Growing pains. An old wives's tale? Well, yes and no. Adolescents do experience accelerated growth spurts. And the foot, ankle, and leg pains that young boys - and increasingly girls - report are associated with growth plate centers.
Thin, flat, crescent - shaped growth centers separate bone and cartilage in younger children. As a child nears puberty, these growth centers close and ossify, the process by which cartilage becomes bone.
the ages of 8 and 12, when boys and girls become more active in
sports, or dance, a child may complain of pain or parents may notice
limping. While these complaints are historically more common among
boys, as more and more girls join in hockey, soccer and other team
sports, they, too,
The most common growth center complaint I treat is severe pain behind the heel, which stems from overusing the foot and ankle in hard training. The fibers of the Achilles tendon pull on the heel's growth plate and create inflammation within the heel bone.
Growth center pain is even more common among children who have flat feet, toe-in or have other foot problems. For these youngsters, an orthotic, a splint or soft cast is usually enough to properly position and strengthen feet and ankles, and prevent future pain and injury.
With prompt treatment, growth center pain persists only a few days or weeks and surgery is rarely needed. Untreated, growth center injury can require long term treatment. Such an injury can even result in fracture or dislocation of the growth plate, chronic pain, muscle imbalance, reduced range of motion, shortened limbs or permanent joint deformity. In extreme cases, a total joint replacement may be necessary.
When I suspect a youngster's pain is growth plate related, I x-ray the area to rule out fractures or dislocation of the growth plate, which is held together only by cartilage. I examine the child's practice and game schedules, and I often find the youngster is playing sports year-round, practicing daily, warming up with wind sprints and skipping proper cool-down exercise.
Kids will resist interrupting their game and practice schedule, even for a short time. But sometimes the podiatrist must immobilize the injured growth center in a soft removable cast or splint for a brief period. Then, more often than not, he or she, can prescribe an orthotic for the shoes that allows the child to play, without re-injury.
Usually, when growth center pain occurs, modifying activity is enough to remedy the problem. Above all, parents and coaches must never allow a youngster to play through injury or pain.
The writer is a surgeon podiatrist who practices in
This is a reprint from the Pulse Section of the
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