Written by Rich Saxton
Helping children stay active, manage growing pains and enjoy sport with confidence.
Children and teenagers are naturally active, whether they are running around the playground, playing football, dancing, swimming or competing in organised sport. Being active is essential for developing strong bones, muscles and coordination, as well as supporting physical and mental wellbeing.
However, growing bodies can sometimes experience aches, pains and injuries, particularly during periods of rapid growth or when activity levels increase.
At Run Serve Health Physiotherapy, we help children and young athletes understand their symptoms, recover from injuries and build the strength and confidence they need to stay active.
A few of the common things I see in clinic are below.
Growing Pains
Growing pains are a common complaint in childhood, particularly in children aged 3–12. They typically cause aching or throbbing sensations in both legs, often around the thighs, calves or behind the knees.
Symptoms usually occur in the late afternoon or evening and may occasionally wake children during the night. Children are generally pain-free during the day and can continue their normal activities.
Despite the name, growing pains are not proven to be directly caused by growth itself.
What can help?
Gentle massage of the affected muscles.
A warm bath or heat pack, used safely.
Gentle stretching if it feels comfortable.
Monitoring symptoms and maintaining a balanced activity routine.
Persistent pain, pain affecting only one leg, swelling, limping or symptoms that occur during activity should not automatically be attributed to growing pains. These symptoms warrant assessment by a healthcare professional.
Osgood-Schlatter Disease
Osgood-Schlatter disease is a common cause of knee pain in active children and teenagers, particularly during growth spurts. It frequently affects those involved in sports that include running, jumping, kicking and rapid changes of direction.
The condition causes pain and tenderness at the bony prominence just below the kneecap, where the patellar tendon attaches to the shinbone.
Symptoms often become more noticeable during sport, particularly when sprinting, jumping, kneeling or climbing stairs. A visible bump below the kneecap may also develop.
How can physiotherapy help?
Treatment focuses on managing symptoms while allowing children to remain active where possible. This may include:
Temporarily reducing activities that aggravate the pain.
Strengthening the quadriceps, hamstrings and hip muscles.
Improving flexibility and movement control where appropriate.
Gradually rebuilding running, jumping and sporting activity.
Osgood-Schlatter disease usually improves as the child finishes growing. The aim is to manage symptoms effectively rather than automatically stopping all sport.
Sever's Disease (Heel Pain)
Sever's disease is a common cause of heel pain in physically active children, usually between the ages of 8 and 14. It occurs when the growth area at the back of the heel becomes irritated.
It is particularly common in children who play football, athletics, gymnastics, basketball or other sports involving repeated running and jumping.
Children may complain of pain at the back or underneath the heel, especially during or after activity. They might start limping, avoid running or find it uncomfortable to walk barefoot.
What can help?
Reducing running and jumping temporarily if they cause pain.
Gradually returning to sport as symptoms settle.
Appropriate calf strengthening and stretching where indicated.
Reviewing footwear and training loads.
Using heel supports if recommended following assessment.
Sever's disease is usually self-limiting, but appropriate management can help children remain comfortable and return to activity more confidently.
Patellofemoral Pain (Pain Around the Kneecap)
Pain around or behind the kneecap is common in active teenagers, particularly those who run, jump, squat or participate in court sports.
Symptoms may include a dull ache at the front of the knee, discomfort when climbing stairs, pain during squats or lunges, or stiffness after sitting for a long time.
There is rarely one single cause. Training increases, muscle capacity, movement patterns and changes during adolescence can all contribute.
How can physiotherapy help?
A physiotherapist can assess how the knee, hips and lower limbs work together, identify contributing factors and develop a tailored strengthening programme. Gradually increasing activity and improving strength can help teenagers return to sport without repeatedly aggravating their symptoms.
Ankle Sprains and Sporting Injuries
Ankle sprains are common in children who play football, rugby, basketball, tennis and other sports involving quick turns or changes of direction.
A sprain occurs when the ligaments supporting the ankle are stretched or injured. Symptoms can include pain, swelling, bruising and difficulty putting weight through the foot.
Although many ankle sprains recover well, returning to sport too early can increase the risk of repeated injuries.
A good recovery involves more than waiting for the pain to disappear.
Rehabilitation may include restoring ankle movement, rebuilding strength, improving balance and developing confidence with hopping, landing and changing direction. A gradual return-to-sport programme helps ensure the child is ready for the demands of their activity.
Significant swelling, severe pain, deformity or an inability to bear weight should be assessed promptly, as some injuries may involve a fracture or growth plate.
Muscle Strains and Overuse Injuries
Children who participate in several sports, train frequently or suddenly increase their activity levels may develop muscle strains or overuse injuries.
These can affect areas such as the hamstrings, calves, groin and hip. Symptoms may develop suddenly during a sprint or kick, or gradually over several training sessions.
Repeated loading without sufficient recovery can also contribute to bone stress injuries, which may present as increasingly localised pain during activity.
Prevention starts with sensible training habits.
Increase training volume and intensity gradually.
Include rest and recovery days.
Develop age-appropriate strength and movement skills.
Avoid repeatedly pushing through worsening pain.
Ensure adequate nutrition, hydration and sleep.
Persistent or worsening pain deserves attention, particularly when it begins to affect walking, everyday activities or sleep.
Why children's injuries need a different approach
Children are not simply smaller adults. Their bones, growth plates, muscles and tendons are still developing, and their physical capabilities can change considerably during adolescence.
A training programme that suits one child may not suit another of the same age. Growth rate, sporting experience, coordination, training demands and recovery all influence how a young athlete responds to activity.
This is why an individual assessment can be valuable when pain persists or repeatedly returns. The goal is not just to settle the current symptoms, but to understand what may be contributing to the problem and help prevent it from limiting future activity.
How can physiotherapy help young athletes?
At Run Serve Health Physiotherapy, we understand how important sport, exercise and physical activity are to children and their families.
Our youth athlete assessments are designed to look beyond the painful area. Depending on the child's symptoms and sporting demands, an assessment may include:
Understanding the history of the problem and training routine.
Assessing movement, strength, flexibility and balance.
Identifying factors that may be contributing to symptoms.
Providing a tailored rehabilitation programme.
Guiding a gradual and confident return to sport.
We work with children and parents to make rehabilitation practical, understandable and appropriate for the child's age and goals.
When should you come in and see us?
Not every ache requires treatment, but persistent pain should not be dismissed as growing pains or something children simply have to put up with.
Consider arranging an assessment if your child:
Regularly complains of pain during or after sport.
Starts limping or changes how they run.
Avoids activities they previously enjoyed.
Experiences recurring knee, heel, ankle or hip pain.
Has symptoms that are worsening or affecting everyday life.
Seek urgent medical advice for a child with a hot, swollen joint, significant pain with fever, an inability to bear weight, severe pain or a sudden major injury. Night pain that is persistent or worsening, unexplained weight loss or other systemic symptoms also warrant prompt medical assessment.
Helping your child stay active and confident
Physical activity should be a positive part of childhood. With the right support, many common activity-related conditions can be managed without unnecessarily stopping children from doing the sports they love.
The key is understanding the cause of the symptoms, adapting activity when needed and building back towards full participation safely.
Concerned about your child's aches, pains or sporting performance?
At Run Serve Health Physiotherapy in Wilmslow, we offer youth athlete assessments to help identify problems, guide recovery and support children in returning to the activities they enjoy.
Visit www.runservehealthphysiotherapy.com, call 01625 315 123 to find out more or book an appointment.