The other day Lil Sis had an early night, but two hours later she came pitter-pattering back down the stairs.
‘Growing pains woke me up, Mummy,’ she wailed, tears streaming down her face.
I gathered her up on the sofa and rubbed her sore legs until she fell asleep in my lap. But it got me thinking: she and Big Sis, who are seven and nine-years-old, often complain of aches along their shins and calves.
They call them growing pains because that’s what I called them when they first complained of the uncomfortable cramping sensation in their lower legs. And I called them that because that’s how MY Mum explained them to me when I suffered the same all those years ago.
OH claims never to have experienced them, but I still clearly remember how they only seemed to strike when I was lying in bed. It was similar to the discomfort of cramps, but without the muscle tightening – like a niggling toothache in my lower legs. Sometimes they’d just be a background distraction, other times they’d be so painful they’d have me twisting and turning in bed.
The girls both get them, but in fact, Big Sis gets hit the worst. She goes through stages where they assail her, night after night, until she’s an exhausted, sobbing heap. Sometimes a hot water bottle is enough to ease them away, other times I have to knead the aching muscles before she can collapse back into sleep.
I never really questioned what they were or why they occurred, because it made sense to me – if your bones were lengthening and all your muscles and ligaments and soft tissues were getting stretched, it seemed perfectly feasible that there might be some discomfort along the way.
But when I tried to look into it in greater depth, to see if there were other ways to help the girls, I discovered the wasn’t any greater depth. In fact, ‘growing pains’ were a bit of an enigma in the medical world.
Although they’re recognised as usually affecting the lower limbs of children aged between three and 12, little is really understood about these pains – in fact, some doctors aren’t even sure if they’re a real thing (although try telling that to my daughters when they’re literally in tears!).
The NHS website recognises growing pains – or ‘recurrent nocturnal limb pain in children‘ – but also acknowledges little is known about this uncomfortable condition that only strikes in the evening and nighttime, particularly after an active day. It lists the symptoms as ‘intense, cramp-like pain in both legs; they most often affect the calves, shins or ankles, but can also affect the thighs’.
While it doesn’t say what causes them, it does point out that they seem to be more common in active children, and those with loose, flexible joints (joint hypermobility), and that they also tend to run in families. Which makes sense, as my sister and I both suffered from them, and there’s hypermobility on both sides of our family (it’s actually one of the reasons I’m so accident-prone, as it affects my core stability and balance).
But as I researched more about it, I realised there simply hasn’t been enough research into growing pains to conclude what causes them. Funds are, understandably, kept for life-changing, or life-threatening medical issues. Which is the way it should be… but that still doesn’t help the girls when they’re suffering (or me when they crawl into bed with me in the middle of the night, crying in pain).
So what CAN we do?
The NHS recommends wearing supportive, securely fastened footwear. If growing pains do start, the advice is to try massage on the leg muscles, or applying heat to the sore areas. If the pain gets really bad, try paracetamol or ibuprofen – a little bit before bedtime may help your child sleep comfortably.
I try not to give the girls painkillers unnecessarily, so we always try heat pads or hot water bottles on their aching legs first. If that doesn’t help, I’ll get body lotion or oil and massage their legs to alleviate the cramps.
But is there any more I could, or should, be doing? To find out more, I approached osteopath Sian Smith, from the Bridge To Health Osteopathic Healthcare clinic.
If you’re not sure what osteopathy is, the NHS describes it as ‘a way of detecting, treating and preventing health problems by moving, stretching and massaging a person’s muscles and joints’.
It’s based on the principle that all the parts the human body have a very particular and precise way of working together, and if something isn’t quite moving or working the way it should, even the tiniest flow-on effect can decalibrate your body, resulting in discomfort and pain.
Osteopathy ensures all the bones, muscles, ligaments and connective tissue are moving and functioning smoothly and properly, improving and ensuring your general wellbeing.
I asked Sian what she knew about growing pains, and if she had any professional tips and tricks for treating them.
‘Growing pains is a general term for non-threatening limb pain in children,’ she explains, ‘and, unfortunately, they are poorly understood.’
Luckily, they’re ‘self-limiting’, she says, which means they only appear for short periods of time during a child’s growing years and don’t seem to have any lasting consequences. ‘But that doesn’t mean you won’t feel worried when your child wakes in tears at night, complaining of pain,’ she adds.
Addressing the ‘growth spurt theory’ Sian points out that the most drastic bone growth occurs between the ages of one and two years – when a child’s height typically increases by around 13cm – yet growing pains most commonly appear between one and five years, and eight and twelve years.
The most accepted theory now, Sian says, is that the muscles and other connective tissues are struggling to keep up with the growth of the bones, resulting in muscular cramps, spasm and fatigue.
Which fits in quite neatly with the thoughts of osteopath and Pilates practitioner, Andy Breakspear, from Breakspear Osteopathy and Pilates.
Andy has a special interest in the function of fascia, which he describes as: ‘the tissues in the body that act like a multi-layered wetsuit, giving our bodies form and holding us together’.’
Up until now, he says, fascia has been regarded by conventional anatomy as less important than the skeletal and muscle tissues; however, recent research has begun to reveal that, in fact, fascia is a vital and vibrant tissue rich in nerve endings.
‘Its health is essential in maintaining the overall structural balance and health of the body,’ Andy says. ‘It’s also been shown to be a source of pain if not kept healthy, or subjected to excessive stress.’
Which is why he has begun to wonder if the fascial tissues could be one cause – or possibly even THE cause – of growing pains.
‘Although there does not appear to be an exact correlation between rapid growth periods and an increase in growing pains, this early childhood stage is a time when there are dramatic changes in a child’s body, with growth and development of not only bones and muscles, but also the associated blood supply and lymphatic tissues as well as the associated nerves,’ he points out.
‘Could it be that with these changes – including bone growth – tensions are increased sufficiently in the fascial ‘network’ that pain can result, which becomes more noticeable when at rest?’
He uses an analogy of a tent with tent poles providing tension to the fabric: if the tent poles are swapped for longer ones then the fabric of the tent is placed under great stress and ‘micro-strains’ and tears can occur. But then the fabric stretches in response, and the tears stop forming.
So, what if our bodies react the same way? Our bones grow, increasing the tension in our fascia and creating pain; the fascia then responds by stretching, thereby releasing the pressure and relieving the pain.
While this process is occurring in all limbs, it’s possibly felt more regularly in the legs as they’re subjected to more weight and stress loading during the day, so the effects are increased. It’s widely accepted that growings pains can feel a lot worse after a particularly active day, so this would also make sense.
Andy is quick to point out that these thoughts are hypothetical – until we learn more about fascia it’s impossible to state categorically whether they’re to blame for these pesky pains.
Quite possibly it’s a ‘perfect storm’ of several things, as some medical professionals believe mechanical factors such as joint hypermobility and flat feet also contribute. There’s even evidence that certain birth factors may make a child more vulnerable to growing pains, such as a low APGAR score (a health and reaction test given to babies soon after birth) and low birth weight and/or length – possibly because of their effect on bone strength.
Other studies have detected a possible link to vitamin D deficiency, which can affect bone mineral density and reduce bone strength.
‘It’s therefore likely that – as with many conditions with no single clear cause – there are most likely a number of factors involved,’ Andy concludes, ‘possibly even including psychological ones.’
Sian also flags up a condition called Osgood-Schlatter disease, when an over-tight muscle tugs on the base of the kneecap, creating a tender lump. The condition is more common with athletic children and gets more painful with activity. More of an overuse injury than an actual disease, Osgood-Schlatter usually improves with rest and disappears once they stop growing.
So those are some possible causes, but what can we do to ease the discomfort of growing pains?
It seems like I’ve been on the right track, as Sian’s first recommendation is to use heat pads or hot water bottles to apply warmth to the aching muscles. ‘This helps by increasing blood flow to tight muscles, reducing tension and fatigue,’ she explains.
Warm baths can also have the same effect. ‘Whilst there is no official research,’ she adds, ‘many patients report the use of (bath) salts (believed by some to help restore deficient magnesium levels) as helpful in reducing limb pain – and it certainly won’t do any harm.’
She recommends keeping a diary of when the growing pains occur and noting down what your child did that day, so you can look for patterns. This way you can give them a bit of paracetamol or ibuprofen before bed, and proactively treat the pain before it begins.
She also says to make sure footwear is supportive enough, looking for trainers that provide support to the foot arch and the ankle, and can be firmly fastened with velcro or laces.
Stretching is another way to combat pain. ‘If your child is old enough, it is really worthwhile encouraging them to get into a good stretching habit following exercise,’ she recommends.
If they are still very young you can stretch the hamstring and calf muscles for them.
‘Additionally, a session with a manual therapist, such as an osteopath or physiotherapist, can help, as they can isolate tighter areas and stretch them accordingly.’
All are treatments seconded by Andy, who also recommends the use of massage, heat and gentle stretching to help ease fascial tension, and – hopefully – those growing pains too.
In fact, his clinic has a dedicated YouTube channel full of useful videos, designed to help with all manner of aches and pains, and Andy had selected the following two as being particularly helpful for growing pains.
So while we still don’t REALLY know what causes growing pains – or have a foolproof way of preventing them – I hope you’ve gained some tools and techniques to help alleviate the pain and discomfort, and get your little ones smiling again.
GROWING PAINS TREATMENTS
• make sure footwear is supportive
• stretch before and after exercise, and when pains strike
• apply warmth (try a hot water bottle or reheatable beanbag)
• take a warm bath, try adding magnesium salts to see if they help
• firmly massage affected areas
• administer paracetamol or ibuprofen
WHEN TO SEEK MEDICAL HELP:
Dr Juliet McGrattan – health expert, mum of three and author of Sorted: The Active Woman’s Guide to Health
‘I’d spent 16 years working as a GP but when my twelve-year-old was complaining of leg pain at night, I found myself telling him it was ‘just growing pains’ and then worrying the night away that it might be something more serious.
The term ‘growing pains’ is so vague and that’s really because we don’t know exactly what causes these common leg pains. In actual fact, the term is dubious as they don’t always coincide with a growth spurt at all. Lots of children get them and many don’t get them at all; they can be more common after a very active day, which was definitely the case for my son.
A few nights of achy legs is not a cause for alarm and it’s fine to give your child a dose of paracetamol if the pains are stopping them sleeping. If however the pains are still there in the morning or they are making your child limp, then they need to be checked by a GP.
Growing pains do not make your child unwell, so if they have a high temperature, don’t want to eat or are losing weight then again they need to be assessed, to rule out another cause of their leg pain. Similarly, there shouldn’t be any lumps, bumps or swelling with simple growing pains.
Do make an appointment with your GP if any of these things are happening because rarely, leg pains can be caused by conditions such as childhood arthritis and certain types of cancer and your GP can decide if any further tests are necessary.’
You might also like to read my ‘Top 10 Sneaky Fitness Hacks for Busy Mums‘.