Children go through a lot of changes while they are growing up, especially physically. Bodies are getting taller because of bone and muscle growth, but sometimes the tendons and ligaments that connect muscles to bones, or other bones to each other respectively, have a hard time keeping up. This is because they are made of a different type of tissue than muscles, which does not allow them to stretch as well as muscles. But what does this mean for your child?
As stated above, tendons are responsible for attaching muscles to the bones in your body, at an insertion spot called an “enthesis”. For example, your biceps muscle inserts into a bone in your forearm, called the radius, and is responsible for bending your elbow to make that iconic “biceps muscle”. There are many spots around the body where muscles insert via a tendon into bones; but what does that have to do with the pain your child is experiencing?
Your child may have told you that they were experiencing a lot of pain in their knee(s) or pain in their heel(s) recently and went to the doctor for help; now they have a diagnosis of Osgood-Schlatters and/or Sever’s Disease. But what do these names mean? While the mechanism of the condition is the same, Osgood-Schlatter’s occurs at the knee,
and Sever’s occurs at the heel; the patellar tendon attaches to the tibia, and the achilles tendon attaches to the calcaneus, the heel bone. These conditions cause pain and swelling at the tendon insertion points (apophysitis) at the knee and heel, respectively, causing the tendons to pull at the growth plates at each of these points. But why is this happening?
These conditions are only seen in children that are growing and undergoing growth spurts; in essence, your child is growing at a rate so fast that the tendons that attach the muscles to the bones cannot keep up with the growth rate and size of the bones. The ten
dons are essentially becoming over stretched and pull on the growth plates, which are not fused at this point in an adolescent’s life. These conditions are most common in young athletes that involve jumping/sprinting/running, because these movements heavily load the knee and ankle joints.
Luckily for you and your child, there are a lot of options to help! Physical therapy is a great way to help manage and alleviate the pain that your child is experiencing. What treatment would involve is soft tissue mobilization, motor control work, neuromuscular rehabilitation, offloading, and many other techniques. Depending on the sport or activity your child does, a physical therapist can help design programs specific to that sport or movements that they need to perform.
If you have any questions or inquiries about pediatric/youth physical therapy, please call us or email us over at Restorative Physical Therapy so we can help your child feel stronger and more confident in their body!