Young soccer players are always going and growing. It’s hard to know which aches and pains are serious, and which ones you can ignore.

Any serious athlete will look after his/her body. They will…

• Recover well
• Cross-train

… and do what they can to stay fit and healthy.

But injuries are inevitable in any sport. Athletes can only reduce the risk of the big ones, and weather out the small ones.

Some young athletes have the unique experience of growing pains. It’s not really an injury since they never seem to correlate with any activity. And although growing pains are harmless, they can feel quite severe.

When it comes to active young athletes, how do you know if an ache is a growing pain or something else?

What Are Growing Pains?

The thing is… no one really knows what growing pains are. Scientists have studied growing pains since the early 1800s and no one has definitively announced what causes them and why they happen.

People have educated guesses, though.

The most recent systematic review (to my knowledge) looked at 32 studies that have attempted to explain the phenomenon. Here are theories that have gotten the most attention thus far. ⁽⁴⁾

• Vitamin D insufficiency: repeated studies have been conducted to investigate this theory – either they’re onto something, or they’re going down the wrong rabbit hole.
• Genetics: there is strong evidence that links genetic susceptibility to growing pains.
• Psychological factors: one study found that a child’s reaction to past painful events will influence if the child will later experience growing pains (or will report that he/she is having them).

One study showed that most of their subject group (children) who had growing pains also had vitamin D deficiency or low levels. Of that group, a fourth had insufficiency or significantly low levels. ⁽⁶⁾ A different study went further: children with the lowest levels of vitamin D also had the most reported growing pains. After giving them a vitamin D supplement, their pain significantly reduced. ⁽¹⁾

*Please note that this is not a direct recommendation to give a youth player a vitamin D supplement if they have growing pains. Instead, ask your doctor if this is appropriate.

You have to wonder, though… Did the pain reduce because of the supplement, because the child was “supposed” to feel better and so they did (placebo effect), or because it went away with time?

Since we’re on the subject of a placebo effect and psychological responses, we may as well touch on the psychological factor behind growing pains.

Really, it comes down to fear and anxiety around painful adverse events. If someone is more fearful of feeling pain, they are more sensitive to painful events when they happen. Pain science is very interesting but also very complicated. Many of the studies revolve around pain experience and psychosocial influences.

However, it can get quite controversial when discussing psychosocial factors.

If you’re interested in reading more about the psychological responses to growing pains, you can check out the study. Please note that their conclusions pull from data and are not a reflection of personal beliefs. Research articles don’t sugar-coat things so that it delivers well. They just say what they find. Scientists who publish this type of academic research can sound harsh and cold, especially referring to emotional familial connections. Academic writing is just that way.

And yet, you wouldn’t think it would “go there” with a subject as light as growing pains. When something hasn’t been explained, scientists will look everywhere for the explanation.

Who Gets Growing Pains?

Growing pains occur in children and young teens, usually during a growth spurt, but not always. Less than 50% of children will actually experience them. Reported age ranges are 3-12 years old.⁽²⁾

The severity can range widely. Sometimes pain can come and go month to month, and other times it can be severe and occur frequently. The children who experience growing pains do not have any specific connection to a disease process or confirmed genetic predisposition. ⁽²⁾

It is rare, and likely near impossible, for grown adults to experience growing pains the way children do. Aches and pains in adulthood are likely from something else.

So, Growing Pains or Something Else?

We don’t know what causes growing pains, but we do know who gets them.

We also know what they feel like and how to differentiate them from other pains. However, doctors cannot definitively diagnose growing pains since there is no way to test for it.

If a young athlete is having pain and growing pains are suspected, there is criteria that pediatricians will use to help narrow down their clinical diagnosis. ⁽⁵⁾

Clinical Diagnostic Criteria for Growing Pains

• Intermittent pain, days with and without
• 1-2x per week, usually in the evening
• Joints unaffected
• Usually lower limbs along shins, calves, thighs, back of the knee
• Both legs hurt, usually simultaneously
• Resolved pain the following morning
• No signs of inflammation or obvious injury process
• Does not affect ability to play sport

This criteria is excellent to rule in the diagnosis. But, as a healthcare professional, relying on this alone can land you in some deep water. It’s best to also rule-out other possibilities that are of immediate threat.

Unofficial Criteria for “Something Else”

• Something happened which started the pain, a “mechanism of injury”
• Pain is constant
• Occurs everyday at some level of severity
• Joints are likely affected
• One limb hurts, sometimes both, but one more than the other
• Pain continues through the morning
• Pain is reproduceable: “it hurts when I do ___ every time”
• Inflammation and swelling are present
• Limping, sport avoidance
• There are other symptoms present (fever, stomach ache, headache, vomiting, etc)

If you can rule out that it’s “something else” and confirm the criteria for growing pains, you could have nothing to worry about.

If you suspect that it is something else or you’re not sure, best to head to the doctor to check it out.

How Can I Make Growing Pains Go Away

You cannot prevent growing pains since no one knows what causes it.

The only way to make it “disappear” is to go to sleep since it should be gone in the morning.

But if the pain happens to be pretty bad, here’s what has been shown to work:⁽³⁾

• Over the counter pain medication
• Heat and massage over affected area
• Stretching
• Assuring the player that it’s not serious

The main reason that heat, massage, or stretching may help is because it places a different stimulus on the area and distracts the brain from interpreting pain. You’re basically desensitizing the area to make it feel better.

Various pain medication may or may not help considering there’s no (known) inflammatory response, so it could be a placebo effect. But if it does work, it really doesn’t matter in the moment because it solves the problem. Just make sure the medication is appropriate before using it.

Assuring the player that the pain isn’t serious creates peace of mind. It decreases anxiety around the pain experience. This recommendation is to address the psychological factors regarding pain, which is especially important with hypervigilant athletes.

You could try vitamin D supplements, although the research isn’t all there, and you should probably talk to your doctor before starting any medication/supplement regimen.

Don’t Let Growing Pains Trick You

Some young athletes often experience growing pains, and it’s usually unavoidable. But, if growing pains do occur, they are nothing to worry about and tend to be easily managed.

It’s tricky to differentiate between growing pains and an injury with young athletes, especially if the pain becomes intense. There are ways to decode the symptoms.

Remember to refer to your doctor if you’re unsure about the condition.

Don’t let growing pains get in the way!

Referenced Citations

1. Insaf AI. Growing Pains in Children and Vitamin D Deficiency, The Impact of Vit D Treatment for Resolution of Symptoms. J Hea Med Nurs. 2017;39:80–85.
2. Kanta P, Gopinathan NR. Idiopathic Growing Pains in Pediatric Patients: Review of Literature. Clinical Pediatrics. 2019;58(1):5-9.
3. Lehman PJ, Carl RL. Growing Pains. Sports Health. 2017 Mar-Apr;9(2):132-138. doi: 10.1177/1941738117692533. Epub 2017 Feb 8. PMID: 28177851; PMCID: PMC5349398.
4. Pavone V, Vescio A, Valenti F, Sapienza M, Sessa G, Testa G. Growing pains: What do we know about etiology? A systematic review. World J Orthop. 2019 Apr 18;10(4):192-205. doi: 10.5312/wjo.v10.i4.192. PMID: 31041161; PMCID: PMC6475815.
5. Peterson H. Growing pains. Pediatr Clin North Am. 1986;33:1365–1372.
6. Vehapoglu A, Turel O, Turkmen S, Inal BB, Aksoy T, Ozgurhan G, Ersoy M. Are Growing Pains Related to Vitamin D Deficiency? Efficacy of Vitamin D Therapy for Resolution of Symptoms. Med Princ Pract. 2015;24:332–338.