What is recommended by academic studies?

Academic studies have recommended to assess growth and maturity between 3 and 12 times per year depending on the maturity status and injury risk assessment. For athletes who are still before their growth spurt (below 85% of their Predicted Adult Height and growing at a steady pace of 5-6 cm/year), 3 measurements per year are considered sufficient. Once athletes are in their growth spurt (between 85 and 95% of PAH; Sanders et al, 2017), a closer monitoring is recommended, with measurements at least every 3 months. When increased injury risk has been identified due to rapid growth (>7.2 cm/y), recent injuries, or significant asymmetries, monthly assessments may be warranted (Ribeiro et al, 2026; Towlson et al, 2021).

Considering that for boys the average pubertal growth spurt starts around 11.5 years old and peaks around 13.5 years, the number of measurements should increase about 1 year earlier to also catch the start and peak of the growth spurt of early maturing athletes. The table below can be used as a guideline for number of measurements of standing height per age category. Note that these are recommendations for boys. As girls’ growth spurt starts about 2 years earlier, recommended number of measurements also shifts 2 years. However, keep in mind that the effect of the growth spurt on athletic performance, injury risk, and dropout is different for girls than for boys.

What are the disadvantages of measuring monthly?

Some clubs closely monitor the physical development and injury risk of their youth players, and therefore assess growth and maturity on a monthly basis. Yet, measuring monthly also has some important disadvantages. It increases the risk of ‘analysis paralysis’ or ‘data smog’. You want the right information at the right time, not a constant stream of data of which most it is redundant. But more importantly, measuring every month can introduce more uncertainty in the results. Here are three reasons why measuring monthly will often give you confusing results.

First, the typical Technical Error of Measurement (TEM) for standing height is about 0.38cm (Ulijaszek & Kerr, 1999). So if an athlete who is still before the growth spurt is growing at a steady 6cm per year, he/she would grow 0.5cm/month. However, if after one month your second measurement shows a growth of 0.5cm, that growth could also have been around 0.1 or 0.8cm, taking the TEM into account. This would result in a growth velocity between 1.2 and 9.6 cm per year, which is the difference between growing alarmingly slowly and very fast. With actual growth being close to the TEM, it is difficult to determine whether the reported growth was real or a result of a normal error in measurement.

Second, a correct assessment of growth velocity is further complicated by a considerable daily variation in standing height. The intervertebral discs make up to about 25% of the length of our spine. As these discs get compressed during the day due to gravity and impacts, our spine gets shorter. This results in a daily variation of stature of about 1.1%, which can amount to more than two centimetres in adults (Reilly et al, 1984). About half of this shrinkage occurs in the first hours immediately after rising, the rest is dependent on the posture and physical activity during the day (Tyrell et al, 1985). So measuring before or after training could make a difference of more than 1 cm, even in children. And even if you always measure on the same moment, the posture and level of activity in the hours prior to the measurement might still affect the athletes’ stature slightly.

Finally, evaluating changes in growth velocity is further complicated by the fact that human growth is not always a continuous process, but often occurs by discontinuous, aperiodic saltatory episodes (Lampl and Johnson, 1993; Caino et al, 2006). In other words, an athlete can grow 1cm in a single day, followed by a month of no growth. So a growth velocity of 12 cm/y in one month, followed by 0 cm/y in the next could be a correct reflection of the actual growth.

How to deal with this uncertainty in the growth velocity data?

Because of the measurement error, daily variation, and the episodic nature of growth, even if you follow all procedures correctly, measuring standing height monthly will likely result in data that puts the athlete repeatedly above and below the commonly used injury risk threshold of growing faster than 7.2cm/year (see black dotted lines in the figure 2; Kemper et al, 2015; Monasterio et al, 2024).

First and foremost: carry out the assessments of standing height carefully and precisely. You can find the full instructions here, but summarised: Always use the same reliable equipment, measure on a standard moment of the day before physical activity, and pay close attention to the correct posture. Failure to carry out a correct assessment of stature consistently will introduce considerable bias in your results.

Measuring every 3 months instead of every month reduces the data volatility as the share of the measuring errors compared to the actual growth will be lower, and the timing of the short growth episodes will be less impactful. This results in a smoothened growth curve (blue dotted lines in figure 2). Alternatively, for practitioners who prefer monthly measurements, the growth velocity can also be calculated over a 3 month period instead of since last measurement.

To avoid categorising an athlete repeatedly as in or out the injury risk group, it is also advised to always check the historical data using the graph. Although the visual assessment of growth curve is a valid method to determine Peak Height Velocity, it is a skill that requires some education (Monasterio et al, 2024). Especially when stature is measured monthly, practitioners should learn to read through the volatility.

Finally, it is worth noting that growth velocity should not be evaluated as an isolated metric. Alongside with growth velocity, studies have also identified percentage of predicted adult height (%PAH) and prior injuries as important risk factors for growth related injuries (Johnson et al, 2022; Monasterio et al, 2021; Arnold et al, 2017). These metrics should therefore always be evaluated together.

How Hylyght supports the monitoring of growth velocity and maturation

With the Growth Tracker, Hylyght offers a highly specialized tool to facilitate monitoring growth and maturation, and to bring science into practice. It helps clubs and organisations overcome the three main barriers to implement an effective growth and maturation monitoring system:

1. Measure data efficiently and reliably

Using either the Hylyght test app, or a connected Seca 286, data flows directly into the Hylyght platform. The connected Seca has the additional benefit of reducing inter-rater variability.

2. Assess the results according to scientific standards

Instead of using elaborate spreadsheets, use the Hylyght platform safely stores and manages all data. Access management allows you to easily grant or revoke access to the data when a trainer joins or leaves the club. The Growth Tracker dashboard allows you and other stakeholders to see and interact with the most important metrics such as growth velocity since last measurement, 3-month growth velocity, Percentage of Predicted Adult Height, and many more. To reduce ‘data smog’, we highlight wat really matters. We follow academic literature and update our platform according to the latest scientific insights and recommendations.

3. Guide your athletes by bringing the results into practice

Turn insights into practice by communicating clear reports, customised for injury prevention and bio-banding. Keep parents and players informed by granting them access to their information, or provide a simplified growth report. Add custom PDFs to the reports to provide additional information. And keep track of the availability of your players using the medical dashboard.

References

Arnold, A., Thigpen, C. A., Beattie, P. F., Kissenberth, M. J., & Shanley, E. (2017). Overuse physeal injuries in youth athletes: risk factors, prevention, and treatment strategies. Sports health, 9(2), 139-147.

Johnson, D. M., Cumming, S. P., Bradley, B., & Williams, S. (2022). The influence of exposure, growth and maturation on injury risk in male academy football players. Journal of sports sciences, 40(10), 1127-1136.

Kemper, G. L. J., Van Der Sluis, A., Brink, M. S., Visscher, C., Frencken, W. G. P., & Elferink-Gemser, M. T. (2015). Anthropometric injury risk factors in elite-standard youth soccer. International journal of sports medicine, 36(13), 1112-1117.

Monasterio, X., Gil, S. M., Bidaurrazaga-Letona, I., Lekue, J. A., Santisteban, J., Diaz-Beitia, G., ... & Larruskain, J. (2021). Injuries according to the percentage of adult height in an elite soccer academy. Journal of science and medicine in sport, 24(3), 218-223.

Monasterio, X., Cumming, S., Larruskain, J., Johnson, D. M., Gil, S. M., Bidaurrazaga-Letona, I., ... & Williams, S. (2024). The combined effects of growth and maturity status on injury risk in an elite football academy. Biology of sport, 41(1), 235-244.

Reilly, T., Tyrrell, A., & Troup, J. (1984). Circadian variation in human stature. Chronobiology international, 1(2), 121-126.

Ribeiro, N., Martinho, D. V., Monasterio, X., Gonzalo-Skok, O., Loureiro, N., Ferreira, R., ... & Tavares, F. (2026). From Theory to Practice: The Role of Growth, Maturation, and Workload in Injury Risk Mitigation for Young Male Soccer Players. Strength & Conditioning Journal, 48(3), 312-327.

Sanders, J. O., Qiu, X., Lu, X., Duren, D. L., Liu, R. W., Dang, D., ... & Cooperman, D. R. (2017). The uniform pattern of growth and skeletal maturation during the human adolescent growth spurt. Scientific reports, 7(1), 16705.

Towlson, C., Salter, J., Ade, J. D., Enright, K., Harper, L. D., Page, R. M., & Malone, J. J. (2021). Maturity-associated considerations for training load, injury risk, and physical performance in youth soccer: One size does not fit all. Journal of sport and health science, 10(4), 403-412.

Tyrrell, A., Reilly, T., & Troup, J. G. (1985). Circadian variation in stature and the effects of spinal loading. Spine (Philadelphia, PA. 1976), 10(2), 161-164.

About the Author

Dr. Pieter Vansteenkiste is a sports scientist and postdoctoral researcher at Ghent University, specializing in physical education, motor control, and performance data. With a PhD focused on visual information in movement steering, he has authored numerous peer-reviewed scientific papers on sports performance, motor development, analytical methods and talent identification.

Dr. Vansteenkiste’s work bridges academic research and practical sports science, supporting innovative projects like SportKompas and SPOKI. Discover his publications and research via Ghent University and connect on LinkedIn.

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