What should you know about growing muscle pain?

Children may describe a dull ache in the calves, thighs or behind the knees after a busy day. The symptoms can be intermittent, affect both legs and be gone by morning. Muscle soreness after unfamiliar activity may improve as the body recovers, but the term growing muscle pain should not hide a more specific problem. Pain at the bump below the knee can occur with Osgood-Schlatter Disease, and pain at the heel can occur with Sever's Disease; both need assessment when symptoms persist or affect activity.

Let the child rest from the activity that provokes symptoms, then return gradually as comfort allows. Gentle calf or thigh stretching, light massage and warmth can be soothing when the muscle is not injured. Encourage fluids and regular meals, and check whether new shoes, a training change or a recent illness preceded the pain. Track the side, location, timing, activity and morning movement. Never massage a swollen, hot or acutely injured area; seek advice instead.

Arrange a review if pain is one-sided, lasts into the day, repeatedly limits activity or comes with stiffness, weakness or a change in walking. Prompt care is appropriate for fever, swelling, redness, warmth, marked tenderness, unusual bruising or persistent night pain. Go to urgent care after a serious injury, for sudden severe pain or when the child cannot use the limb normally.

Is this muscle soreness or does the location suggest a joint, tendon or growth-area problem? When can activity restart? Would an examination or physiotherapy help? What symptoms should we record before follow-up?