All too often, when someone between the ages of 10-16 complains of pain in one of their joints, their concerns are dismissed as ‘growing pains’, and it is assumed that the discomfort will subside independently of treatment.
Although it is true that during periods of rapid growth certain parts of your body are more susceptible to pain, it does not mean that when such pain occurs it should be treated with any less care than when it occurs in an older person.
In fact, labelling a young person’s injury as ‘growing pains’ is really doing them a disservice.
The term is too vague, especially considering that it can cover a myriad of different problems which each require their own diagnoses and treatments. To help parents manage what can sometimes be regarded as just ‘growing pains,’ here are the two most common types of injuries that can occur to developing bodies, as well as how to diagnose and treat them.
Osgood Schlatter Disease
Osgood Schlatter Disease is when the area at the top of the shin, where the knee tendons join the muscles of the lower leg, becomes inflamed. This injury is common in adolescent people as it affects the “growth plate” of the shinbone. This is called the “tibial tuberosity.”
While someone’s shins are still growing, the top of the bone (where it connects to the knee) is formed of cartilage. This cartilage gradually develops into bone during the final stages of growth.
As cartilage is a soft, pliable substance (in stark contrast to bone), excessive pulling placed upon it by the quadriceps during movements such as jumping and sprinting can put strain on this tissue. The strains can lead to chronic inflammation if these movements are regularly repeated, so children who play a lot of sports are more likely to develop the problem.
Symptoms of Osgood Schlatter Disease
Osgood Schlatter Disease usually manifests itself as pain and swelling just below the kneecap. In healthy individuals, you should be able to feel a hard area between your kneecap and the top of your shin. This is your “tibial tuberosity.”
In those with Osgood Schlatter Disease, this area will be visibly swollen and will likely be visibly protruding. Furthermore, the area will be hot and tender to the touch. In more severe cases, the amount of pain and swelling will reduce mobility in the knee, making it difficult for someone to straighten their leg entirely. Osgood Schlatter Disease usually flares up during sports, and slowly (but not always entirely) subsides when the sufferer is at rest.
People who play sports which involve repetitive squatting and jumping, such as football, basketball and long-jump are particularly likely to develop the problem.
Treatment of Osgood Schlatter Disease
Osgood Schlatter Disease is usually caused by a weakness or lack of flexibility in the quadriceps. It is this weakness that leads to excess pulling on the tendons that connect the knee to the tibial tuberosity.
Therefore the best way to treat the problem is through stretches and exercises that make the quadriceps more supple. The most common of these involves standing on one leg, and pulling the heel of the other leg into your bottom.
Tightness in your hamstring and calves can also lead to muscular imbalances in the thighs and knee that contribute to the development of Osgood Schlatter Disease. Therefore stretches that target these muscles may also be beneficial. A physiotherapist should prescribe a stretching plan if your child has this problem.
Decreasing activities which put strain on your knees, such as running and jumping should also be done in conjunction with stretching. This break does not need to last long, however, rather just a few weeks if you do daily stretching to strengthen the relevant muscles.
As the pain subsides you can gradually return to sports, just remember to stretch your quadriceps and hamstrings before and afterwards.
Severs Disease is pain and inflammation in the heel caused by excessive strain on the growth plate that connects the calf muscle to the back of the foot. Much like with Osgood Schlatters Disease, this inflammation is caused by tendons pulling on the cartilage that the growth plate is made out of. In the early stages of adulthood this cartilage turns into bone.
Signs and Symptoms of Severs Disease
Severs Disease causes pain in the heel. This pain can be so bad that it can make walking difficult for a sufferer. The pain can restrict movement and make it difficult for someone to put their foot flat on the ground.
This can be particularly problematic as repeatedly walking or running without flattening your foot on the ground can further tightens someone’s calf muscle. This can, in turn, worsen Severs Disease. Although swelling is not usually visible, the heel can be warm and puffy to the touch due to inflammation.
Severs Disease usually affects sprinters and long distance runners. It’s the repetitive running motion that puts strain on the calcaneus. It is particularly common in boys as they tend to have less flexible hamstrings and calf muscles than girls.
Treatment of Severs Disease
Severs Disease is caused by a lack of flexibility in the hamstring and calf muscles, as well as the Achilles tendon. These three areas need to be stretched in order to prevent future pain.
Walking and running posture will need to be examined and addressed as well. Tight calf muscles and hamstrings can lead to someone walking on their toes, which only further tightens these muscles. Walking posture needs to be consciously addressed and changed.
In addition to stretching, maintaining proper hydration during endurance sports such as long distance running can also reduce muscle fatigue. This muscle fatigue contributes to poor running posture that can lead to additional strain on the calcaneus and aggravate Severs Disease.
In short, stretching, addressing walking and running posture, and staying hydrated during exercise will help reduce the symptoms of Severs Disease in the long term.
Treating more acute flare ups, such as immediately after exercise, can be done through applying ice to the affected area and taking anti-inflammatory painkillers such as ibuprofen.
The best approach to treating growing pains
In many ways, Osgood Schlatters Disease and Severs Disease are similar. They are both caused by strain to “growth plates,” areas of cartilage that will eventually develop into bone.
While this development into bone will make those areas stronger and more resilient to pain, the fact that they are coming under duress during adolescence is indicative of certain muscle weaknesses. These muscle weaknesses are likely to manifest themselves again as injuries later on in someone’s life, particularly if they play a lot of competitive sports.
As a young body is more “plastic” than an older one, it is best to treat these problems when they first crop up. Therefore taking growing pains seriously, rather than waiting for them to disappear, can benefit someone years into the future.