphysis of the second metacarpal in six out of two hundred families. It unites with the shaft between the 4th and 6th-7th year sometimes, however, not until the 14th year. In the seal and some other animals all the metacarpals have proximal and distal epiphyses (Quain). The epiphyses join the shafts between the 15th and 20th years. There may bean independent epiphysis for the styloid process of the 5th metacarpal. The epiphysis of the metacarpal of the index finger appears first. This is followed by those of the 3d, 4th, 5th, and 1st digits.
Proximal epiphysis of the first metacarpal 3d year
Distal epiphyses of the metacarpals 2d year
Phalanges Diaphyses 9th week (Mall)
First row Proximal epiphyses 1st-3rd year (Pryor) The shafts of the phalanges of the second and third fingers are the first to show centres of ossification. The phalanges of the little finger are the last, the epiphysis in the middle finger is the first to appear. This is followed by those of the 4th, 2d, 5th, and 1st digits.
Middle row Diaphyses 11th-12th week (Mall) The centres in the shafts of this row are the last to appear. The epiphysis of the phalanx of the middle finger is the first to appear. This is followed by those of the ring, index, and little finger (Pryor).
Proximal epiphyses 2nd-3rd year
Terminal row Diaphyses 7th-8th week The terminal phalanx of the thumb is the first to show a centre of ossification in the shaft. This is the first centre of ossification in the hand. It is developed in connective tissue while the centres of the other phalanges are developed in cartilage (Mall). The epiphysis of the ungual phalanx of the thumb is followed by those of the middle, ring, index, and little fingers. The fusion of the epiphyses of the phalanges with the diaphyses takes place in the 18th-20th year.
Proximal epiphyses 2nd-3rd year
Sesamoid bones Ossification begins generally in the 13th - 14th years, and may not take place until after middle life (Thilenius). For table of relative frequency in the embryo and adult see p. 385.
Days and weeks refer to the prenatal, years to the postnatal period. M = male F = female.

According to Poirier, Traite d'Anatomie, p. 138, two centres appear in the eighth week, and unite in the third month to form a centre of ossification for the body of the scapula.