Growing Pains? Knee Pain in Kids and Teens

Growing pains?

Many children experience aches and pains as they grow which are typically written off as ‘growing pains’, told there is nothing that can be done and that they will ‘grow out of it’.

There is some truth to this; during a growth spurt the bones will lengthen first and then the muscles adapt and lengthen to keep up and there can be a period of discomfort around the joints whilst this happens.

However in young sporty children these ‘growing pains’ may well indicate a traction apophysistis (growth plate injury) that needs to be carefully managed to avoid long-term problems and ensure a quick return to sport.

What is a traction apophysitis?

Osgood Schlatters knee image

This happens when the muscles are pulling on the growing part of the bone that hasn’t fully fused yet – like a rope pulling on cement that hasn’t hardened. If this area is overloaded by repeated, forceful muscle contractions, inflammation, pain and microtrauma to the growth plate will result.

This usually happens in very active sporty children who typically play 10+ hours of sport a week – especially kicking, sprinting and jumping activities like football, basketball and gymnastics. It always occurs during a growth spurt and is thought to affect around 20% of 9-16 year olds.

The main areas affected are the knee (Osgood-Schlatters disease) giving pain below the knee cap, or the ankle (Severs disease) giving pain above the back of the heel. Both conditions are associated with tightness of the muscles surrounding these joints pulling on their respective growth plates.

What can be done about it?

Rest, ice and anti-inflammatories can be helpful but most kids won’t want to wait months and months for their bones to stop growing before they return to sport, particularly if they are a budding athlete.

Will stretching help?

If the muscles are tight why don’t we just stretch them?

Well this actually pulls on the area where the muscle attaches to bone, potentially making it worse, not better!

So in response to this dilemma the Strickland protocol has been developed by a Physiotherapist to address the cause of the pain (tight muscles pulling on the growth plate) and to help guide return to sport and activity.

What is the Strickland Protocol?

The Strickland Protocol involves:

  • Applying a specific type of massage towards the insertion of the muscle to improve a muscle’s length and reduce its tightness, which reduces the pull on the tendon attachment – this needs to be done for a minimum of 2 minutes a day.
  • Once underlying tension is taken out of the muscle, helping it to catch up in length with the bone, the attachment site seems to repair in double quick time.
  • Once the child feels no pain in stretch position, we replace massage with stretches, safe in the knowledge that it should be able to cope with the loading of stretches.
  • Massage is continued in parallel with stretches to speed up process of elongation.
  • Rest from aggravating activities is essential – for a minimum of 3 weeks we recommend nothing more strenuous than walking, otherwise this delays healing substantially!
  • An important aspect is the involvement of the parent / guardian as the protocol cannot be done without their help & cooperation, as it will be them that performs massage on daily basis.
  • This is followed by sport-specific rehab and addressing a biomechanical or technique issues as we guide you back to sport.

Does it work?

YES! It has a 95% success rate in 3 weeks when correctly adhered to!

How can goPhysio help?

If your son or daughter is suffering with knee pain (or pain at their heel), you may have been to see your GP who has advised you that there is nothing that can be done, your child just needs to rest. However, we have found that by using this treatment protocol we can effectively help children get back to what they should be – running round, doing sports and having fun!

What we can do to help you and your child is assess the problem thoroughly to make sure we’re confident with the diagnosis. We will then advise you on the best course of action. The great part is that the treatment is pretty simple, with our guidance you can carry out the programme at home – we’re here to provide extra support and advise on progress as and when you need it.

We also offer a specialist Young Rehab service, which provides guided specific rehab programmes for kids, you can read more about this here.

Reviews

What They Say​

Antonia Perez
Antonia Perez
2023-11-25
We got an appointment promptly, the appointment went smoothly. Very nice physios. 👌
Fran Helen
Fran Helen
2023-11-06
Really knowledgeable and supportive, with clear advice to help. I feel so reassured after this appointment, highly recommended, they really listened to me. Thank you.
Brenda Hinnell
Brenda Hinnell
2023-10-27
First visit and in urgent need of physio as really suffering from not being able to run. Lottie was very patient and understanding with a lovely manner. She worked wonders and I am looking forward to my next visit.
James Grierson
James Grierson
2023-10-21
Great first appointment, really listened to my problems annd thorough anssessment and have come up with a clear rehab plan to get me back on track.
Nuisha Russo
Nuisha Russo
2023-10-21
I had a really good visit to GoPhysio. I have had sciatica for two months and it wasn't showing any signs of improvement. Sophie gave me a thorough assessment and then provided acupuncture and ultra sound. After one visit my sciatica has almost gone. I am really pleased.
kay luffman
kay luffman
2023-10-08
Everyone at go physio is so helpful & friendly. I have been receiving treatment for golfers elbow from Hannah Gelder, and couldn’t be happier, I wish I had gone earlier! She explains everything well, and guides you through exercises etc. very amiable and makes you feel at ease. Highly recommend
Chris Kitchen
Chris Kitchen
2023-10-07
They are a great friendly team who always manage to sort my sports injuries out. Can recommend them highly
Mark Dewey
Mark Dewey
2023-10-05
Go Physio definitely the place to go, came away feeling better and reassured and with a plan going forward.
Christine Raw
Christine Raw
2023-10-05
Very professional service and excellent treatment. Listened and gave good advice.
Kay Horton
Kay Horton
2023-10-05
I have been attending goPhysio for about two years. As a company they are very professional and provide a very good level of service to include efficiency and courtesy and are always consistent in their approach. This very much includes the admin /reception team whom are the first people you make contact with. My Physio has excellent knowledge and has assisted me with sound advice and ongoing exercise regimes which are achievable and realistic. This has supported me well in between appointments. Although always busy I am normally able to see Roz at a mutually convenient time. Thank you to all the team