The Achilles tendon is the thick band of tissue that joins the lower part of the calf (the muscles at the back of the lower leg) to the heel. These muscles play an essential role in pushing off the ground when walking and running but also in absorbing forces as you land. Sudden increases in the amount of exercise you are doing, especially where there are larger forces involved, for example, running further, running uphill, playing more tennis etc, can often result in the break down of the Achilles tendon. This results in Achilles Tendinopathy.
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