By Physiotherapist Jacky Balfour
If you have children who play sport they may from time to time complain of aches and pains – or with kids just being kids – get injured.
Often these problems will settle over a few days, but if your child complains of persistent pain around the knees or heels this may suggest an underlying condition. These may include:
- Chondromalacia Patella
- Osgood-Schlatters
- Sever’s Disease
The terminology can sound quite scary, but they are all quite common conditions that I regularly see as a physiotherapist in sport-playing children. Let me explain a little more about each condition.
Chondromalacia Patella – Pain at the front of knee / in the knee cap
This is a condition that produces pain around the front of the knee in the knee cap or patella area. There is often a feeling of ‘grating’ or ‘grinding’. It is aggravated by walking downstairs, squatting, impact sports and sitting for prolonged periods with the knee at or beyond 90 degrees of bend. It is more common in girls especially in their early teens and younger.
It is caused by a softening of the cartilage on the under surface of the patella that leads to inflammation and irritation between the patella and the femur (thigh bone).
It can be due to over-training, over-loading, biomechanical issues, muscle weakness or imbalance.
Osgood-Schlatters – Pain at front of knee, below the knee cap
This condition is characterised by pain at the front of the knee below the knee cap. The tibial tuberosity at the top of the tibia (shin bone), often becomes enlarged as well as painful. It is aggravated by sports that involve running, jumping and kicking, walking downstairs and kneeling. It is more common in boys in their early teens and younger.
It is caused by the pull of the quadriceps (thigh) muscle and tendon acting on the tibial tuberosity which is a growing point or growth plate on the bone and this then becomes irritated and inflamed. This is known as an epiphysitis.
Again, over-training, over-loading, biomechanical issues and muscle imbalance can contribute to the problem. Stretching can be important in the management of this condition.
Sever’s Disease – Pain or swelling at the back of the heel bone
This is a condition characterised by pain and often swelling at the back of the heel bone. It is aggravated particularly by sports that involve running and jumping. It is more common in boys in their early teens or younger.
It is caused by the pull of the calf muscles and the Achilles tendon acting on the heel bone at the growing point or growth plate and this becomes inflamed. Like Osgood-Schlatters it is an epiphysitis.
As with the two conditions mentioned above, over-training, over-loading, biomechanical issues and muscle imbalance may contribute to the problem. Stretching can play an important role in managing the condition.
What to do when your child complains of aches and pains
As well as the conditions mentioned, there are numerous other conditions and injuries that can produce pain around the knees or heels. If you have a child who is complaining of pain in these areas and it is not settling it is useful to seek the advice of a physiotherapist.
We will look at the demands of their sport and training regime and assess:
- Possible biomechanical issues
- Joint mobility
- Muscle strength, balance and tightness.
These problems can usually be corrected with appropriate physiotherapy treatment, advice and exercises. If necessary we can liaise with your child’s coach to discuss training modifications. They generally all resolve with time and do not cause permanent problems into adulthood.
Are you concerned about your child’s aches and pains? Please contact myself Jacky, or my physiotherapy colleagues Tracey or Jehan at the Waldegrave Clinic on 020 8943 2424 and we will be happy to help.
JACKY BALFOUR, PHYSIOTHERAPIST, WALDEGRAVE CLINIC
