Why is my Child experiencing knee pain?


Have you noticed your child has rapidly begun growing recently and is now complaining to you about knee pain? If so, keep reading as today we will discuss the 2 most common causes of knee pain in growing children and young teenagers.

As your child reaches puberty, growing is inevitable. However, some children grow at much faster rates than others. If your child is particularly active, has recently increased their number of sports, days of training, number of sessions or had inadequate recovery between training sessions all while having a rapid growth spurt, this provides the perfect storm for knee pain to present itself.

Why is this the case?

When a child has a growth spurt, bones like the femur in the thigh grow rapidly. However, muscles and tendons tend to grow at slower rates. This leads to an overactivity and stretching of the quadriceps muscle group and patella tendon which creates a traction or pulling force at the knee at susceptible growth plates. Bones do not grow from the middle of the bone. Instead, they grow from the ends of bones in areas known as growth plates. During childhood and adolescence, these growth plates are made of cartilage instead of bone. The cartilage is never as strong as the bone, so a sudden growth spurt can trigger the traction pulling force from the quadriceps and patella tendon which can irritate the cartilage and present as swelling and knee pain.

High training loads or sudden increases in training or the number of sports the child is engaging in can further load the knee by increasing the loading of the quadriceps muscle group, causing additional traction or pulling forces at the knee particularly in sports like soccer, basketball, AFL, netball, tennis and athletics which require lots of running, jumping and change of direction activities. High levels of loading create additional forces through the growth plates in the knee and left untreated can lead to more serious conditions like avulsion fractures.

There are 2 very common growth-related conditions which you should look out for in your child which affect 2 different growth plates in the knee. The growth plate at the top of the tibia (shin bone) (1) or the growth plate at the bottom of the patella (kneecap) (2).

1. Osgood-Schlatter Syndrome


2. Sinding-Larsen and Johansson Syndrome

Sinding Larson-Johannsson pain is found at the bottom of the patella (kneecap) at the proximal (top) end of the patella tendon whereas Osgood Sclatters point of pain is lower. The point of pain for Osgood Schlatters is below the knee joint where the distal end (bottom part) of the patella tendon attaches to the tibial tuberosity (top of the shin bone). This can present as a visible bump which can be seen when your child’s knee is bent. If your child has Osgood Schlatters they will almost always find kneeling very painful.

Why see a Physiotherapist?

A physiotherapist will be able to help settle your child/teenager’s symptoms through a variety of methods including taping, education, and load and pain management strategies.

For a long time, these 2 conditions were managed with ice and rest and the advice that they go away on their own when the child finishes growing. However, there is so much more that can be done to minimise your child’s frustration and time away from sport, better manage their pain and to use this time to become stronger athletes for the future. A structured strength and conditioning program will allow surrounding areas such as the hip abductors, glutes, hamstrings, adductors, calves and feet to be strengthened, improving lower limb biomechanics and reducing knee loading and pain. Guidance from a physiotherapist will also allow for the gradual implementation of quadriceps and knee-dominant exercises in a way that will not flare up your child’s symptoms, ultimately leading to less time on the sidelines and a happier child.

If your child is experiencing knee pain, give Ace Sports Clinic a call or book online.

By Olivia Skerman – Physiotherapist, Ace Sports Clinic