Growing pains are common muscle aches in the legs experienced by many children. They often occur during growth periods, affecting 10% to 20% of children, and up to 40% in those aged four to six. While the term suggests a connection to growth spurts, there is no direct evidence that growth itself causes the pain.
Understanding Typical Growing Pains
Typical growing pains cause an aching or throbbing sensation, most commonly in the leg muscles. These sensations frequently affect the front of the thighs, the calves, and the area behind the knees. The pain is usually felt in both legs, though it might shift from one leg to the other during different episodes. Unlike joint pain, growing pains do not typically involve the joints themselves, and movement of the legs does not usually make the pain better or worse.
The pain often emerges in the late afternoon or early evening and can sometimes be severe enough to wake a child from sleep. Despite the intensity, the pain typically resolves by morning, allowing the child to be active and pain-free during the day. Growing pains commonly affect children between the ages of 3 and 12 years, though some may continue to experience them into early adolescence. Simple measures like massage, warmth, or over-the-counter pain relievers often help alleviate the discomfort.
Ankle Pain and Growing Pains
While growing pains are a recognized condition, they are not commonly associated with the ankles. Typical growing pains are muscular aches, distinct from joint pain, involving the long bones and muscles of the legs, not the ankle’s joint structures. However, some sources refer to pain in the heel, specifically Sever’s Disease (calcaneal apophysitis), as “growing pains in the ankle or heel” due to its occurrence in growing children. This condition involves inflammation of the growth plate in the heel bone, often exacerbated by physical activity. It is important to differentiate this localized growth plate irritation from the more generalized muscular aches commonly understood as growing pains.
Other Reasons for Ankle Discomfort in Children
Given that true growing pains are uncommon in the ankles, other factors often account for ankle discomfort in children. Overuse injuries are a frequent cause, especially in active children who participate in sports involving repetitive stress on the ankles, such as running and jumping. This can lead to conditions like tendinitis, where tendons become inflamed, or even stress fractures, which are hairline breaks in the bone from repeated impact.
Minor injuries, such as twists or mild sprains, are also common as children explore and play. These can cause localized pain, though typically without significant swelling or an inability to bear weight. Ill-fitting footwear can contribute to ankle pain by placing undue stress on the feet, affecting gait and posture.
Certain anatomical variations can also predispose children to ankle discomfort. Hypermobility, or having overly flexible joints, can lead to instability and increased strain on the ligaments and muscles supporting the ankle, potentially causing pain and a higher risk of sprains. Flat feet, where the arch of the foot is collapsed, can also contribute to ankle strain by altering the biomechanics of the lower limb. These conditions can lead to pain, particularly after activity, as the foot and ankle structures work harder to maintain stability.
When to Seek Medical Advice
While many instances of ankle discomfort in children are minor, certain signs warrant prompt medical evaluation. It is advisable to consult a healthcare provider if the pain is persistent, lasting throughout the day, or worsens over time. Pain accompanied by visible swelling, redness, warmth, or tenderness in a specific area of the ankle also indicates a need for medical attention.
A medical consultation is also recommended if the child is limping, refusing to bear weight on the affected ankle, or experiencing difficulty moving the ankle. Additional symptoms such as fever, a rash, loss of appetite, or general weakness alongside the ankle pain are significant red flags. If the pain follows an injury, or if it does not improve with rest and home remedies, seeking professional medical advice is important to rule out more serious underlying conditions.