It's not a news flash that teens can have periods of rapid growth and pain. What might be interesting to know, is how this period of rapid growth combined with sports plays out in the school nurses office. A little background first, I serve a population of teenagers between the ages of 10-14 years old, in a district that has a thriving diverse sports program. Every sport imaginable. All year.
On occasion both male and female students have presented with possible growth related pain, however males more often then females. Often a student (and it's usually an athlete playing 1-2 sports each season) will come to the health office initially because they are sore. I see them walking down the health office hallway with an altered gait, usually limping and with an expression of pain on their face. Most times they can point directly to the area that hurts. It's almost never described as a general all over pain. Sometimes there is swelling, tenderness and redness present in the painful leg/foot.
Now here is where my job as a school nurse always gets interesting. Most adolescence (developmentally appropriate by the way) do not fully understand their bodies yet, and are not able to communicate that they attribute their pain to one thing or another. Usually the complaint is that they have a specific pain and have NO idea why. I then ask students some carefully thought out open ended questions, examine their painful lower extremity and then attempt to put the pieces together. I spend some time going over anatomy and growth of their body combined with the impact of sports. We talk about ways to decrease the pain and prevent further injury. I contact the parent and relate what I've observed through examination, observation and conversation. I recommend an appointment with a pediatrician and to delay their child's sports or impact related activities until then.
After students are seen by their pediatricians, the two common diagnosis' I see are Sever's (primarily the heel) and Osgood-Schlatter (primarily the knee/shin). Generally speaking both are related to growth plates in the bone and over or frequent/repetitive use of leg/foot muscles/tendons. The result being pain, swelling and irritation of one or both legs or heels. Typically the student is monitored closely by a pediatrician or orthopedic doctor and treated with ice, medication, rest and physical therapy. Sometimes, a temporary cast is needed as well. Recently I read this article by Sports Medicine Pediatrician Dr. Loud, in which he advocates for a varied sports experience to decrease the physical impact on a growing body, I find this to be an excellent prevention strategy. Balancing the health benefits of being a student athlete with an eye for moderation can help reduce some 'growing pains' and or injuries. I enjoy helping student athletes explore their symptoms and find the right medical resource so they may get back on track!