Growth of children
Naturally we are all glad when our children grow and thrive. Taking out the shoes from the previous autumn, only to find out they are much too small – we’ve all been there! Pants, jackets, sleeves, everything too short! Autumn is often the time for a growth spurt after children recharged their energy over the summer. But such a growth spurt can be really painful at times!
Our bones are not fully formed when we are born. In the course of embryonic development, a rod of cartilage turns into a structure containing the core of a bone at its centre. Bone substance is gradually formed from this primary bone core. The cartilage tissue is reduced, layer by layer, while bone is formed at the same time. Blood vessels later grow all the way to the ends of our bones (epiphysis).
A second bone core is then formed in the area of the epiphysis. Often, these secondary bone cores only fill the epiphyseal space at the time of birth.
The thickness and length growth of the bones is far from complete at birth. There is a cartilaginous space, the epiphyseal, between the epiphysis covered by articular cartilage and the bone shaft.
Subsequent lengthwise growth occurs at the epiphyseal at the ends of the bones. That is why it is also called the growth plate.
The growth plate turns to bone around the age of 20. Once the epiphyseal is closed, lengthwise growth stops.
The growth itself is controlled by the growth hormone STH (somatotropic hormone). This hormone is released up to the end of puberty.
An interaction between the growth hormone and the sexual hormones testosterone and oestrogen causes a growth spurt with the onset of puberty. This process slows as the level of the growth hormone decreases.
Children are always growing and that sometimes causes specific problems, notably growing pains.
Some children suffer from growing pains with dragging pain as early as 4 to 10 years of age. The attacks usually begin in the evening when the child should be sleeping. Interestingly children grow the most while they are sleeping because that is when the release of growth hormones is greatest.
Children tend to feel diffuse, dragging pain. Mostly the legs are affected, sometimes the knees. It is typical for these complaints, often described as dragging pain, to occur in the evening or shortly before falling asleep, only to disappear by the following morning.
The joints on the other hand are not painful. This phase lasts about two weeks. Then things normalise again for six months. The child’s mobility and sports activities are generally not restricted.
Generally this pain does not occur every night but around twice a week.
In case of growing pains, bone formation and growth as well as the development of tendons, ligaments and muscles should be supported, beginning in the toddler stage.
Typical for growing pains:
- The complaints do not occur during physical activity, but only at rest.
- They are frequently troublesome in the evening and at night, after children were active during the day.
- The night-time complaints disappear by morning.
- The pain mainly affects the long bones. Pain is felt in the area of the knee, along the lower leg, on the shin, calf and ankle.
- It does not always occur in the same place, sometimes on the left or right, sometimes both.
- The painful areas are not reddish or swollen.
- There is no chronic pain, but always phases that are entirely pain-free.
- Laboratory tests are negative.
Growing pains are always an exclusion diagnosis, meaning a thorough examination is required, possibly even with X-rays and a blood count. After all, the pain may indicate a serious illness (such as an infection, bone fracture, rheumatism or even a bone tumour).
Aside from bone growth, it is important to remember that connective tissue also has to be formed. The organs grow, and the tendons and ligaments have to keep pace with overall growth as well. Muscle cramps and joint pain may also occur.
Pain during growth may be caused by soft tissue growing more slowly than the bones. This puts strain on the periosteum during a growth spurt, causing pain. The muscles, tendons and ligaments also do not grow as fast when the body stretches at night and grows by 0.2 millimetres in one spurt. However, pain may also be associated with exertion during the day, the development of the nervous system, pain processing or hormonal influences.
Schuessler salts are important for physical growth of any form.
Around the age of 10, the hormone system also gets involved with the onset of puberty.
Sex hormones are produced and the thyroid gland may need support as well. This should be discussed with your doctor. All of these processes demand a supply of energy and powers of regeneration. Children may be sluggish and tired during this time.
Girls have their first menstruation and female curves soon become apparent. The entire metabolism is transformed and some girls respond with fainting spells or an increased need for rest.
In boys, the voice starts to break and facial hair begins to sprout. The figure changes. Many who look like young men on the outside are still insecure boys on the inside, grappling with themselves and the world. Adolescents may experience mood swings, feel offended more easily and lose their equilibrium more quickly. We are all familiar with these difficult times for adolescents and parents.
The use of deodorant increases as perspiration often starts to smell unpleasant. Pimples erupt on the face, greasy skin and hair result in a need for more frequent washing.
Adolescents who are active in sports usually complain of limb and bone pain on the heels and knee joints and become more prone to injury, spontaneous fractures or simply joint pain that can be precisely localised.
Some adolescents grow tremendously in length over a relatively short time. Growing pain also occurs in case of delayed growth. Puberty begins somewhat later in those affected, but then they catch up and reach their normal adult size.