All issues > Volume 20(12); 1977

Original Article

J Korean Pediatr Soc. 1977;20(12):953-958. Published online December 31, 1977.

Study on the Correlation Between Hyperextension of the knee Joints and Growing Pain.

Hee Woo Yang¹

¹Department of Pediatrics, College of Medicine, Seoul National University, Korea.

Abstract

Children who complain growing pain are not rare at our outpatients clinics. The causes of growing pain have been variously suggested due to poor sleeping posture, strenous exercise and muscular strain, etc. Hyperextension of the knee joints, however, has never been implicated as the cause of growing pain. To study role of hyperexntension of the knee I producing growing pain, the author surveied 3,174 children, aged from newborn to 18 years, for angles th knee joints. The angle of the nee joints was measured arbitrarily as following: when th line connecting between the greater trochanter of the femur(A) and the lateral condyle of the femur(B) passes the malleolus of the fibula? the knee joints angles were measured as 0degrees. Angles obtained by the anterior hyperextension of B-C was recorded as positive, and the posterior flexion of B-C as negative. The measurements were performed while the examinee lied on a flat table with their knee joints fully extended by the assistance of the examiner The children who had history of serious trauma or surgical operation in the leg, and bone, joint and neuromuscular diseases were excluded from the study. One who had experienced growing pains during the period six months preceeding the day of examination was classified as positive for growing pains. All children were classified in the age groups. The frequencies and mean+/-S.D. of the knee joint angles of various age groups in boys and girls are shown in Tables 1 and 2, respectively. These revealed that the mean knee joint angles of children positive for growing pains are significantly greater(p<0.01)in degree of hyperextension compared with those negative for growing pain as well as children as total age group. The number of children who experienced growing pains was four-fold greater than that of those who had not growing pain in the children with the hyperextended knee joints greater than 1 S.D. from the mean angle of the age group(Table 3). Conversely the number of the children who had not growing pains was tuenty-seven-fold greater than that of those who had growing pains in the children with the angle of the knee joints within 1 S.D. from the mean of the age group(Table 4). In questionnaires either children or their parents answered the knee as the main location of the pains in 48.7%, and the thigh in 37.9%, and the calf in 19.8%. More than 95% of the children with growing pain complained them at night or in the evening. Concerning the severity of the pains, 83.6% of the children said the pains were mild and endurable, in 11.2% sleeping was disturbed, and 5.2% complained of severe pains. Most of the children with growing pain considered rest and/or hot or cold compress was all that needed to relieve the pains. In the children with growing pains, 70.7% answered that the pains developed around the days of strenous physical exercises, and in 28% its developmentn had no relation to physical exercise. Although many of the children who experienced growing pains were physically active at the same time, hyperextension of the knee joints seems to be the single contributory factor of the growing pains and strenous exercise causing greater weight bearing to the hyperextended knees of these children.

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