What people mean by growing pains
Growing pains is a catch-all phrase, not a diagnosis. Doctors use it for a specific and harmless pattern: aching in the muscles of both legs, typically the thighs, calves or behind the knees, coming on in the late evening or waking a child in the night, and completely gone by morning. It affects a large minority of children between roughly 3 and 12 years.
Parents, understandably, use the same phrase much more widely. Any ache in a growing child gets filed under growing pains, including knee pain in a 13-year-old footballer or heel pain in a netballer. That is where the phrase becomes a problem, because it suggests waiting it out is the answer when the pain is actually coming from training load.
Does growing actually hurt?
Not directly. There is no evidence that lengthening bone is painful, and children do not get growing pains only in the periods they grow fastest. What does happen during a growth spurt is that bones lengthen before muscles and tendons adapt to the new lever lengths, and growth plates at the knee, heel and hip are temporarily less tolerant of repeated pulling and impact.
So growth is not the pain. Growth is the reason the same training week your child managed easily six months ago now produces a sore knee or heel.
Telling growing pains from an injury
Looks like true growing pains
- Both legs, often changing sides night to night
- Muscles ache rather than one tender point
- Evening or night-time, gone by morning
- Walking, running and sport are normal
- Rubbing the legs and a cuddle usually settle it
Looks like a load-related injury
- One leg, one spot your child can point to
- Tender to press on a specific bump or bone
- Worst during and after running, jumping, kicking
- Limping, or avoiding activities they used to enjoy
- Worse in the weeks after a growth spurt or a busier fixture list
The pattern matters more than the intensity of the pain.
If it is load-related, what is it likely to be?
All of these respond to the same broad approach: keep sport in but reduce the highest-impact volume, then progressively rebuild strength and tolerance rather than resting completely and returning to a full week in one step.
- Pain on the bump below the kneecap, most often Osgood-Schlatter disease.
- Pain at the back or underside of the heel, most often Sever's disease.
- Pain at the lower tip of the kneecap, most often Sinding-Larsen-Johansson syndrome.
- Diffuse pain around the front of the knee on stairs and after sitting, often adolescent patellofemoral pain.
- Aching along the front of the shin after running on hard surfaces, often shin splints.
What to do about genuine growing pains
- Reassure. Knowing it is harmless and temporary changes how a child experiences it.
- Massage the aching muscle, a warm bath before bed, and a consistent bedtime routine all help.
- Keep them active. Restricting sport does not reduce night pain and costs them the benefits of being active.
- Check footwear is not worn through, particularly if they live in one pair of trainers.
- Keep a simple note of which nights it happens. A pattern that tracks busy training days points to load, not growth.
When to see a GP
The goal is not to worry families. It is to stop a manageable load-related problem being labelled as growing pains for six months while a young athlete quietly drops out of the sport they love.
Get it checked
One joint that is swollen, hot or stiff in the morning; pain in one spot that is getting worse week on week; a limp; night pain that is in the same place every time; fever, rashes, unexplained weight loss or tiredness; or pain that stops your child using the leg normally. None of these fit the growing pains pattern.