Dealing with Growing Pains: Foot Health Tips for Children

Many parents have experienced the late-night wakeup call of a child complaining about aching legs or sore feet. These mysterious aches, commonly called "growing pains," affect up to 40% of children, typically between ages 3 and 12. While they're usually harmless, understanding what causes them and how to provide relief can make a significant difference in your child's comfort. This guide explores growing pains, related foot health concerns, and how proper footwear plays a role in keeping children's feet healthy and pain-free.

Understanding Growing Pains

Growing pains is somewhat of a misnomer. Research has shown that these pains don't actually correlate with periods of rapid growth, and bones growing don't cause pain. Instead, the current understanding is that these aches result from muscle fatigue, often after particularly active days. Children's muscles are still developing, and they may not have the endurance to fully recover from sustained activity.

The pain typically occurs in the late afternoon or evening, often waking children at night. By morning, the pain has usually disappeared completely. This pattern is characteristic of growing pains and helps differentiate them from other conditions.

Common Locations

Growing pains most frequently affect the front of the thighs (quadriceps), the calves, and the area behind the knees. Some children also experience aching in the feet, particularly in the arches or heels. The pain is usually felt in both legs, though it may be more pronounced on one side.

Notably, growing pains affect muscles, not joints. Pain specifically in the joints – knees, ankles, or toes – may indicate a different condition and should be evaluated by a healthcare provider.

Causes and Contributing Factors

Physical Activity

Active children are more likely to experience growing pains, particularly after days with more than usual running, jumping, or climbing. Sports practice, school physical education, and playground activities can all contribute to muscle fatigue that manifests as nighttime aching.

Flat Feet and Foot Structure

Children with flat feet or other foot structure variations may be more prone to leg and foot aches. When the foot doesn't have a normal arch to absorb shock, more stress is transferred to the muscles of the leg. This can lead to fatigue and discomfort, particularly after activity.

Hypermobility

Some children have naturally loose ligaments and joints, a condition called hypermobility or being "double-jointed." While generally not harmful, hypermobile children may experience more muscle and joint aches as their muscles work harder to stabilise flexible joints.

Poor Posture and Gait

How a child stands and walks affects how force is distributed through their body. Poor posture or gait abnormalities can put extra stress on certain muscle groups, contributing to fatigue and aching. Addressing these issues through awareness, exercise, or sometimes orthotics can help reduce discomfort.

The Role of Footwear

Proper footwear plays an important role in foot health and can help reduce growing pains and related discomfort. Shoes that provide appropriate support, cushioning, and fit help distribute forces evenly and reduce muscle strain.

Support and Cushioning

Shoes with good arch support help children with flat feet by providing external support the foot doesn't naturally have. Cushioning in the heel and forefoot absorbs impact forces from walking and running, reducing the workload on leg muscles.

However, it's important not to over-support developing feet. Children's feet need some freedom to develop strength and flexibility. The goal is appropriate support for your child's specific needs, not maximum support for everyone.

Proper Fit

Shoes that are too small can cause direct foot pain, while shoes that are too large make muscles work harder to control the foot within the shoe. Both situations can contribute to fatigue and discomfort. Regular fit checks ensure your child's shoes are still appropriate as they grow.

Activity-Appropriate Footwear

Using the right shoes for each activity helps reduce strain. Running shoes for running, court shoes for basketball, and cleats for soccer each provide specific support for those movements. Using school shoes for sports, or vice versa, doesn't give muscles the support they need.

Managing Growing Pains at Home

Massage

Gentle massage is one of the most effective ways to relieve growing pains. Rub the affected muscles with moderate pressure, using long strokes for larger muscles and circular motions for smaller areas. Many children find this comforting, and it helps relax tight muscles and improve blood flow.

Heat Application

Warmth helps relax muscles and can provide significant relief. A warm bath before bed can help prevent nighttime pain, while a heating pad or warm water bottle wrapped in a towel can soothe aches that wake your child at night. Never apply heat directly to skin, and supervise young children with heat sources.

Stretching

Regular stretching can help prevent growing pains by keeping muscles flexible. Focus on the calves, hamstrings, and quadriceps. Hold each stretch for 20-30 seconds without bouncing. Making stretching part of the bedtime routine can reduce nighttime pain episodes.

Simple stretches include calf stretches against a wall, sitting hamstring stretches reaching toward toes, and standing quadricep stretches holding the ankle behind the body. Make these fun by doing them together as a family activity.

Pain Relief Medication

Over-the-counter pain relievers like paracetamol or ibuprofen can be used for occasional severe episodes. Always follow age-appropriate dosing guidelines and consult your pharmacist or doctor if you're unsure. Pain relief medication isn't typically needed for regular growing pains managed with massage and stretching.

Specific Foot Conditions in Children

Sever's Disease

Sever's disease (calcaneal apophysitis) causes heel pain in active children, typically between ages 8-14. It occurs when the growth plate in the heel becomes irritated from repetitive stress. Unlike growing pains, Sever's disease causes localised heel pain that worsens with activity and is present during the day.

Management includes reducing high-impact activities, using heel cushions or cups in shoes, stretching the calf muscles, and wearing supportive footwear. Most cases resolve once the growth plate matures, but proper management prevents ongoing discomfort.

Plantar Fasciitis

While more common in adults, children can develop plantar fasciitis – inflammation of the tissue along the bottom of the foot. This causes heel and arch pain, particularly with first steps in the morning. Flat feet, rapid growth, and inadequate footwear support contribute to this condition.

Ingrown Toenails

Tight shoes and improper nail trimming can cause painful ingrown toenails. Trim nails straight across, not curved, and ensure shoes have adequate toe room. If an ingrown nail becomes infected or doesn't improve with home care, seek medical attention.

When to See a Healthcare Provider

While growing pains are common and generally harmless, some symptoms warrant professional evaluation. Consult your child's doctor or a podiatrist if your child experiences pain that persists into daytime hours, pain in joints rather than muscles, swelling, redness, or warmth in the painful area, limping or reluctance to walk, pain that doesn't respond to home management, fever or other signs of illness with the pain, or pain in just one leg consistently.

A healthcare provider can perform a proper evaluation to rule out other conditions and recommend specific treatments if needed. For ongoing foot concerns, a paediatric podiatrist specialises in children's foot health and development.

Building Strong, Healthy Feet

Beyond managing pain, focus on building strong, healthy feet that will serve your child well into adulthood. Encourage barefoot time in safe environments to strengthen foot muscles. Ensure adequate physical activity for overall fitness, but balance active days with recovery. Provide supportive, well-fitting footwear for all activities, and maintain regular foot health checks, especially during growth spurts.

By understanding growing pains and taking steps to support your child's foot health, you can help them stay active, comfortable, and pain-free through their growing years.