01 January 2017
Your child’s body is trying to tell you something
• Aching limbs and joints - why they should be addressed
• Easy to resolve in as little as one session with an expert physiotherapist
• Children do not always need a GP referral
• Specialist team at Progress, the Cambridge Centre for Health and Performance, offer a comprehensive musculoskeletal service for children
When a child complains of aching limbs it is all too easy to pass it off as “growing pains.” Tom Quantrell the national lead for paediatric physiotherapy for Spire Healthcare, based at Progress, part of Spire Cambridge Lea Hospital , explains why they should not be ignored.
“All too frequently I get asked: ‘is there such a thing as growing pains?’ The answer is a definite yes, and then I explain why to tired looking parents and children who have been searching for an appropriate answer to why their normally fit and well child is unable to take part in their activities of choice because of pain.
“Sadly, “it’s just growing pains” is a comment all too often thrown out there, seemingly without a great deal of thought and without other possibilities being considered.
“Of course children and adolescents grow, but where I take issue is when a concerned parent takes their child to a professional and explains that when they play football for 20 minutes or overstretch to play a cricket shot, their child’s knee pain is at the point where they are in tears and cannot continue, only to be told it is growing pains. I am pretty sure that there has not been a rapid increase in height during the first half of a game or while overstretching for a pull shot”.
Here are 5 things to remember when addressing so called “growing pains”:
1. You should seek specialist advice if your child is in distress or can no longer do what they want to do because they are in pain.
2. Do not take too long to get advice and help because once you have it, the child is usually fairly quick to fix. On average you only need to see them for three sessions unless it is post-operative rehab.
3. You do not always need a GP referral to visit a physiotherapist.
4. You really need to see a physiotherapist who has experience in treating children and adolescents with musculoskeletal problems– not someone who only sees adults – as they will have a different perspective.
5. If night time aches (growing pains) persist, still seek advice in case there is an underlying problem.
Patient, Max Ramsden – 11 years old and a sports fanatic
“Max lives for sport,” – that is how his father Nigel describes him. Max runs, plays cricket and football yet his favourite sport is rugby which he plays for the under 11s at Royston Rugby Club.
Three years ago Max suffered significant pain in his knee joints. He was told he would need surgery as his hips hadn’t rotated. Instead, his parents rested him for one summer, he seemed to recover and all was resolved until a year ago when he started to suffer heel pain.
His father explains: “We knew of the team at Progress and decided to fund treatment ourselves. One session was all it took. Tom put Max through his paces, but in such a way that it was Max who designed the exercises under Tom’s expert tuition. Tom provided tips and an exercise programme which Max followed once back at home. Now he is pain free and if he does ever feel pain returning, he reaches for his physio roller and carries out the exercises on his own. Now he is happily playing sport again and back playing for the under 11s at Royston Rugby Club.”
What is the science behind the pain?
When we grow the brain releases a hormone, your skeleton reacts to this hormone and will start to grow. This can often occur through the limbs at a more rapid rate than the trunk. The soft tissue adapts over time under load, this load is the stretch from the growing skeleton it is attached to and the normal activities of an active child or adolescent. What can occur is that soft tissue becomes “short” or “tight” relative to the rapidly growing skeleton. As a result there might be pain, but these symptoms are related to growth and biomechanical in nature and in most cases they are quite easy to treat to allow normal growth, development and activities to continue.
As Tom explains:
“I often use the analogy of growth being a fast flowing river, where a child with pain has just washed up on to the shallows. Normally there is nothing structurally “wrong” or “damaged”, and it just takes a well-directed push to get the child back in to the fast flowing river that is normal growth and development. This is where a thorough and appropriate assessment is beneficial and sound advice and a course of treatment can be provided.
“I, along with a number of leading doctors do think that children can suffer from growing pains. I would describe a growing pain as one that occurs at night, is diffuse that you cannot put your finger on, but however bad has completely resolved by the morning. However, if your child regularly or consistently complains of this type of pain, do see your GP as these symptoms can also present in a number of conditions that need further investigations.
“This does not mean that in the case of the child who complains of pain during activity that it is not related to growth. In fact, the most common problems I see in this young age group (10-16 years) are biomechanical problems associated with an excessively quick period of growth in an otherwise fit and well child. These can be easily managed with appropriate and often very basic physiotherapy input such as foam rolling and/or stretching “tight” tissue, adapting and managing sporting work load and improving the recruitment of certain muscle groups.