Growing Pains and Dietary Habits in Young Athletes: A Cross-Sectional Survey

Abstract

Background/Objectives: Growing pains are a common cause of recurrent limb pain in children, but their etiology remains unclear. Physical activity and nutrition are important factors for musculoskeletal health, but their specific relationship with growing pains has not been well established in young athletes. This study aimed to assess the prevalence of growing pains in child and adolescent athletes and evaluate their adherence to the Mediterranean Diet. Methods: A cross-sectional study was conducted with 916 athletes aged 8-17 years from sports academies in Alicante, Spain. Data were collected via an online survey assessing demographics, pain types, and adherence to the Mediterranean diet. Results: Self-reported pain was highly prevalent, affecting 78.5% of children and 93.5% of adolescents. Musculoskeletal and nocturnal pain increased with age, with nocturnal pain significantly more frequent in girls among children (p < 0.001). Additionally, 32.6% of children and 51.9% of adolescents had received a formal diagnosis of growing pains. Despite this, only 13.7% reported using analgesics, with no significant gender differences. Adherence to the Mediterranean diet was mostly moderate, with children reporting higher fruit and vegetable intake than adolescents, while adolescents consumed more healthy fats and carbohydrates, and participants without pain showed overall healthier dietary patterns. Conclusions: Idiopathic musculoskeletal pain is highly prevalent among young athletes, and their adherence to a healthy diet is suboptimal, challenging the assumption that physically active children maintain well-balanced diets. This underscores the importance of early nutritional education as a strategy to support musculoskeletal health and reduce pain in physically active youth.

Keywords: Mediterranean diet; dietary habits; growing pains; musculoskeletal pain.

Figure 1

Distribution of participants reporting pain by age group. Question 1 refers to musculoskeletal pain without an apparent cause, assessed by asking, “Do you feel pain or discomfort in muscles, joints, bones, or tendons, even if you haven’t had any injury or fall during sports?” Question 2 refers to nocturnal pain without an apparent cause, assessed by asking, “Do you suffer from pain in your arms, legs, or back without a known cause, especially at night?”, and Question 3 refers to diagnosed growing pains, “Has a pediatrician or doctor ever told you that you suffer from growing pains?”. The combined variable includes participants who responded affirmatively to at least one of the three questions. * p < 0.05, *** p <0.001. All comparisons were conducted using the Chi-square test.

Figure 2

Percentage of participants experiencing pain. Distribution of participants reporting pain classified by age group and gender. Question 1 refers to musculoskeletal pain without an apparent cause, assessed by asking, “Do you feel pain or discomfort in muscles, joints, bones, or tendons, even if you haven’t had any injury or fall during sports?” Question 2 refers to nocturnal pain without an apparent cause, assessed by asking, “Do you suffer from pain in your arms, legs, or back without a known cause, especially at night?”, and Question 3 refers to diagnosed growing pains, “Has a pediatrician or doctor ever told you that you suffer from growing pains?”. The combined variable includes participants who responded affirmatively to at least one of the three questions. * p < 0.05; *** p < 0.001; ns, non-significant. All comparisons were conducted using the Chi-square test.

Figure 3

Adherence to Mediterranean diet by age. Distribution of participants according to different adherence levels. Adherence was classified based on the KIDMED test score as high (≥8 points), medium (4–7 points), or low (<4 points). Data are presented descriptively without statistical significance analysis.

Figure 4

Dietary habit categories by age group and gender. Percentage of participants classified into different dietary habit categories based on their responses to the KIDMED questionnaire, stratified by age groups (A) and gender (B). Participants could be included in multiple categories based on their dietary responses. Data are presented descriptively without statistical significance analysis.

Figure 5

Mediterranean diet adherence and dietary habit categories and presence of pain. (A) Distribution of participants by adherence to Mediterranean diet, classified as high (≥8 points), medium (4–7 points), or low (<4 points) (A), and percentage of participants classified into different dietary habit categories (B). Data are classified based on KIDMED test and stratified according to whether participants reported pain or not. Participants could be included in multiple categories based on their dietary responses. * p < 0.05; **** p < 0.0001; ns, non-significant. All comparisons were conducted using the Chi-square test.