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Bilateral leg pain in a 9 year old

Discussion in 'Biomechanics, Sports and Foot orthoses' started by markleigh, Mar 24, 2011.

  1. markleigh

    markleigh Active Member

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    I'm seeking some advice for my 9 year old son. He is a big boy both in height (1.55m) & weight (50+kg). He's had symptoms of Severs for several years & over the last 12 months probably increasing discomfort in a multitude of leg regions including Achilles, medial tibia, tibial tubercle & to a lesser extent thigh region. I have in the past diagnosed these as being related to his physical size, growth & underlying mechanical issues. Use of orthoses & at times strapping have helped but not as much as I'd expect/hope & normally see in my patients. He does not have other symptoms in the upper body. I'm becoming increasingly concerned that maybe something else is happening due to the lack of success with my treatment, even though examining his legs tonight his pain is all in classically strained areas. I have recently put him in new functional orthoses with minimal improvement. What am I missing? Is this consistent with some arthritic issues? Any other thoughts/suggestions greatly appreciated? From a concerned & confused father
  2. Mark maybe get some blood work done. Rule out some stuff, but my suggestion is get another Pod who you respect to assess your son. You should make sure you are not in the room. This may shed some new light on the problem that Dad and Son relationship is getting in the way off - just an idea might so your what have I missed thoughts.
  3. Ben

    Ben Member

    What sort of loads is your son doing also? And this question involves all organised sport, plus recess and lunch time plus school sport (pe) etc. Maybe go through and manage that stuff as well as foot orthoses too?!
  4. Foot Monkey

    Foot Monkey Welcome New Poster


    Considering his age, I would be concerned that he's had Sever's symptoms for several years as this is an atypical presentation - however in the larger child, very active it can occur. Where you go with this depends on the history (and family history).

    With him experiencing thigh pain, as with all children, the hip and back will need checking.

    If he is systemically well, this is good - and usually blood tests can be unhelpful - if you are thinking of a rheumatology problem, history is most important...non mechanical pain and diurnal occurance, swellings, extra articular features etc.

    If this is a mechanical problem (it could also involve a non-mechanical component) - rest should alleviate the problem and I would give this a fair try, if this doesn't reasonably reduce the pain to satisfactory levels, paediatric rheumatology is usually a good place to refer on, as they overlap/ have a good understanding of MSK/ orthopaedic conditions too.

    ...don't hang onto a problem that won't go away!

    Hope this helps
  5. markleigh

    markleigh Active Member

    Thanks all for your comments/suggestions. I don't think it's systemic as it's all lower limb, aggravated by physical activity & he has received relief in the past from orthotic control. The big thing I think I didn't appreciate was a friend/Pod who assessed him for me highlighting how tight he is in the lower extremity. Maybe another example of why we shouldn't treat our own family. She has put him on some solid stretching together with the nice "threat" that I'll be calling to see how you are going.
  6. bkelly11

    bkelly11 Active Member

  7. METaylor

    METaylor Active Member

    Get him checked for coeliac disease. Sounds to me as though he's not absorbing minerals properly and so minor musculo-skeletal strains that happen all the time in active people, are not repairing. Low zinc - white spots on nails, frequent infections, growing pains at night in primary age child, taste disorder so food tastes terrible, fussy eater. Low manganese and/or zinc - growth abnormalities and joint pains. The lower body is just where we do more damage as children - eg all kids have more scars on knees than on elbows. If he's overweight he's getting too many empty carbs which means not enough meat n vegies, the foods that are full of nutrients. Dr Margaret Taylor Adelaide South Australia - see my website for more info. www.drmtaylor.com.au

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