Growing Pains and Growth Plate Disorders

Growing Pains and Growth Plate Disorders

Children are different from adults in many ways. The most readily apparent way in which they are different is that they really grow!

Their bone structure is quite different with the presence of growth plates at the ends of many bones. These lend themselves to a variety of different problems that may occur.

The primary concern we see  in the growing child is a group of conditions called osteochondroses. This is a particular type of damage to a growth site. It may occur at a joint site in which case it is called an “articular osteochondrosis”. At sites at which a joint does not occur, this problem is called a “non-articular osteochondroses”.
It may occur at tendon attachments, ligament attachments or in areas that receive a lot of impact stress.

In clinical practice it is most frequently seen at the sites of tendon attachment- particularly the tibial tuberosity (Osgood-Schlatter’s disease) and at a site of both impact stress and tendon attachment – the calcaneus (Sever’s disease).

Theory holds that both overuse and tight muscles may contribute to the  problem.
On X-ray the epiphysis (portion of bone attached to the rest by a growth plate) frequently reveals a fragmentation.
Osgood Schlatters has a bony bump near the knee

Osgood-Schlatter’s disease is an osteochondrosis that occurs at the tibial tuberosity at the site of insertion of the patellar tendon. It is manifested by a pain and a usually a bump at top of shinbone below the knee cap. Repetitive contractions of the quadriceps muscle is thought to be a  contributing factor.
This is seen most often in children aged 9 to 15 years. It is usually self-limited. The usual recommendation is for rest until symptoms abate, with appropriate biomechanical correction (possibly Orthotics).

Sever’s Disease (Calcaneal Apophysitis) is a disorder of the growth plate of the calcaneus. Symptoms most often occur at the posterior aspect of the growth plate, but sometimes occur at the plantar aspect. The achilles tendon attaches to the posterior aspect of the growth plate and the plantar fascia takes part of its origin from the plantar aspect. Clinically this occurs more often in boys than girls.All Kids experience growing pains regularly
The age of onset is usually between 8 to 12 years. Pain is usually related to activity levels.
In most cases the posterior aspect of the calcaneus will be tender. Occasionally, the plantar aspect may be tender or both of these locations may be found to be tender. Frequently the achilles tendon is tight and there may have been a recent increase in activity.
The factors contributing to this disorder are similar to those causing plantar fasciitis,  a tight achilles tendon appears to be as great a contributor as pronation.

Treatment for growth plate disorders is geared toward minimising pain and discomfort, whilst maintaining activity levels as much as possible.
Osteochondroses and other growth related pain are considered manageable conditions, not curable.
This means that whilst we are very good at getting  kids out of pain, they often require an ongoing management plan of stretching, pre and post game routine changes, footwear and orthotic changes during the growing years, as well as close monitoring to avoid ‘flare ups’ during those growth spurt stages.
At Gladesville HealthCare, our philosophy is to maintain a treatment regime while your child is playing their sport, keeping them active and performing – and avoiding the approach of stopping involvement in activity as much as possible.

If your child is finding it difficult to perform due to heel, foot or knee pain or they are complaining of pain during the day at school or after activity, it is likely they are suffering from one of the many osteochondroses we treat at Gladesville HealthCare.
Make an appointment today with one of our practitioners- as with most conditions we treat, the sooner we see it, the quicker we can treat it- and the less time it will take to ease!

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Gladesville Healthcare Clinic
74 Morrison Rd
Gladesville NSW 2111.

Clinic Hours: Monday to Friday: By Appointment
Tel: 9816. 3071
Fax: 9816 2037

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