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Children’s Feet & Growing Pains

A side view of a foot with a hand holding the ankle. The ankle is highlighted red signifying pain

Growing pains aren’t just painful and frustrating for children, they can also see them miss out on their favourite sports and activities with their friends. Our podiatrists treat growing pains by getting down to the root of why they occur - helping get kids back to doing the things they love as quickly as possible.

Growing pains affect children between the ages of 3 and 12 years, often (but not always) during a growth spurt. There’s a common misconception that growing pains are one of those natural problems that are a part of adolescence that kids must see through and wait until they pass themselves, with no available treatment at home or professionally. The truth is that there is always a cause for musculoskeletal pain, and when we identify the cause, knowing which steps to take to help resolve the problem is often straightforward. This is exactly the case for growing pains.

What Are Growing Pains?

To understand what growing pains are, it’s important to understand how our bones grow. Before our bones mature, they contain specific cartilaginous areas called ‘growth plates’ which our body uses as a construction site to add new bone cells to, and hence grow our bones. Being a work in progress, these growth plates aren’t as strong as the rest of the bone, making them more vulnerable when tension is applied to the bone. 

While our bones grow, our muscles do too, lengthening and strengthening, and going through periods of tightness as they lengthen and keep up with the body’s growth. As muscles attach to the bones, they pull and place tension on the bone when kids are moving and active - and it’s the growth plates that become irritated and painful as a result. This is how growing pains start, and continue until the tension on the bone from growing muscles and tendons is reduced and normalised.

Signs Your Child Is Experiencing Growing Pains

Episodes of growing pains are generally frequent, with 43% of children with growing pains being shown to have an attack at least once per week, and some experiencing daily pain for over six months. If your child is experiencing growing pains, they may:

  • Report pain during or after sports that settles with rest
  • Find that bending and moving their feet and legs a certain way can exacerbate or settle symptoms
  • Awaken during the night in pain
  • Limp after sports
  • Experience throbbing, redness or swelling at the affected growth plate

Growing Pains In The Heels (Sever’s Disease)

Growing pains at the back of the heels occur when a tight Achilles tendon that attaches to the heel bone pulls and irritates the growth plate that is present at the back of the heel. The Achilles is the strongest tendon in the body and exerts tremendous force during running, so this is the most common area we see for growing pains. This is medically known as Sever’s Disease - but don’t worry, this is not a disease but a condition that we can help with.

Learn More About Sever's Disease Learn More About Sever's Disease

Growing Pains In The Knees (Osgood Schlatter Disease)

When growing pains develop in the knees, it means that the tendon that comes down from the thighs and crosses the knee to attach at the top of the shin bone (tibia) has irritated the growth plate in the area, leading to growing pains at the knee. As this tendon is stretched when the knee is bent, any bending movements like squatting or running can bring on pain. This is medically known as Osgood Schlatter disease.

Learn More About Osgood Schlatter Disease Learn More About Osgood Schlatter Disease

Growing Pains In The Midfoot (Iselin’s Disease)

Growing pains in the midfoot is known as Iselin’s Disease, and affects the middle of the foot, along the outside. This pain is caused by irritation to the growth plate at the base of the fifth metatarsal (outer long bone of the foot), right where you’ll feel a natural bony protrusion with your fingers. This time, the tendon responsible for the pulling and irritation is called the peroneus brevis.

Kohler Disease

Kohler disease is another condition that causes pain, redness and swelling at the navicular bone in the foot. It often occurs in children aged between five and ten years and is linked to a disruption in the blood supply to the foot which can then cause the bone to die, break or collapse before healing and hardening. While this condition is rare, if your child experiences pain in this area, it’s important to bring them in to see a podiatrist as soon as possible.

Freiberg’s Infarction

Freiberg’s infarction describes the premature death of bone, most often at the head of the second metatarsal bone of the foot, due to an interrupted blood supply to the area. Freiberg’s most often affects children or teenagers in their second decade of life, and symptoms can look like pain or stiffness at the ball of the foot, swelling and pain when putting weight on the foot.

At What Age Do Children Usually Experience Growing Pains?

Growing pains typically affect children between 3-12 years, but as growth can vary in children, some kids have growing pains later into their adolescence.

Diagnosis

Our podiatrists diagnose growing pains by speaking with your child and learning about their pain and symptoms, like when their pain starts, what worsens it, and their daily activities. We then perform a physical examination, part of which involves ruling out other causes of pain like a muscle or a tendon injury, to ensure the right treatment is delivered. This is usually sufficient to help us make a confident diagnosis.

Treatment For Growing Pains

While growing pains can resolve on their own over time, this can take time, and we are confident that we can keep kids playing sport and we do not promote ceasing activity from social sports and activities which kids are not usually keen to do. To help, you can start making some simple changes at home, or get a custom treatment plan from our podiatrists to help get your child back on the field and feeling great.

At home

To help treat growing pains at home, you can: 

  • Use ice packs on the area before and after physical activity for approximately 10-15 minute intervals to reduce the window of discomfort
  • Ensure your child’s school shoes and running shoes are comfortable, supportive and well-fitting, and encourage them to avoid bare feet  
  • Encourage your kids to perform daily stretches specific to the location of the growing pain
  • Gently massaging the muscles

How we can help

Our Brisbane-based podiatrists work extensively with children to help relieve pain and discomfort, and get kids back to doing the things they love. Based on the results of our assessment, we’ll create a tailored treatment plan to best support the tender area and reduce the stress on the growth plate. The treatment plan may involve:

  • Custom foot orthotics to help with any existing alignment problems on the feet and support the bones and tendons involved
  • Stretching and strengthening exercises - stretching tight muscles can help reduce the strain on the site where the tendon attaches, and hence the growth plate. Strengthening can help address muscle strength imbalances and weakness that is contributing to the pain
  • Footwear assessment - certain shoes may be aggravating to growing pains, depending on their location. For example, low-set soccer boots increase the strain on the Achilles and so may worsen the symptoms of Sever’s disease, whereas shoes with a slight heel raise may help relieve symptoms. We’ll assess how your child’s footwear is contributing to their pain and if they’re doing a good job providing support to the feet and keeping them well aligned. If needed, we can make recommendations for new footwear
  • Changes to physical activities - we want to help keep your child active through their recovery, so we may make changes or modifications to their existing physical activities, introducing activities that can support their recovery and not work against it
  • Padding and strapping as short term interventions to keep the children playing while we wait for long term solutions like orthotics to be made
  • Releasing muscle tension with percussive therapy for example, Theragun.

Prevention

You can help your child reduce their risk of developing growing pains by:

  • Encouraging them to warm up well before playing sports to help to loosen their muscles
  • Keeping an eye on their technique and helping them maintain it properly
  • Limiting sports that stress the painful area and elicit painful symptoms
  • Ensuring they have supportive, well-fitted shoes with good shock absorption

Other Children’s Foot Problems We Treat

We see and treat a wide range of children’s foot and leg problems, including:

When it comes to children’s feet and legs, it can sometimes be difficult to tell if there’s a problem, especially if they’re not reporting any pain. We recommend bringing your kids in for a foot check if you’re noticing and concerned about:

  • The way your child walks
  • Very regular tripping and falling
  • Not being able to keep up with friends during exercises
  • Skin rashes between toes
  • Discoloured or ingrown toenails
  • Uneven wear patterns in shoes
  • Limping 
  • Abnormal foot or leg positions
  • Hard skin lumps or bumps


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