It’s common for active children and teenagers to complain of aches and pains, especially during growth spurts or busy sporting seasons. Parents are often told, “It’s just growing pains”, but in some cases, ongoing pain may signal an overuse injury rather than normal development.
Knowing the difference can help prevent minor issues from becoming long-term problems.
What Are Growing Pains?
Growing pains are a benign, non-injury-related condition commonly seen in children aged 3–12 years. Despite the name, they are not directly caused by bone growth, but are thought to relate to muscular fatigue and increased activity levels (Evans & Scutter, 2007).
Typical features of growing pains include:
- Pain in both legs (often calves, thighs, or behind the knees)
- Pain occurring in the evening or at night
- Pain that resolves by morning
- No pain during sport or daily activity
- No swelling, limping, or loss of function
Children with growing pains usually remain fully active and pain-free during the day.
When Pain Is More Likely an Injury
Pain is less likely to be “just growing pains” if it has features more consistent with a musculoskeletal injury, particularly in active children who train or compete regularly.
Red flags suggesting injury include:
- Pain on one side only
- Pain that worsens with sport or running
- Pain that persists during the day
- Pain causing limping or reduced performance
- Pain that does not settle with rest
- Localised tenderness to touch
Overuse injuries are common in young athletes due to repetitive loading of bones, tendons, and growth plates (DiFiori et al., 2014).
Common Injuries That Mimic “Growing Pains”
In active children and teenagers, pain is often related to training load rather than growth itself.
Common conditions include:
- Osgood–Schlatter disease (knee)
- Sever’s disease (heel)
- Bone stress reactions or stress fractures
- Tendon overload (e.g. patellar or Achilles tendon pain)
- Muscle–tendon junction overload
These conditions typically worsen with activity, unlike growing pains.
Why Active Kids Are More at Risk
Young athletes are particularly vulnerable to overuse injuries because:
- Their bones and tendons are still developing
- Training loads may increase rapidly
- Recovery between sessions may be insufficient
- They often play multiple sports simultaneously
Bone and tendon tissues adapt more slowly than muscles, meaning pain may appear after performance has already improved (Bennell et al., 1999).
When to Seek Physiotherapy Assessment
A physiotherapy assessment is recommended if your child:
- Has pain lasting more than 2–3 weeks
- Is missing sport due to pain
- Has pain on one side only
- Complains of pain during or after training
- Has recurrent pain each season
Early assessment helps identify whether pain is normal, load-related, or something that requires further investigation.
How Physiotherapy Helps
Physiotherapy for active children focuses on:
- Identifying the true source of pain
- Assessing strength, control, and movement patterns
- Managing training loads safely
- Reducing injury risk while keeping kids active
The goal is not to stop sport, but to support safe participation and long-term development.
Key Takeaway for Parents
If pain:
- Happens only at night and settles by morning → more likely growing pains
- Happens during sport, on one side, or affects performance → more likely injury
When in doubt, early assessment can save months of frustration and time away from sport. Our physios can help with these related conditions and appointments can be made here.
References
Bennell, K. L., Malcolm, S. A., Thomas, S. A., Reid, S. J., Brukner, P. D., Ebeling, P. R., & Wark, J. D. (1999). Risk factors for stress fractures in track and field athletes. The American Journal of Sports Medicine, 27(6), 810–815. https://doi.org/10.1177/03635465990270062101
DiFiori, J. P., Benjamin, H. J., Brenner, J. S., Gregory, A., Jayanthi, N., Landry, G. L., & Luke, A. (2014). Overuse injuries and burnout in youth sports. British Journal of Sports Medicine, 48(4), 287–288. https://doi.org/10.1136/bjsports-2013-093299
Evans, A. M., & Scutter, S. D. (2007). Prevalence of “growing pains” in young children. Journal of Pediatric Health Care, 21(4), 267–275. https://doi.org/10.1016/j.pedhc.2006.06.006
Read More….
For more information on Severs Disease, read our blog HERE
For more information on if weight training stunts growth in children, read our blog HERE
Fore more information on Osgood-Schlatter Disease, read our blog HERE