Growing Pains – Are they fact or fiction?

Parents frequently hear their young soccer player’s knee pain is due to “growing pains.” I believe this is a misnomer. Growing, in and of itself, is not painful, nor does it directly result in pain. Physiologic consequences of skeletal growth can lead to a condition such as muscular imbalance that can secondarily become painful, but to lump painful knee conditions into the category of “growing pains” is inaccurate.

Knee pain among young athletes is commonly a result of trauma, muscular imbalance, growth plate irritation and overuse. Traumatic injuries are easily recognized as they are acute, and the source and mechanism of injury are observed. Muscular imbalance occurs as soccer players’ long bones grow faster than the surrounding muscles. This imbalance frequently leads to hamstring tightness. As a result, the patella and anterior knee are overloaded leading to pain. Growth plate irritation often occurs in active young athletes as well. This condition occurs due to overload of the growth plate at the top of the soccer player’s leg in the anterior knee. It results in a bump at the front of the knee. Finally, young athletes often experience overuse injuries, such as tendonitis. Patellar tendonitis and plica irritation are common examples.

Treating non-traumatic injuries usually begins with rest and ice. Muscular imbalance and tendonitis are usually treated with physical therapy and specific exercises and stretching. Growth plate problems are treated with rest and immobilization. Traumatic injuries are treated variably according to their type.

In conclusion, knee pain in the growing athlete is not due to growth alone. A specific diagnosis should be made and treatment directed accordingly. Lumping all sources of knee pain under the diagnosis of “growing pains” results in failure to provide appropriate treatment, which, in turn, slows down the athlete’s recovery time.

Power, Takeoff Speed and Agility

Speed is of great importance in most sports and especially soccer. Recovery from a stolen ball, breaking to a header, outrunning a defender to the ball and breaking to an open space all depend on explosive takeoff speed. Speed often defines a player and clearly distinguishes the exceptional player from the average one.

In a medical and physical sense, speed is the muscles ability to generate power. Maximum power and related maximum force are directly related to strength. Thus, strength is a major component of speed. Speed is also dependent on the stretch shortening cycle of the muscle and the ability of muscle to store elastic energy. This depends both on flexibility and neuromusclar interaction. Thus, speed is dependent on strength, flexibility and neuromuscular activation – all of which are trainable.

Speed training has evolved as medical science has isolated the essential elements of speed. This training involves specific strength base development and explosive power or plyometric training. Monitoring strength/speed progression allows for optimal improvement.

Along with speed, agility is a key factor in elite athletes. Agility is the ability to change direction at high speed and under control. This allows for speed to become more effective in attacking players. Agility is dependent on strength, flexibility and neuromuscular reaction time – all of which are trainable as with explosive speed development. Agility training is not ball dependent and can be trained off the field (i.e. the school gym, etc.).

Speed and agility are integral components in soccer performance. Strength gains, improvement in reaction time and in overall agility also help in injury avoidance and decreased injury severity. The agility to outrun or avoid a tackler or better withstand a blow are added benefits to speed/agility training. As soccer physicians, it is this dual benefit of improved performance and injury avoidance that is most exciting.

Adopting a Weight Training Program Key to Enhancing Performance

Weight training – also called strength or resistance training – not only can improve soccer players’ strength and athletic performance, but also can prevent injury.

What is weight training?

Weight training means adding resistance to your body’s natural movements to make those movements more difficult, and help muscles become stronger.

Benefits of weight training

Weight training increases fitness by:

  • Increasing muscle strength and endurance
  • Enhancing the cardiovascular system
  • Increasing flexibility
  • Maintaining the body’s fat within acceptable limits.

Weight training can be an important component of a fitness program, regardless of your age or gender.

Weight training equipment

You can use free weights or weight machines. Free weights are less expensive than weight machines and are more easily adapted to smaller and larger body types. Machines are safer than most free weights because the weight is more controlled. If you use free weights, select a set of barbells or dumbbells and a weight bench for the upper extremity and barbells for the lower extremities. For all lifting, remember to use a weight belt. Some people feel weight gloves offer better grip strength; however, they are not necessary. Good athletic shoes providing firm floor traction are a must.

Starting a weight training program

First, establish goals for your program. Decide if you want to obtain good muscular tone and cardiovascular endurance, to build muscle strength in a particular muscle group to improve sports performance, or to rehabilitate an injured muscle.

To improve muscle tone and cardiovascular performance, exercises should be done at least four times a week for approximately 20 to 30 minutes a session. You can take very short rest periods (30 seconds or less) between exercises. This program generally consists of 15 to 20 repetitions of an exercise for each major muscle group.

To build strength, exercise the muscle group that you want to strengthen until fatigued. This program incorporates fewer repetitions than circuit training. For example, do three sets of repetitions, but only 8 to 10 repetitions per set, with a longer rest period of 60 to 90 seconds between each exercise. This routine may be done every other day, but not as frequently as a circuit program because the fatigued muscles need longer to recover.

To rehabilitate an injured muscle, your program will be similar to the circuit training program of higher repetitions and lower weights. However, a rehabilitation program, unlike a circuit training program, focuses on working the injured muscle group.

An exercise professional, such as a certified athletic trainer, sports physical therapist, exercise physiologist or strength and conditioning coach, can help design a program suitable for your needs.


Always check with your physician before beginning a weight training program, particularly if you are over the age of 30 or have any physical limitations. If you have musculoskeletal problems, see an orthopedist to ensure that the program will not aggravate those problems.


To avoid injury when weight training:

  • Wear appropriate clothing
  • Keep the weight training area clean and free of debris
  • Stay well hydrated while lifting
  • Get adequate rest
  • Eat sensibly
  • Stretch after warming up, but before lifting
  • Always use a spotter when doing bench presses and squats
  • Lift with a buddy, whenever possible.