If your child wakes up in the middle of the night with muscle aches, it could be something as simple as growing pains. “Growing pains are real,” says Mark A. Rieger, MD, senior orthopedist of The Pediatric Orthopedic Center in Cedar Knolls. “Kids typically complain of an achy sort of pain in both legs.”
The pains usually occur in the legs, calves and thighs, but kids occasionally feel them in the feet or hips, too. “It’s a diffuse pain that’s not localized in one spot,” says Ashley Conklin, DPT, pediatric clinical specialist in physical therapy at Rutgers School of Health Professions in Newark. “Growing pains are benign. They’re usually intermittent, don’t usually occur every night, and can often be managed at home.”
Although it’s not certain why some kids experience growing pains, they often occur after an active day of playing or sports, says Rieger. Growing pains affect kids from preschool to adolescence, but they’re most common in girls ages 12 to 14 and boys ages 14 to 16. Kids are often pain-free during the day but are awakened by the achiness at night.
If you suspect growing pains, try treating your child at home. Massage the area, use heat or ice (whatever your child prefers), and give an age-appropriate dose of an anti-inflammatory medication, says Conklin. These methods usually relieve the discomfort.
WHEN TO SEE THE DOCTOR
If your child has intense pain that can be pinpointed to a specific location, pain that worsens, or any pain brought on by a trip, fall, or injury during sports, your child should be seen by a doctor right away to rule out other causes, such as a fracture, says Rieger.
Sometimes kids experience other types of orthopedic issues that also require evaluation by a doctor.
Fractures occur from trauma, with sports being one of the main causes, says Conklin. If your child has a fall or collision on the field, have him or her evaluated before they return to play. Fractures in kids are common around growth plates, or the areas of new bone growth near the ends of long bones, such as in the thigh or lower legs. “The risk is that if these are not put back into place correctly, it can impact how the bone grows,” says Conklin.
Overuse injuries occur from doing the same movement over and over. Overuse injuries that involve the growth plates include Little League elbow, Little League shoulder, or Sever’s disease, which affects the heels and is prevalent in young athletes, says Conklin.
The pain from overuse injuries usually increases over time or following the activity. Sometimes these injuries improve with rest, ice, compression, and over-the-counter pain medications, but the pain recurs with activity and eventually gets to the point that the child can’t exercise, says Conklin.
Scoliosis is an abnormal curvature of the spine. “Most cases occur in children at age 10 or 11, caused by the spine growing with a curvature rather than straight,” says Alexandra Kondratyeva, DO, pediatric orthopedic surgeon at The Children’s Hospital at Saint Peter’s University Hospital in New Brunswick. “The causes of scoliosis are largely unknown. The condition generally occurs due to a genetic predisposition. In some cases, the causes can be identified on an MRI. These causes could be due to small or large intraspinal cysts or other congenital spinal cord abnormalities.”
Diagnosing scoliosis is done by screening during annual pediatric examinations and school-based screenings during adolescence with the help of a forward bend test. “Treatment for mild cases consists of physical therapy in conjunction with bracing where necessary,” says Amie Kawashima, DO, pediatric orthopedic surgeon at The Children’s Hospital at Saint Peter’s University Hospital in New Brunswick. “Bracing usually is indicated in kids who are still growing.” While bracing doesn’t straighten curves, it does prevent curvature progression. With curves of 50 degrees or more, surgery usually is required.
Limb length discrepancy is a common condition, although all of us have small differences in the length of our legs. “It’s often the cause of scoliosis, so if we see kids with a positive bend test, we also investigate if there’s leg length discrepancy,” says Conklin. While there are no effective exercises because it’s a structural issue, it’s usually treated by removing the insole out of one shoe or adding a lift.
HOW TO HELP YOUR KID AVOID SPORTS INJURIES
Make sure your child is not overusing muscles and learns proper warmups for each sport to prevent injuries. You also should ensure you replace their running shoes and sports equipment, such as cleats, when needed, says Rieger.
Kids should take time off, too, especially if they are dedicated to one sport. Or have them work with a personal trainer to develop a program that targets and strengthens all areas of the body, says Conklin.
In addition, if your child was injured, ask about physical therapy (PT). A PT evaluation may identify weaknesses that can be improved with strengthening and stretching in order to prevent re-injury, says Conklin.
Finally, teach kids to speak up if they’re hurt, and don’t encourage them to “play through” if they’re in pain. “It’s about vigilance,” says Rieger. “If your child is complaining and it doesn’t seem right to you, have your child seen by your doctor. Trust your instincts because you know your child best.”
— Arricca Elin SanSone is a New York-based health and lifestyle writer.
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