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‘Growing Pains,’ Is There Actually Such A Thing?

Parents frequently hear their children complain of aches and pains that affect their lower extremities. Some parents and even pediatricians attribute that to “growing pains.” But is there such a thing as growing pains? In this article we will take a look at some conditions that affect lower extremities in kids.

Sever’s Apophysitis

Sever’s apophysitis is a condition that affects children of the ages 8-14. Boys are more commonly affected than girls. Typical symptoms include pain in the back of the heel, which is worse with and after activities. The affected foot does not normally look any different than the unaffected foot. There is no noticeable swelling or bruising. X-rays also do not show any visible pathology.

Clinically, the patient will complain of pain when the heel bone is squeezed. Normally there is no history of trauma, however, trauma can also trigger this painful condition. Predisposing factors include high level of athletic involvement (doing more than one sport at a time), body weight, tightness of the calf muscles, flat feet and improper shoes (flip flops or flats).

Although Sever’s apophysitis is self-limiting, meaning that it eventually resolves by itself, it is best to have it evaluated and treated, as it may take a long time (months and, in some cases, years) until the symptoms go away.

Due to the intensity of symptoms, aggressive treatment is recommended and includes modification of activities, rest, ice, massage , anti-inflammatory medications, heel lifts in shoes, custom orthotics (inserts in shoes), calf stretches, and physical therapy. In severe cases, cast immobilization for 2-4 weeks is helpful. Overall, the prognosis for Sever’s apophysitis is excellent.

Iselin’s Disease

Iselin’s disease is inflammation of the growth plate of the fifth metatarsal base. Just like Sever’s apophysitis, Iselin’s affects physically-active children between ages of 8 and 14.

The most common sports leading to this condition include soccer, gymnastics, dance and basketball. Iselin’s apophysitis is an overuse condition of the base
of the fifth metatarsal. Tight calf muscles, high arch and flat foot type are predisposing factors.

Your child will complain of pain along the outer edge of the foot that is worse with activity and improves with rest. He/she may limp or walk on the inside of the foot.

The growth center may be enlarged, red, and painful to the touch as compared to the other side.

Treatments are similar to those of Sever’s apophysitis: modification of activities, ice, anti-inflammatory medications, custom orthotics, calf stretches, and in severe cases- cast immobilization.

Osgood-Schlatter

OSGOOD-SCHLATTER is a common cause of knee pain in children ages 10 to 15. It occurs due to a period of rapid growth, combined with a high level of sporting activity.

Osgood-Schlatter sounds far more frightening than it actually is. It is a common cause of knee pain in children ages 10 to 15. It occurs due to a period of rapid growth, combined with a high level of sporting activity.

These changes result in a pulling force from the patella tendon on the tibial tuberosity (bony protrusion at the top of the shin). This area then becomes inflamed, painful and swollen. Typical presentation includes pain over the tibial tuberosity, which is worse with and after athletic activities.

The area may become visibly inflamed and even larger in size than the unaffected side. Treatments include rest, ice, anti-inflammatory medications, quadriceps stretching, bracing (knee support knee strap to decrease tension on the patellar tendon) and physical therapy.

If you are at all concerned about your child, make an appointment today.

Did you know that June 1 was National Running Day?

Whether you take a leisurely jog or sprint to the finish line in a marathon, running is great exercise. In fact, running is one of the easiest and most popular sports among non-professional athletes.

Running offers many benefits, including improved cardiovascular and respiratory function, weight loss, reduced cholesterol and increased muscle and bone strength, as well as a healthier mental outlook. But with any sport or activity comes the risk of injury.

Runners of all levels are at risk for significant injuries to their hips, knees, legs, ankles and feet. One of the best ways to prevent injury is to avoid injury. By taking simple precautions and watching for signs of potential problems, individuals can prevent or minimize many injuries.

The majority of injuries are caused by excess — running too far, too fast or too often. In addition to strains and sprains, blisters and cramps, some of the more common injuries include:

· Hip and thigh injuries — Bursitis, stress fractures, and hamstring pulls or tears are typically caused by inflammation and strain from overexertion or
improper running techniques.

· Knee injuries — Patello-femoral syndrome, more commonly called “runner’s knee” is characterized by a dull ache or sharp pain under or around the  kneecap and is often accompanied by a grinding sensation when the knee is bent then straightened. Iliotibial Band (ITB) Syndrome can also produce inflammation and pain in and around the knee.

· Leg injuries — Shin splints or medial tibial stress syndrome is a cumulative but painful condition resulting from too much force being placed on
the shinbone (tibia) and surrounding tissues.

· Ankle injuries – Sprains vary in severity but typically result in pain, swelling and bruising. Achilles tendonitis is a painful inflammation in the back of the ankle, which if left untreated, can lead to a ruptured tendon.

· Foot injuries — Plantar fasciitis, which can cause sharp pain or a dull ache in the bottom of the foot near the heel or in the arch, is typically caused by poor foot structure, inadequate running shoes or a sudden increase in the distance run. Improper shoes and downhill running can also cause painful Runner’s toe.

The good news is that these injuries are treatable, but more importantly can be prevented or minimized by following some basic training guidelines and  running techniques.

Some tips to help you

Invest in a good pair of running shoes. Running in worn out shoes is a prime cause of many injuries. Make sure to replace them when you’ve logged about 600 kms.
Stretch regularly before and after you run to avoid tightening of muscles. Be sure to include stretches for the hips, thigh, hamstring, calf and ankle, as well as the back.

Perform warm up exercises such as light jogging or sprinting prior to engaging in a full run.

Include cross training in your overall exercise regimen to help strengthen a wide range of muscles. Consider activities such as weight-training, swimming,
calisthenics or those exercises that use muscles in slightly different ways.

Avoid overtraining – and overexertion. Doing too much, too soon and too quickly can lead to injuries. A good approach for beginners may be to start with a
run/walk technique, alternating thirty seconds of running with thirty seconds of walking for about twenty to thirty minutes, three times a week. Gradually,
increase the length of running segments while keeping them at a manageable pace.

· Stay hydrated especially in warmer weather. Drink at least 1 ½ cups of water 10-15 minutes before running and every 20 minutes during.
· Run on smooth, even and softer surfaces whenever possible. For example, asphalt roads are a better choice than concrete sidewalks.

· Watch for the warning signs of injury. If you begin to experience pain or swelling, stop running and seek medical attention. Depending on the type and extent of injury, treatment may include RICE – Rest, Ice, Compression and Elevation; taking anti-inflammatory medication (aspirin or ibuprofen); and taking time off from running.

– Seek professional advice from a Podiatrist if you are injured or have any concerns