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Growing up can be a pain...

What are growing pains and when is it something more?

Adolescence is a time of great growth – physically, mentally, and socially – and can come along with pain and discomfort. So how do you know when it’s “just growing pains” and when it’s something more?

What exactly are growing pains?

The consensus is that growing pains are aches felt in the thighs, calves, or back of the knees, but not in the joints, and are usually felt on both sides. They usually occur in children from ages 3 -12 years old. These pains are usually felt late in the day or at night, they come and go, and are not worse during activity. A child who has growing pains will have a normal physical examination and no swelling.

What causes this pain?

The short answer is, we don’t know! They don’t actually seem to be associated with periods of rapid growth. They are thought to be from high levels of activity and overuse of the muscles while playing, running, and jumping.

How can you treat growing pains?

Try gentle massage to the area, heat, stretching, or over the counter pain relievers like ibuprofen or acetaminophen. With growing pains, there’s no need to hold your child back from sports or activities. If these don’t improve the pain, then it’s time to call your child’s doctor to rule out other causes of pain.

When is it “something more”?

During periods of rapid growth, the bones lengthen and the muscles don’t have time to catch up. This, especially when combined with repetitive sports like running, jumping, or throwing, can lead to inflammation of the cartilage where the muscles attach to bones over a growth plate, otherwise known as an apophysis. This injury is called apophysitis and is unique to adolescence. Some common areas where this can occur include:

  • The back of the heel (Sever’s Disease)

  • The bony area at the top of the shin bone (Osgood-Schlatter)

  • The bottom of the kneecap (Sinding-Larson-Johansson syndrome)

  • The front of the hip (ASIS Apophysitis)

  • The top of the hip near the waist (iliac crest apophysitis)

  • The bony prominence of the pinky side of the elbow (Little League Elbow)

  • The upper arm near the shoulder (Little League Shoulder)

  • And other locations.

How are the symptoms different?

Children with apophysitis usually have swelling and tenderness over the affected growth plate. Their pain is usually worse during or after their sport, and is more common in sports with repetitive running, jumping or throwing. These symptoms, unlike growing pains are usually experienced after a growth spurt.

How is the treatment different?

If apophysitis is suspected, your child should be evaluated by a physician to rule out an avulsion fracture, which happens when the tendon pulls a small piece of bone away from the main, underlying bone. They may need X-rays to confirm the diagnosis and rule out other injuries. They can also write you a prescription for Physical Therapy!

Physical therapists can assess your child’s mobility, strength, and running gait to optimize movement patterns and reduce the strain placed on the areas of injury, as well as prevent future injury. Strengthening and stretching the muscles involved in the injury can help your child get back to their activities, safely.

Does your teen have aches and pains that are holding them back from the sports they love? Schedule a physical therapy assessment to keep them healthy and strong!

Thanks for reading!


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