Every parent of a sporty child has had this moment: your ten-year-old limps off the pitch complaining about their knee, and you’re left trying to decide whether this is just a normal part of growing up or something that actually needs attention. Say it’s nothing and you risk ignoring a real injury. Say it’s serious and you might be pulling a kid out of the sport they love over something that would have settled by Tuesday.
This isn’t a problem you solve with one quick answer, and that’s precisely the point. Supporting a young athlete’s body through growth spurts and training load isn’t a single diagnosis to tick off. It’s an ongoing, holistic process, one that changes as their body changes, rather than a single treatment aimed at whatever hurts this week.
Growing Pains vs Something More
Genuine growing pains do exist, and they look quite different from an activity-related injury.
Growing pains typically:
- Affect both legs, often in the muscles of the calves or thighs rather than a joint
- Show up in the evening or overnight, not during or immediately after sport
- Aren’t linked to swelling, limping, or tenderness when you press on a specific spot
- Respond well to a gentle massage or reassurance, and are gone by morning
Something worth getting checked, on the other hand, tends to look like this:
- Pain that’s one-sided and focused on a specific point, like just below the kneecap or at the back of the heel
- Pain that clearly worsens with running, jumping, or a particular sport
- Any swelling, limping, or a noticeable change in how they’re moving
- Pain that doesn’t ease with rest, or that’s still there days later
The Two Conditions Every Sporty Parent Should Know About
Two specific conditions account for a large share of what looks like “just growing pains” in young athletes, and both come from the same underlying cause: a tendon repeatedly pulling on a growth plate that isn’t yet mature enough to handle it.
Osgood-Schlatter Disease
This shows up as pain and sometimes a visible lump just below the kneecap, where the tendon from the thigh muscles attaches to the shin bone. It’s remarkably common, affecting somewhere between 13 and 17 percent of youth athletes, typically appearing in girls between 8 and 13 and boys a little later, between 10 and 15. Running, jumping, and kneeling tend to bring it on, which is exactly why it gets mistaken for ordinary knee pain rather than something tied to a growth spurt.
Sever’s Disease
The heel version of the same story. This affects the growth plate where the Achilles tendon attaches at the back of the heel, usually in nine to twelve year olds, and causes pain that’s worse with activity and often tender when the heel is squeezed from both sides. Because the pain sits right where a lot of ankle and lower leg strain shows up too, it’s another one that’s easy to write off as nothing in particular.
Neither condition is dangerous, and neither means a child has to stop their sport entirely. But both need managing properly, because a growth plate under too much ongoing stress can, in more serious cases, affect how that bone develops.
Why Young Bones Behave Differently
Growth plates are areas of developing cartilage at the ends of a child’s bones, and they’re simply weaker than the mature bone tissue that will eventually replace them. During a growth spurt, muscles and tendons often can’t keep pace with how quickly bones are lengthening, which leaves the growth plate taking on tension it isn’t fully ready for. Add in the repetitive, forceful movements common in youth sport, running, jumping, kicking, and you have exactly the conditions these injuries need to develop.
This is also where the bigger picture matters. A child juggling school, a growth spurt, and three training sessions a week is dealing with more than a sore knee. Training load, recovery time, footwear, and even how they’re coping with the pressure of competitive sport all feed into the same picture.
Managing It Properly, Not Just Waiting It Out
The instinct to either push through or stop entirely are both understandable, and both miss the mark. What actually works is somewhere in between: modifying training load rather than eliminating it, addressing flexibility and strength around the affected area, and monitoring how things progress over weeks, not days.
This is exactly where a lot of the common assumptions about physiotherapy get in the way. Physiotherapy for a young athlete isn’t about pulling them out of sport or handing over a generic stretching sheet. It’s about building a plan around their specific stage of growth, their sport, and their training schedule, and adjusting it as they grow into and out of these vulnerable phases.
Young athletes and their parents land at exactly this crossroads with us regularly at Physiocare, unsure whether what they’re seeing is normal or something to worry about. If your child’s pain fits the “something more” list, or you’re simply not sure, get in touch with our team. We’re happy to help you tell the difference.