Question: My son has been complaing of knee pain for the last 2 months, which is worse when he plays soccer. I think it is just growing pains but it doesn’t seem to be going away. Is there anything I can do to help?
A: With the winter sports season well under way, we tend to see a big increase in young patients with ‘growing pains’ that are beginning to interfere with their sporting activity. Two areas of pain that children often complain about are in the front of the knee, and in the heel. These are often known as Osgood-Schlatters Syndrome, and Sever’s Syndrome respectively.
Osgood-Schlatters is characterised by pain in the upper part of the shin bone, where the ligament from the kneecap (patella) attaches to the top of your leg bone (tibia). It is often associated with an obvious lump, redness and some swelling.
It is most common in children between the age of 9 and 15 and often occurs following a growth spurt. It is far more prevalent in active children, particularly those involved in running and jumping sports such as basketball, netball, volleyball, soccer and gymnastics and is more common in boys than girls.
Symptoms include redness and a lump over the top of the shin bone, pain with running, jumping and/or stairs and in severe cases even walking. It can occur on only one leg, or both legs simultaneously.
Treatment firstly consists of ice and relative rest from the aggravating activity. It may also be appropriate to talk to your Doctor regarding a course of anti-inflammatories to help settle the initial inflammation down. This should be followed by an appropriate stretching and strengthening programme that focuses on decreasing use of the front thigh muscles (quadriceps) and increasing the use of the other muscles around the hip. Often analysis and education of correct running and jumping techniques will help decrease loading on the knees, and not only help in a quicker return to activity, but also prevent the problem from reoccurring as well.
Sever’s is a relation to Osgood Schlatters however it affects the heel rather than the knee. It is characterised by localised tenderness over the heel, occasionally with an obvious lump, and difficulty with any activity that uses the calf muscles such as walking, running or jumping.
Treatment again consists of ice and rest, followed by an appropriate stretching and strengthening programme. Use of a heel raise will often help decrease stress on the heel in the short term while the pain settles, and enable an earlier return to activity.
Both conditions often settle within a few months with appropriate rest and treatment however severe cases have been known to continue for 1 – 2 years.
