Engaging in regular exercise and physical activity provides comprehensive physical and mental health benefits for children. Research indicates that the earlier children are introduced to active play and sports, the more likely they are to maintain these benefits throughout their lives. If you have an active kid, you will know that they hate to miss out on the sport and activity they love. However, with the increased level of activity and sport, there is a tendency for sports injuries to arise due to stressed and overloaded tissues. As podiatrists, we want to help your child assess, identify, and treat these issues so that they can keep doing the sport they love. In this article, we will outline 4 common foot and knee-related issues and how paediatric podiatry can help.
1) Growing pains
The term “growing pains” refer to the pain children experience when they go through growth spurts. While any child can be affected, research has shown that active children are more prone to experiencing growing pains in their feet, legs and knees. Boys and girls are equally affected.
Growing pains occur when the bones of their lower limbs grow faster than their muscle, resulting in a pull and stretch on the muscles. Pain is commonly located either in the muscle belly (e.g the calf muscle at the back of the leg (Fig 1)), or at the tendon/ muscle attachment (e.g the Achilles tendon at the back of the heel). Children are more likely to experience pain if there is a family history of growing pains. Sports that involve a high amount of rapid muscle contraction and extension involving the calf and quadricep muscles (e.g sprinting and kicking in soccer) will accelerate the stretch and strain on the already underdeveloped muscles and tendons, leading to increased pain.
There is a common type of growing pains that involves the fusion of children’s bony growth plates. These are named depending on the growth plate involved. The three most common are: Sever’s Disease (calcaneal apophysitis), Osgood-Schlatters, and Sinding-Larsen Johansson. Fortunately, these conditions tend to resolve with age, and are highly treatable with a podiatrists’ help.
Fig 1. Growing pains are common in kids when going through growth spurts
2) Sever’s Disease (Calcaneal Apophysitis)
Sever’s disease (medically known as calcaneal apophysitis) occurs when the growth plate at the back of the heel has excess movement from the rest of the heel bone (calcaneus) and becomes irritated and sensitive (Fig 2). This commonly occurs when the calf muscles grow tight due to a growth support in the legs. This is further compounded by high activity and certain sports (soccer, basketball, athletics). It is most commonly between the ages of 8-14 years old.
A child with calcaneal apophysitis will often complain of pain in one or both heels, particularly after activity and sport. Your child may even display a limp and be very protective of their foot and ankle (e.g not wanting to jump, hop, walk up or downstairs). Sometimes, children may tip-toe walk as a result, to place less stress and pressure on their heel due to the discomfort.
Treatment typically involves some rest, icing, stretching and strengthening of the calf muscle, foot orthotics and footwear advice to reduce stress on the heel.
Fig 2. Calcaneal apophysitis – a common cause for heel pain in children
3) Osgood-Schlatter’s disease (tibial tubercle apophysitis)
Osgood-Schlatter’s disease (medically known as tibial tubercle apophysitis) occurs at the growth plate where the patella tendon attaches to the tibia bone on the lower leg. It is characterised by a prominent and painful bump just below the knee that is worse with activity and better with rest (Fig 3). In your child’s growing legs, this growth plate is a weak point of high stress, especially if they play sports that involve alot of jumping or running. Like most growth plate-related conditions, it tends to self resolve in months to years. After growth slows, typically age 16 in boys and age 14 in girls, the pain will no longer occur despite a bump potentially remaining.
Paediatric Podiatry Treatment typically involves rest, activity modification, rehabilitation exercises of the hips, thigh, knee and calves, and wearing shock-absorbing insoles during sports.
4) Sinding-Larsen Johansson syndrome
A very similar condition to Osgood-Schlatter’s disease, Sinding-Larsen Johansson disease refers to swelling and irritation of the growth plate of the patella (kneecap) Fig 3. Pain occurs on the origin of the patella tendon which is right at the bottom of the kneecap. This pain might get more severe with squatting or kneeling, manifest as swelling and tenderness around the kneecap, and result in a swollen or bony bump at the bottom of the kneecap.
Treatment is very similar to the strategies used for Osgood-Schlatter’s disease. It is key to differentiate between the two conditions to ensure appropriate and timely treatment.
Fig 3. Osgood Schlatters vs Sinding-Larsen Johansson syndrome; it’s all about the location!
Seek Paediatric Podiatry Treatment For Your Child’s Foot Pain
While there are issues which happen to active children playing sports that are related to growth stages, it does not mean that your child has to suffer or give up on sports. Our podiatrists are here to help you and your child with any pain or injury. During your consultation with us, you can expect:
- Assessment of the problem occurring and a diagnosis
- Effective treatment (e.g stretching and strengthening program, foot orthotics)
- Footwear advice for school and sports shoes
- Padding and footwear modifications
- Foot, ankle or knee strapping
- Pain management advice
- A long-term treatment and return to sport plan
If your child is experiencing foot pain, drop us a message to speak to our podiatry team or to book an appointment today!
