Has your child ever complained of sore shins or achy legs? Growing pains are very common in pre-teens, but they are often misunderstood. These aches and discomforts typically occur in the legs, particularly in the shins, calves and thighs, and are often felt in the evening or at night. The pain often comes and goes but can bring with it sleep disruption, discomfort and lots of tears. Physiotherapy can help manage and alleviate growing pains, reduce discomfort, improve flexibility, and strengthen muscles during these growth phases. We’ll explore the nature of growing pains in pre-teens, the potential causes, and how physiotherapy can play a key role in supporting children through these growing stages.

Growing pains are a common complaint among pre-teens, typically affecting boys more than girls. Common symptoms of growing pains include:

• Aching pain in the legs, often around the shins, calves, or thighs.
• Pain that is more noticeable during the evening or night, often disrupting sleep.
• Episodes of pain that may last for several minutes to an hour and then subside.
• Tenderness or soreness when pressure is applied to the affected areas.

Unlike more serious musculoskeletal conditions, growing pains do not cause visible swelling, redness, or warmth in the affected area. There are also no long-lasting effects on the child’s ability to move during the day.

The exact cause of growing pains remains unknown. In fact, there is no evidence that growing is painful for a child. It has been suggested that the pains could be linked to restless legs syndrome or muscle pain at night simply caused by overuse during the day, such as running, climbing and jumping (as children do!).

No matter what causes these pains, physiotherapy is effective for managing them. It addresses physical discomfort by improving muscle strength, flexibility and posture while alleviating pain. Here are some of the key physiotherapy techniques used to manage growing pains in children:

1. Stretching and Flexibility Exercises: One of the most important aspects of physiotherapy for growing pains is stretching. Stretching exercises help to lengthen tight muscles, release tension, and improve flexibility, all of which can ease the discomfort caused by muscle strain during periods of rapid growth. Some common stretches include hamstring stretch, hip flexor stretch, calf stretch and spinal stretches.
2. Strengthening Exercises: Weak muscles are more prone to strain, especially during periods of rapid growth, so strengthening exercises help prevent discomfort and improve stability. Core strengthening, leg strengthening and postural muscle strengthening help with proper alignment and reduce strain.
3. Manual Therapy: Therapeutic massage can help reduce muscle tightness and improve blood flow to the affected areas. Physiotherapists may also use gentle joint mobilisations to improve the movement and flexibility of the joints.\
4. Cold and Heat Therapy: Applying ice packs to the affected areas can help reduce inflammation and numb the pain. Heat can be used to relax tight muscles and increase blood flow to the affected area. Physiotherapists may suggest alternating cold and heat therapy depending on the symptoms.

While growing pains are a common and natural part of childhood, there are proactive measures you can take to minimise their impact on everyday life.

While too much physical strain can exacerbate growing pains, regular physical activity is essential for strengthening muscles, improving flexibility, and promoting overall health. Encourage activities that engage the entire body, such as swimming, cycling, or dancing. It's equally important to avoid overexertion, which
can increase muscle fatigue and trigger growing pains. Be mindful of the intensity and frequency of activities, and allow for adequate rest between exercise sessions.

• Stretching before and after exercise: Incorporating stretching routines before and after physical activities can improve muscle flexibility and reduce the risk of tightness that can lead to pain. Stretching exercises, such as hamstring stretches, calf stretches and hip flexor stretches, can help prepare muscles for physical activity and promote relaxation afterwards.
• Good posture: When children slouch, it puts added strain on muscles, which can add discomfort during growth. Physiotherapists may provide guidance on how to sit up straight with feet flat on the floor, shoulders relaxed and back supported. Exercises like planks, bridges and shoulder blade squeezes can improve posture and reduce strain on muscles and joints.
• Proper footwear: Shoes that lack proper support can lead to poor posture, imbalance, and increased strain on the legs and back, contributing to discomfort and pain. Well-fitted shoes that align the feet correctly help distribute pressure evenly, reducing the risk of developing leg and back pain.
• Calcium and Vitamin D: Foods rich in calcium, such as dairy products and leafy greens, along with vitamin D (which helps the body absorb calcium), are essential for maintaining strong bones during growth periods.
• Rest and recovery: Rest is an important part of managing and preventing growing pains. Physical activity and growth spurts put a strain on the body, so allowing plenty of time for rest and recovery helps muscles and joints heal and reduces the risk of pain.
• Regular physiotherapy check-ups: For children who experience frequent or intense growing pains, regular check-ups with a physiotherapist can help identify any underlying issues and prevent future issues. Physiotherapists can assess muscle strength, flexibility, posture and movement patterns to ensure that the child’s musculoskeletal system is developing properly.

Growing pains are a common yet often distressing part of childhood. While they are typically temporary, the discomfort associated with growing pains can interfere with a child’s sleep and overall well-being. Fortunately, physiotherapy provides effective strategies for managing and preventing growing pains. With the right guidance and interventions, growing pains can be effectively managed, allowing children to continue developing without long-term discomfort or pain.