Children can often suffer from growing pains – experienced when the long bones of the body (arms, legs, etc) physically outgrow the muscles covering those bones. The tightness in the muscles pulls where they attach to the bones, and pain is experienced. Active children (particularly in high impact sports on harder surfaces) can suffer a more serious form of this phenomenon where the growth plates – cartilage areas where bone growth comes from – get pulled and strained on by the tightness in the muscles and tendons. When this happens at the heel it’s called ‘Sever’s Disease’, and when it happens at the knee it’s called ‘Osgood-Schlatter Disease’.
Sever’s disease most commonly affects children from age 8-14 and is one of the most common causes of heel pain in active young people. The equivalent in adults is Achilles problems. Sever’s effects the point where the Achilles tendon inserts into the heel. In children, the bone is softer than the tendon, so it is the point where the tendon inserts into the bone that injured rather than the tendon itself. This area can then become quite angry and children will complain of pain after exercise and sometimes during too, which is eased by rest. If there has been pulling and pain for a little while a bony lump can appear.
Osgood -Schlatter is the same type of injury as Sever’s but it effects slightly older children, age 10-15 and it effects the Patella tendon of the knee. The Patella tendon is the tendon that joins the quadriceps muscles to the leg bone. Children will have the same complaints are Sever’s but the pain is localised to just under the knee cap.
Both conditions are caused when the leg is loaded beyond it’s capacity. At this time of year when children are returning to busy active schedules, which involve different acitivities from the summer, we need to have an awareness that overload can cause problems in our children too.
While these conditions sound scary, and can cause a great deal of pain, they can both be very treatable with simple adjustments.
Prevention is better than cure……If children are going through a growth spurt they are more susceptible, so perhaps introduce some stretching for calves, hamstrings and quads into your childrens routine before bed. Ensure return to activities is as gradual as possible e.g. don’t introduce a long walk /cycle at the weekend in the first few weeks. If the horse has bolted, then don’t worry as the primary treatment is a “mobility” routine and we need to consider modifying activities and exercise routines until it has settled.
You may think this is sounding familiar for most things to do with injury that we talk through…….MANAGE THE LOAD. Our body, which fab at adapting, can only do so within the capacity of the structures being loaded and if we suddenly increase load we can overload tissue and cause injury. In growing youngsters, because the muscles are shorter, they are more at risk and have a more limited capacity, but the tissue outwith growth spurts still has a capacity and we need to work with our bodies rather than against them.
For more information or individualized assessment and treatment- book in to see anyone of our specialist physiotherapists!