Leg pain is a common complaint in growing active kids. It can be difficult to recognise if it is just “growing pains” or if something else is going on and when it might be a good idea to get it checked out. Hopefully this article will help.
– Growing pains are described as pain in the legs that occur occasionally and worsen by the early evening or at night time and gone again by the next morning.
– Growing pains can be of musculoskeletal origin and usually in both legs at the same time. – Growing pains affect the muscles of the calves, thighs, shins or behind the knees. – Sometimes growing pains can relate to activity or a noticeable growth spurt but not always.
Researchers have considered if growing pains are related to reduced bone density in the legs but this has yet to be determined.
It is tricky to diagnose as several other causes of leg pain need to be excluded first. Pain that is so severe that it stops participation in sport or normal daily activities is not growing pains. A good reference point of when to have a chat to the GP would be if the pain is recurring frequently or not improving, odd/unusual symptoms, unable to bear weight or severe pain.
Osgood-Schlatter Disease is one of the most commonly occurring musculoskeletal knee conditions in kids. Around 10% of adolescents may develop OSD on one or both knees.
Kids will generally complain about pain at the front of the knee on the area known as the Tibial Tuberosity- the small bump at the top of the shin bone where the patellar tendon attaches to a growth plate that is not yet mature.
This usually occurs around 8-13 yrs for girls and 10-15yrs for boys. In the past boys would be more likely to be affected, however with increased sports participation of girls this difference in genders has narrowed.
OSD is most common in very active kids who play sports with lots of running, kicking, jumping or those who have had a rapid growth spurt. They will complain of pain in the front of the knee, the tibial tuberosity can be sensitive to touch and sometimes swelling can be present. Parents may notice that they are limping when walking as well. The knee pain is often worse after walking up and down stairs, sitting and kneeling for a long time as well as high impact activities like jumping, kicking and running.
So what is actually going on?
Well this condition is an overload injury. Imagine the tendon at the front of the knee tugging on the growth plate which has not yet closed. This irritation can become really painful with increased frequency of sports participation. OSD will eventually go away once the growth plate has closed in late adolescence.
What to do in the meantime?
Having a proper assessment by your physio is a good starting point to help get an assessment and diagnosis of the cause of leg pain. Your physio will be looking at locating the site of the pain, checking out muscle strength and flexibility as well as looking at the way movements such as walking, bending, squatting all contribute to the injury. Your physio will help work out an individualised treatment plan. Treatments may consist of modifying sports and school activity if needed, taping, stretching and strengthening exercises.
References
1. Friedland, O., Hashkes, P. J., Jaber, L., Cohen, H. A., Eliakim, A., Wolach, B., & Uziel, Y. (2005). Decreased bone speed of sound in children with growing pains measured by quantitative ultrasound. The Journal of rheumatology, 32(7), 1354-1357.
2. Ladenhauf, H. N., Seitlinger, G., & Green, D. W. (2020). Osgood–Schlatter disease: a 2020 update of a common knee condition in children. Current opinion in paediatrics, 32(1), 107-112.
3. Circi, E., Atalay, Y., & Beyzadeoglu, T. (2017). Treatment of Osgood–Schlatter disease: review of the literature. Musculoskeletal surgery, 101(3), 195-200.
4. Neuhaus, C., Appenzeller-Herzog, C., & Faude, O. (2021). A systematic review on conservative treatment options for OSGOOD-Schlatter disease. Physical Therapy in Sport.
