As they grow, many children will experience an aching in their legs otherwise known as "growing pains". Little is known about why this occurs. It is often at night and on days following excessive activity such as jumping and running. The typical areas to be affected by the front and back of the thighs, the back of the calves and the back of the knees. On these occasions heat and massage coupled with stretching can be very effective.
What we must be careful not to miss is apophysitis. Immature athletes differ from mature athletes because of their open growth plates in their bones. These don’t fuse until into their teen years. The apophysis is a point of bone where the tendon attaches from the muscle to the bone. Repeated traction caused by the contraction of the muscle as the child exercises can pull on this bone attachment site. Rather than the tendon or the muscle being affected, the bone is affected. Tenderness is felt over the bony point but can also spread in a wider area around this point, making differential diagnosis from general growing pains difficult. Stretching and heat on this occasion can be the worst thing to do. This is when an assessment with a physio is beneficial. They will help to diagnose the cause of the problem and on some occasions imaging may be warranted.
It is very common to have apophysitis where the calf muscle attaches to the heel. This is called “Sever’s”. The problem can also be seen around the knee in Osgood-Schlatter’s- this is where the quadriceps tendon attaches to the tibia, or shin bone
Up around the pelvis similar things can occur where the hamstring and the quadricep muscles attach. However both of these areas can also be subject to and an “avulsion injury”. This is where a fast movement such as with kicking or sprinting has resulted in immediate pain. The speed of the contraction of the muscle has actually pulled the bone away from the pelvis together with the tendon and the muscle. That is to say that the bone is actually broken. On such occasions the physio will also advise that you undergo imaging such as an MRI (MRI is often preferable as it will detect this type of injury but does not involve high doses of radiation), and maybe see another medical expert such as a sports physician or orthopedic surgeon.
How to treat these types of injuries:
- In all cases extreme care with stretching must be undertaken as this can cause the muscle to further pull on the bone simply further aggravating things. Where there is no avulsion injury, alterations in the amount of load, that is the amount of exercise, that the child is partaking in must be addressed.
- A short period of relative rest to allow healing may be required, and a careful return to exercise can then be undertaken.
- Massage to release the tight muscles (as they have been stretched over the growing musculoskeletal frame) can be beneficial. There are many ways that you can do this yourself at home.
- Taping can be very valuable in helping to support the tendon attachment and reduce stress at this point.
- Often there is a biomechanical reason why the child might have put more stress through certain muscle groups. An assessment by the physio of how your child moves will help to assess what other muscle groups need to be strengthened and used, and what possible technique changes may help.
- An individualised program can then be designed. Young children and adolescents have very specific injuries the adults do not get.
At Physiologix our physios have advanced training to allow them to treat this population group and the injuries they specifically get. Should you have any queries please do not hesitate to contact us.