Muscle, bone and joint pains are very common in young people. Sometimes pain comes from normal growth, while other times it’s due to specific injury. So when do you see a doctor?
Dr. Spencer Richards is a Sports Medicine Physician and has advice on what “growing pains” need professional help and which ones don’t.
Sometimes pain can be a sign of something serious that needs to be evaluated by a doctor, whereas other times it will go away with some TLC from Mom and a few basic home interventions.
Here are five areas of discussion for common pediatric muscle, bone or joint pains:
1. Growing pains – Most often these pains come from the growth plates in bones. Growth plates are areas of bones where new bone cells are born and developed. Compared to most bone, growth plates are a little weaker and can be a source of pain when overused or overstressed. Common sites for growth plate pain include the following:
a. Heel—a condition called Sever’s disease which typically affects 9-11 year olds.
b. Knee—a condition called Osgood-Schlatter’s disease which affects 12-15 year olds.
c. Hip—a condition called iliac apophysitis which affects 15-17 year olds.
Pain from growth plates varies from achy and mild to fairly intense. It is usually worse during or after sports or exercise. Fortunately, young people can typically continue their activities despite pain unless it is bad. The pain usually responds to rest, ice, and anti-inflammatories (like advil or aleve), which are most effective when taken consistently for about two weeks. Straps, pads, or other devices can help alleviate pain as well. Even though having pain in a growth plate sounds serious, it is not. The growth plate typically keeps on growing without problems, and eventually, as it gets stronger, these problems go away naturally.
2. Sprain/strains – Most sprains and strains are not serious in the long-term, although some are very painful and seem bad initially. Ankle sprains, knee sprains, wrist strains, and hip flexor or hamstring strains are common examples. These typically happen because of a specific injury. The pain from these injuries is often worst in the first week, but then gradually improves over the course of 2-4 weeks. Common treatments included Rest, Ice, Compression (wrap, brace, sleeve), and Elevation for swelling—R.I.C.E. is a pneumonic used to remember these tools. Doctors usually recommend anti-inflammatories as well for two weeks (advil, aleve, ibuprofen, etc). Excessive bruising, severe pain, inability to stand or walk, or other concerns would be reasons to have the injury checked by a doctor.
3. Overuse injuries – These days, young people are becoming more and more involved with sports and other physical activities (dance, tumbling, cheer, etc). With more hours expended in these activities, there are more opportunities for injury. Overuse injuries develop slowly over time, when too much repetitive movement or strain on a particular body part causes a breakdown of that part. Common overuse issues include the following:
a. Shoulder and elbow – commonly seen in throwing athletes ages 12-16.
b. Gymnasts – wrist, elbows and back are common sites for overuse injuries in gymnasts.
c. Tendons – large tendons such as the Achilles, patellar, and hamstring tendons often develop overuse injuries in running athletes (cross-country, soccer, etc) and dance/drill.
d. Stress fractures – these are an overuse injury of bones.
Overuse injuries tend to be more serious problems. They often take a longer time to heal than sprains/strains and can cause prolonged time away from sports/activities if not recognized early and treated appropriately. The pain associated with overuse injuries often is constant and worse with activity.
4. Back problems— Back issues in young people can be a serious problem. The most common reason for back pain, a muscle strain, is usually easy to identify by an injury (falling, twisting, swinging) and by a fairly quick return to normal (~ 2 weeks). More serious back problems come on more slowly and instead of getting better over time, they get worse. The most common serious back issue in young people is a stress fracture. This is often seen in gymnastics, cheer, tumbling, football and soccer. The pain is usually in the low back. It is often worse bending backwards than bending forward. These need to be seen by a doctor who can diagnose and treat, so that long-term complications don’t arise (surgery, chronic back pain).
5. Red Flags – This is not a specific condition, more a list of warning signs that a young person’s pain may be more serious and need medical attention.
a. Persistent and/or worsening pain despite rest and common treatments
b. Other symptoms in addition to pain, such as fever, rash, swelling, pain in multiple joints and decreased interest from the young person to do things they normally enjoy doing
c. Night pain, particularly pain that wakes a young person
d. Changes in mechanics of movement, such as limping, altered running, changed swing, or favoring or protecting certain body areas.
Hopefully, this provides some basic but useful information to parents trying to navigate the eventful world of parenting young, active kids. As sports medicine specialists, we have unique training in helping get kids recovered and back to their activities in a safe manner. We have offices from Bountiful to Riverton, with doctors ready to help however we can. Feel free to call and talk to one of our athletic trainers if you have a question about an injury or pain or whether your child needs to be seen or not.
For more information, contact Intermountain Sports Medicine Specialists: www.sportsmedgroup.org
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