Growing Pains

By:  Robert H. Sheinberg, D.P.M., D.A.B.F.A.S., F.A.C.F.A.S.

Foot, ankle and leg problems in the growing child are often considered to be “Growing Pains” in the bone and muscles of the lower extremity.  While in a small number of cases this might be true, in a majority of the cases the pains that plague these children and teenagers may be caused by lower extremity malalignment problems. 


  • Excessively flat feet or feet that point to the outside. 
  • Children that are knock-kneed. 
  • Tight muscles, especially the calf, hamstrings and external rotator muscles of the hips.


  • Pain with activities, especially along the inside of the shinbone.
  • Premature fatigue with activity.
  • General avoidance of activity and sports.
  • Leg pain, especially at night.
  • Lower back pain.
  • Often associated with toe walkers. 

Many children who have been diagnosed with growing pains have primary causes that can be addressed with great success.  Many of these children are not able to keep up with their peers during activity due to pain and premature fatigue and ultimately this may affect their self-esteem.  They become more likely to sit at home and work with computers and are less likely to participate in sports.  Inactive children usually become inactive adults who may be overweight. 

It is critical to understand why these children or teenagers are having leg discomfort and not have the problem brushed off as growing pains.

Treatment may include:

  • Changing of shoe gear to add more support.
  • Physical therapy to decrease overall muscle tightness and to improve muscle strength, coordination and reaction time.
  • Custom molded orthotic (sole inserts) to realign the lower extremity.  In many cases this will almost overnight eliminate a lot of the leg pains that these children experience. 
  • Casting the leg to stretch the calf muscle may be needed.

Early identification of predisposing causes to these growing pains is important to the child and teenager’s overall health and wellness.