Growing pains in the ankles typically respond well to gentle massage, warmth, and stretching before bed. These aches are extremely common in children, affecting roughly 20 to 37% of kids depending on the study, and they almost always resolve on their own without lasting effects. That said, ankle pain specifically deserves a closer look, because several other childhood conditions can cause pain in and around the ankle joint.
Why “Growing Pains” Are Misleading
Despite the name, growing pains have nothing to do with bones actually growing. The name stuck from an outdated theory, but researchers now know the pain isn’t caused by growth spurts. The real cause remains unclear, though several factors likely play a role: overuse of muscles from physical activity during the day, low vitamin D levels, flat feet or joint hypermobility that puts extra stress on the legs, and even anxiety or emotional distress. There also appears to be a genetic component, meaning your child is more likely to get them if you or your partner had them too.
Classic growing pains tend to show up in the thighs, calves, and behind the knees. They typically hit in the late afternoon or evening, often waking a child from sleep, and are gone by morning. They affect both legs, never just one, and they don’t cause limping, swelling, or redness. Most children experience them between ages 4 and 12.
Ankle Pain May Not Be Growing Pains
The ankles aren’t a typical location for growing pains, so it’s worth considering other possibilities before assuming that’s what you’re dealing with. One of the most common culprits in active kids is a condition called Sever’s disease, which is inflammation of the growth plate at the back of the heel where the Achilles tendon attaches. It’s not actually a disease but rather a stress injury. The hallmark signs include pain in the back of the heel that gets worse after running or jumping, swelling or redness around the heel, stiffness in the foot after sleeping, and walking on toes or limping to avoid pressure on the heel. If your child’s pain fits this pattern, the management is similar to growing pains but may also require a break from high-impact sports and sometimes heel inserts.
Other conditions that can cause leg and ankle pain in children include juvenile arthritis, bone infections, stress fractures, and various growth plate irritations. Some children experience a pain amplification syndrome similar to fibromyalgia in adults, where normal signals from the body get dialed up by the nervous system.
Red Flags That Need Medical Attention
Most childhood leg pain is harmless, but certain signs point to something more serious. Pay attention if your child has:
- Pain in only one leg or ankle, especially if it’s the same side every time
- Swelling, redness, or warmth around the joint
- Limping or refusing to walk or put weight on the foot
- Pain that persists into the morning or is still there during the day
- Fever, night sweats, or rash
- Unexplained weight loss, fatigue, or loss of appetite
- Symptoms lasting longer than seven days or getting worse over time
A child who suddenly can’t walk or bear weight needs to be seen urgently. Joint swelling combined with reduced range of motion and fever can indicate a joint infection, which is a medical emergency.
How to Relieve the Pain at Home
If the pattern fits classic growing pains (both legs, evening or nighttime, no swelling, gone by morning), several strategies can help your child feel better and get back to sleep.
Massage
Gently rubbing the painful area is one of the simplest and most effective options. Use your thumbs to work small circles around the ankle and up through the calf. You don’t need a specific technique. Firm but gentle pressure for a few minutes is usually enough to ease the ache. Many parents find this is the single best tool for settling a child who wakes up crying from the pain.
Heat
A warm bath before bed can help relax the muscles in the lower legs and reduce the likelihood of nighttime pain. If your child wakes up with pain, a heating pad or warm towel wrapped around the ankle and calf for 10 to 15 minutes works well. Avoid placing a heating pad directly against skin, and don’t leave it on while the child falls back asleep.
Stretching
A simple bedtime stretching routine targeting the calves and ankles can make a noticeable difference over time. One effective stretch: have your child stand facing a wall or chair, step one foot back, keep that heel on the ground, and lean forward until they feel a gentle pull in the back of the lower leg. Hold for 20 to 30 seconds per side. Repeat two to three times on each leg. Doing this routine two to three times a day, and especially right before bed, helps keep the muscles around the ankle loose.
For younger kids who won’t hold a stretch, try having them sit on the floor with legs straight and gently pull their toes back toward their shins. Making it into a game helps with consistency.
Pain Relief Medication
Acetaminophen is a safe option for children when the pain is bad enough to keep them awake. For kids under 12, the standard liquid form contains 160 mg per 5 mL and can be given every four hours as needed, up to five doses in 24 hours. Children under 2 should not take acetaminophen without a doctor’s guidance. Ibuprofen is another option and has the added benefit of reducing inflammation, which is particularly helpful if the pain turns out to be related to a growth plate issue rather than classic growing pains. Always dose by your child’s weight, not their age.
Reducing How Often Episodes Happen
Because growing pains tend to flare after especially active days, you may notice a pattern. Track which days your child complains of pain and what activities they did. On heavy activity days, a warm bath and calf stretches before bed can work as preventive measures. Making sure your child is wearing supportive, well-fitting shoes during sports and play also helps reduce strain on the ankles and lower legs.
Low vitamin D and low bone density have been linked to growing pains in some research. If your child doesn’t get much sun exposure or eats a limited diet, it’s worth discussing vitamin D levels with their doctor. Flat feet and hypermobility are also associated with more frequent episodes, and both can put particular stress on the ankle area. Supportive insoles or a physiotherapy assessment can help if either of these applies to your child.
Most children outgrow these pains entirely by their early teens. In the meantime, the combination of stretching, massage, and warmth handles the vast majority of episodes without any need for further intervention.