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.