As sports participation increases so too does the incidence of injuries, both acute and overuse. The growing skeleton is particularly susceptible due to the presence of growth cartilage at 3 locations; the epiphyseal plate, the joint surface and the apophysis. The risk of injury is most pronounced during the rapid growth spurt of adolescence when other factors, such as muscle tightness across joints, also become important in the aetiology of sporting injury. Overuse injuries seen in this age group may reflect the growth characteristics of the immature skeleton or may be of the type seen in adult athletes undergoing rigorous training schedules. Recent developments in organised competitive sport have seen growing individuals undertake prolonged and intensive training programmes when they are particularly at risk of sustaining an overuse injury. The training programme is one of a number of risk factors important in the generation of injury, many of which can be modified or controlled to an extent. Other factors such as growth deformities or malalignments are peculiar to the individual and preparticipation evaluation of the young athlete helps to identify those at risk. Whilst long term disability rarely eventuates, the loss of enjoyment and temporary incapacity resulting from this type of injury is significant. It is apparent that many of these injuries are preventable, and given the information available concerning the factors involved in their aetiology, it is the responsibility of coaches and health professionals alike to become involved in their early diagnosis, treatment and prevention.