tendon in children

Overview

Tendons are strong, flexible cords that connect muscles to bones. When a child has a tendon problem, it means these cords are irritated, inflamed, or injured, causing pain and sometimes swelling near a joint.

Yes. Active children often experience tendon-related pain, especially in the heel, knee, or elbow during growth spurts and sports.

It mainly affects growing children and teenagers who play sports, run, or jump regularly. Both boys and girls can be affected, though some conditions are more common in boys.

Symptoms

Common symptoms

• Pain near a joint or along a tendon line
• Swelling or tenderness over the tendon
• Stiffness, especially after rest or in the morning
• Pain during or after activity

Symptoms in children

• Pain at the back of the heel (Achilles area)
• Pain just below the kneecap
• Pain or tenderness on the inner side of the elbow (common in throwing sports)
• Limping or favouring one leg
• Pain that gets better with rest and worse with activity

Symptoms in older adults

• This article focuses on children. Tendon problems in older adults are usually related to age-related wear and tear and have different symptoms and care.

Causes

Main causes

• Repeated overuse of the same tendon during sports or activities
• Sudden increase in training intensity, duration, or frequency
• Tight muscles or tendons around a growing bone
• Patchy growth spurts that put extra stress on tendons

Risk factors

• Playing sports that involve running, jumping, or throwing (e.g., football, basketball, athletics)
• Training without proper warm-up or cool-down
• Using ill-fitting footwear
• Previous tendon injury or a family history of tendon problems

When to see a doctor

See a doctor urgently if:

• The child cannot move a joint or bear weight on a limb
• The tendon area is very swollen, hot, or red
• There is a visible gap in the tendon
• Symptoms continue for more than a week despite home care

Book a routine appointment if:

• Make an appointment with a GP or pediatrician if pain interferes with daily activities or keeps coming back
• Ask the doctor about seeing a physiotherapist or sports medicine specialist

Diagnosis

A doctor will ask about the child's symptoms, activity levels, and medical history, then examine the painful area. They may gently press on the tendon and ask the child to move the joint.

Tests that may be done

• In most cases, no tests are needed. If symptoms are unusual or severe, the doctor may recommend an X-ray to rule out bone problems, or an ultrasound scan to look at the tendon.

What to expect at your appointment

The appointment usually takes about 15 minutes. The doctor will explain what the problem is likely to be and recommend a treatment plan. They may refer the child to a physiotherapist or a specialist if needed.

Treatment

Treatment focuses on reducing pain and swelling, allowing the tendon to heal, and gradually returning to normal activity. It usually starts with simple home care.

Self-care at home

• Rest the affected area for a few days — stop the sport or activity that causes pain, but keep the child gently moving for daily tasks unless it hurts
• Apply a cold pack or ice wrapped in a cloth for 10–15 minutes several times a day to reduce swelling
• Elevate the affected limb when possible to help swelling go down
• Encourage a gentle stretching routine once the severe pain settles — a physiotherapist can guide this

Medical treatments

A doctor or physiotherapist may recommend a structured exercise programme to strengthen the tendon and surrounding muscles. They may also suggest over-the-counter pain relief (only if appropriate for the child's age) and temporary supports like a splint or heel pad. Steroid injections are rarely used in growing children and are not a first-line treatment.

When is surgery considered?

Surgery is rarely needed for tendon problems in children. It may be considered if the tendon is torn or if symptoms do not improve after months of supervised rehabilitation.

Living with this condition

Help your child stay comfortable by keeping the painful area rested during flare-ups, but avoid total rest for more than a few days. Gentle movement helps the tendon heal. Keep note of which activities trigger pain and adjust them.

Lifestyle tips

• Encourage a balanced training plan with rest days between hard sessions
• Make sure the child wears supportive, well-cushioned shoes for sports
• Teach the child to warm up before exercise and cool down after
• Help the child maintain a healthy weight to reduce stress on tendons

Diet and exercise

A balanced diet with plenty of fruit, vegetables, protein, and calcium supports muscle and tendon health. Regular, varied exercise — not just one sport — helps keep tendons strong and flexible.

Mental health and emotional wellbeing

Being unable to play sports can be frustrating for a child. It may help to talk openly about their feelings and plan alternative activities they can enjoy while recovering, like swimming or cycling if pain allows.

Prevention

Many tendon problems can be prevented with regular, age-appropriate training, good technique, proper footwear, and enough rest between hard sessions. Not every problem is avoidable, but these steps lower the risk.

Screening programmes

There is no routine screening test for tendon problems. If your child has persistent symptoms, see a doctor for an assessment.

Complications

If left untreated

• Chronic pain that lasts for months or recurs
• The child may stop performing daily activities or avoid sports altogether
• A partial tear can become a complete tear if the child keeps training through pain

Long-term outlook

With proper care, most tendon problems in children improve within a few weeks to a few months. Many children return to full sports without any lasting problems. Being patient and following a gradual rehabilitation plan is key.

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