WINTER SPORTS & GROWING PAINS IN ADOLESCENTS.
What to look out for and how to prevent the causes.
As we head into the winter months and the return of traditional winter sports following two Covid interrupted years we will see the re-emergence of a group of adolescent conditions known as traction apophysitis or otherwise known as "growing pains"
Most commonly they occur in the following areas;
KNEE - Osgood Schlatter & Sinding Larsen Johansson
ANKLE - Severs
Elbow - "Little League Elbow"
FOOT - Iselin's Disease
These conditions occur during periods of adolescent growth spurts in girls usually peaking around 12 years of age and boys at 14 years. Combined with increasing sporting activities including running, jumping and kicking and often disproportionately tight and weak muscle groups about the weight-bearing levers results in excessive pulling forces around the growth plates of some of the muscle-tendon attachments near the growth plates. This causes an inflammatory response in the growth plates characterized by pain, sometimes swelling and thickening of the bone around the growth plate (think Osgood-Schlatters).
Typical signs and symptoms include;
- Localised pain over bony insertion point of tendon/ligament
- Associated periods of increased physical activity
- Limping during/after bouts of physical activity
- Better with rest
Managing the child with apophysitis (growth pain)
- Activity modifications considering the volume, frequency, and intensity of physical activity bouts
- Correcting muscle/bone length imbalances (stretching tight muscle groups to the long levers)
- Biomechanical correction with orthotics, heel raisers, strapping/bracing
- Pre-season stretching and strengthening of associated muscle groups
- Analgesia as required, hot packs, cold packs, topical NSAID's, judicious use of oral NSAID's
Growing pains or traction apophysitis are a common set of conditions seen in the active adolescent. They can be debilitating for periods of time lasting weeks to months during adolescence but pose minimal long-term consequences and are usually effectively managed with the input of physiotherapy, corrective exercise prescription, activity modifications, and the passage of time.