by Feisal Zaw, Physiotherapist (Leeming clinic)
When your child complains of pain that won’t go away, it’s hard to know whether to wait it out or act. We see and treat patients of all different ages, and while plenty of injuries come with the territory of an active life, not enough is spoken about pain in children and adolescents: what causes it, what to watch for, and when to get it looked at properly.
Kids typically bounce back from aches and strains quickly, and as a result many parents don’t take formal action straight away. If a child has a sore knee after running around at school all day, it doesn’t necessarily mean alarm bells. But there are certain signs to look for when your child may need a bit more than an ice pack and a pat on the back.
Here, we look at red flags, common injuries we see in younger patients, and what parents can do to help prevent pain becoming a longer-term problem.
Red Flags To Look Out For
When it comes to pain in adolescents, red flags are the signs and symptoms we look for as physiotherapists to determine if something more serious could be contributing to an injury. If your child presents with any of the following, it’s worth seeking professional advice sooner rather than later.
Fever or sickness accompanying the physical complaint: A systemic response alongside localised pain can sometimes indicate infection or an inflammatory condition that needs medical attention.
Night pain. Pain that wakes a child from sleep is unusual. Movement-related soreness typically eases with rest, so pain that persists or worsens overnight is a signal worth investigating.
Intense pain on weightbearing: If your child is unable to put weight through a limb, or the pain is severe enough to affect how they walk, this should be assessed promptly — it may indicate a stress fracture or growth plate injury.
No clear cause or explanation: Pain that appears without any obvious injury or incident — no fall, no collision, no sudden increase in activity — warrants a closer look to rule out underlying causes.
Redness or swelling: Visible swelling or localised heat around a joint is the body signalling an inflammatory response. This goes beyond general muscle soreness and should be evaluated.
Common Complaints in Growing Bodies
Sport makes up a big part of the lives of Australian children. In growing bodies, bone, ligament and tendon structures may not yet have the strength to withstand the repeated physical demands of training and competition — and that’s when overuse injuries start to creep in.
Sever’s Disease (Calcaneal Apophysitis)
Sever’s disease is one of the most common causes of heel pain in active children, typically affecting those aged 8–14. It occurs when the growth plate at the back of the heel becomes irritated due to repetitive stress — most often from running and jumping. During a growth spurt, bones can grow faster than surrounding tendons, placing extra tension on the heel. It is not a true disease and is not dangerous, but without proper management it can become quite painful and limit a child’s ability to participate in sport. Physiotherapy focuses on load management, stretching, footwear advice and activity modification to allow the growth plate to settle.
Osgood-Schlatter Disease
Osgood-Schlatter disease causes pain and swelling just below the knee, at the top of the shin bone (tibial tuberosity). It is particularly common in adolescents going through growth spurts who play sports involving running, kicking or jumping — think footy, soccer and basketball. The quadriceps muscle repeatedly pulls on the growth plate in this area, causing irritation and sometimes a visible bony bump. While it usually resolves once growth is complete, physiotherapy can significantly reduce pain and keep young athletes training in a modified capacity during this period.
Lumbar Stress Fractures
Lumbar stress fractures (spondylolysis) are seen frequently in young cricketers, particularly fast bowlers, due to the repetitive extension and rotation demands of their action. Lower back pain in a young athlete that doesn’t resolve with rest should always be investigated. Early identification means early intervention, which dramatically improves outcomes and return-to-sport timelines.
Growth Plate Issues in the Hips
The growth plates around the hips are vulnerable in adolescents who are doing heavy loads of kicking, sprinting or jumping. Pain in the groin or hip that doesn’t settle with a few days of rest is worth getting assessed, as growth plate injuries in this region can be slow to heal without appropriate management.
Considerations for Parents
It’s important to consider how much sport your child is doing overall, and whether there are commonalities across these sports. This gives us a clue as to what physical structures may be getting stressed through overuse, and what injury management might include.
For example:
- Monday: Soccer – Running
- Tuesday: Footy – Running, kicking and jumping
- Wednesday: School Athletics Carnival – Running and jumping
- Saturday/Sunday: Soccer and footy game days – Running and jumping (extended periods)
This is an immense physical load for a growing body and is the kind of schedule we frequently hear from younger patients in the clinic. Unfortunately, we often don’t see these patients until the cumulative load is causing persistent soreness and pain.
Balancing activity with adequate rest and good nutrition is one of the most important things a parent can do to support a young athlete’s body. It’s not about doing less sport — it’s about being smart with load and recovery.
When To See A Physiotherapist
A good rule of thumb: if pain has been present for more than a week and isn’t clearly improving, it’s worth a professional opinion. You don’t need to wait until your child is limping off the field.
Book an appointment with us at Physio73 if your child:
- Has persistent pain lasting more than 5–7 days
- Is showing any of the red flags listed above
- Is modifying how they move to avoid pain (limping, favouring one side)
- Is withdrawing from activities they usually enjoy
- Has recently had a significant growth spurt and is doing regular sport
If your child has a worrying or recurring injury or pain, book an appointment at either clinic and we can help you work out what’s going on.
