Thursday, August 11, 2022

What Causes Knee Pain In A Child

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Any impact injury causing swelling, redness and pain, should be checked out by a physician. Use ice packs to reduce swelling and use your best judgement regarding your childs injury to determine if a visit to the ER is warranted. When in doubt, practice RICE: Rest, Ice, Compression, and Elevation.

Clear signs of when to see a specialist for your childs knee pain include the following:

  • Fever
  • Pain that lasts over 2 weeks
  • Pain in the morning

Knee Pain In Children: Causes And Treatments

When your child complains of knee pain, it is important to know the cause. Knee pain in children can be due to growth something normal and does not require any medical intervention but it could also be due to excessive training or use, an imbalance in muscle strength and flexibility, or Osgood-Schlatter disease .

Here we explain the different causes of knee pain in children, when to see a doctor, and the different treatment options.


What Are The Signs & Symptoms Of A Knee Injury

The signs and symptoms of a knee injury depend on the cause. Most knee injuries cause pain. A knee injury may also lead to the knee feeling weak, “giving way,” or “locking.” Someone with a knee injury might not be able to fully bend or straighten the knee. The injured knee may be swollen or bruised.

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How Are Anterior Knee Pains Treated

Rest and changing the types of activity your child is doing are important and may control the pain. A physiotherapist can teach your child exercises to correct the imbalance in their muscles, advise about suitable activities and guide your childs gradual return to full activity. Surgery is rarely necessary.

Doing the specific exercises given by your childs physiotherapist is important and this needs to be done regularly.

Other helpful measures may include:

  • Cold or heat packs
  • Simple pain relief
  • Short periods using anti-inflammatory drugs
  • Taping or knee supports

Treatment For Knee Pain In Children:

8 Signs Your Childs Knee Needs To Be Examined :: Nationwide Children

If your child has severe injury, you may notice the following in your child:

  • You child is unable to walk or put his/her weight on the knees.
  • You child may experience extreme pain and the knee often look deformed
  • Your child may encounter numbness near the knee region.

The thumb rule to give your child some relief is to follow RICE rule:

Rest: Allow your child to take rest so that you can protect the affected area from the pressure.

Ice: Apply a cold pack of ice on the affected area to minimize the swelling. Keep applying the ice till the swelling becomes less intense. Once the swelling comes down apply the heat compress to the same affected area. Do not apply the ice pack or heat pack directly over the skin.

Compress: Wrap the swollen area with the elastic bandage that can reduce the swelling. Do not wrap the bandage too tightly as this may increase the swelling.

Elevate: Use pillow or cushion to keep your knee elevated while putting compression.

If your child is experiencing the extreme pain, drugs such as Ibuprofen, Aspirin, and Naproxen can be consumed for the immediate relief.

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What Are The Causes Of Anterior Knee Pain

Normally the kneecap slides smoothly along a groove in the thigh bone. In some children, the knee cap rubs against the side of the groove causing irritation and pain. This can be caused by imbalances in the muscles around the knee. Some muscles that support the knee joint may be weak, while other muscles are tight and inflexible.

For example, the quadriceps muscles, at the front of the thigh, may need strengthening to hold the knee-cap in the right position. Sometimes anterior knee pain can be due to problems with the shape of the bones in the legs when the child stands and walks.

Who Gets Knee Pain Or Runners Knee

Prolonged pain in the front of the knee, known as anterior knee pain, is common among active, young athletes and is more common in girls.

Ways to prevent knee pain include:

  • Wearing shoes appropriate for specific sports or activities
  • Stretching before physical activity
  • Stopping any activity that increases pain in the knee
  • Limiting training accordingly

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What Is Anterior Knee Pain

When your child’s kneecap doesn’t move properly or rubs against the lower part of the thigh bone, it can cause anterior knee pain, or pain at the front and center of the knee. Anterior knee pain is also referred to as runner’s knee, jumper’s knee, patellofemoral syndrome, chondromalacia patella and patellar tendonitis.

Your child’s kneecap is positioned over the front of the knee joint. When your child bends or straightens their knee, the underside of the kneecap glides over the other bones that make up the knee. The patellar tendon and quadriceps tendon help your child’s kneecap attach to their shin bone and thigh muscles .

Anterior knee pain can indicate many different problems, including:

  • Chondromalacia of the patella softening or breakdown of the tissue under the kneecap
  • Inflammation of the patellar tendon, where the kneecap attaches to the shin bone
  • Inflammation of the quadriceps tendon, where the top of the knee cap attaches to the thigh muscles

How Is Knee Pain In Teens Diagnosed

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Your healthcare provider will ask about your teens knee pain:

  • Is there a known cause for the knee pain does it happen with certain movements or is there no specific known event?
  • How long has the pain been present?
  • Where on or around your knee do you feel pain?
  • Does the pain wake you up at night?

Your provider will perform a physical exam, checking:

  • Kneecap and knee stability.
  • Alignment of lower leg, kneecap and thigh.
  • Range of motion of hips and knees.
  • Thigh muscle strength, flexibility, firmness.

Your provider may order imaging tests including X-rays or a CT scan or MRI .

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Diagnosis Of Knee Pain In Kids

According to Dr. Mark Halstead, a sports medicine specialist at the St. Louis Childrens Hospitals, parents should not neglect all the knee pain conditions in their children as simply growing pain. While growing pain is common in children aged 5-6 years, a teen or pre-teen can suffer from serious knee injuries, particularly if the child is active in physical sports.

According to Dr. Halstead, children who are involved in active sports like running and football or in multiple sports are more susceptible to knee injuries. Stretching your knees before play or keeping ice on the knees after play can be useful techniques in preventing knee injuries.

Usually, parents can figure out a knee injury, although not specifically, and provide first aid till they rush their little one to the hospital where a thorough diagnosis is later made by the doctor. Read on to know how you and the doctor can provide treatment for knee pain in kids.

Can Knee Pain In Teens Be Prevented

Most knee pain that is caused by injury or overuse can be prevented with some attention and work by your teen, including:

  • Make sure your teen wears proper shoes for the activity/sport and wears knee pads and leg guards . Replace worn out footwear and gear.
  • Engage in muscle strength training exercises. Check with a trainer to make sure proper form and body alignment are being followed. Always do warm up and cool down exercises before and after workouts.
  • Keep your muscles flexible by proper stretching exercises or yoga.
  • Dont engage in activities that cause or worsen knee pain.

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Infection In The Knee

Bacterial infection in the knee may result in conditions such as osteomyelitis and septic arthritis.

In neonates and infants, the symptoms are nonspecific, which may include irritability, refusal to walk, or limited spontaneous movements of limbs.

Whereas in older children, symptoms such as swollen and painful joints associated with effusion, functional impairment, tenderness, and local warmth .

Physiotherapy For Knee Pain In Children

Causes Of Knee Pain In Children,Treatment &  When To See A Doctor
  • Alignment of the lower leg, kneecap, and quadriceps
  • Knee stability, hip rotation, and range of motion of knees and hips
  • The kneecap for signs of tenderness
  • The attachment of thigh muscles to the kneecap
  • Strength, flexibility, firmness, tone, and circumference of thigh and hamstring muscles
  • Tightness of the Achilles tendon and flexibility and position of the feet

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When To Call A Doctor For Knee Pain In Child

Children mostly hurt their knees when they fall while playing. Home remedies, pain killing medications, sprays, and ointments may work well in many situations.

Doctors visit is essential under the following conditions:

  • If your child experiences severe pain around the knee area.
  • Severe swelling and redness around the knee
  • A feeling of stiffness, tenderness, or warmth around the knee.
  • A popping sound when your kid got injured.
  • If the pain lasts throughout the day even after using medication, and home remedies.
  • If the pain is interfering with the normal activities of the child
  • If the child experiences the signs of stiffness, and weakness near the knee.

In conclusion, knee pain may pave the way for many long term problems if not treated properly at the right time.

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Causes Of Knee Pain In Children That May Be Cause For Concern

Aside from knee pain in children due to growth, the causes listed below may be a sign of an underlying condition or knee wear from sports activity .

Knee injuries

Knee pain in children can also appear from an injury . If your childs knee shows the following symptoms, it is best to seek professional advice:

  • If the knee cannot support the weight of the body.
  • The kneecap seems out of place and cannot be fully moved.
  • It creaks when moving.
  • There is swelling and the knee locks up.

Knee infection

Bacterial infection in the knee can lead to conditions such as osteomyelitis and septic arthritis .

In newborns and infants, symptoms are nonspecific, such as irritability, refusal to walk, or limited spontaneous movement of the limbs .

While in older children, symptoms such as sore and swollen joints are associated with effusion, functional impairment, tenderness, and swelling .

Juvenile arthritis

If the child shows signs such as pain, inflammation, stiff joints and fatigue , it could indicate the onset of an autoimmune disease known as juvenile arthritis. The most common type of arthritis in children is called juvenile idiopathic arthritis. Juvenile arthritis can generally affect more joints than the knee, such as the ankle, elbow, wrist, and fingers.

Osgood-Schlatter disease

Jumpers knee

Jumpers knee is a painful knee condition, where accumulated stress on the patellar tendon causes tears in the area .

Soft tissue injuries of the knee

Patellofemoral syndrome

Quadricep tendonitis

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What Causes Knee Injuries

Kids and teens may injure a knee in a fall or accident. Active and athletic kids might have overuse knee injuries. These happen when someone trains too much or makes repetitive motions involving the knee.

Common knee injuries in kids and teens include:

  • sprains: when a ligament stretches or tears for example, an anterior cruciate ligament or medial collateral ligament tear
  • strains: when a muscle or tendon tears part or all of the way
  • tendonitis: when a tendon gets irritated or inflamed, usually from overuse or poor training
  • meniscal tears: when the cartilage between the upper and lower leg bones tears
  • fractures: when a bone breaks
  • dislocation of the patella : when the kneecap slides out of place
  • inflammation of the tendon that attaches the kneecap to the shinbone

  • Osteochondritis dissecans: when a small piece of bone in the knee loses blood supply and breaks off
  • bursitis: swelling of one of the fluid filled sacs that cushion the knee.

What Are The Symptoms

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Anterior knee pain usually affects both knees, although one side can be worse than the other. The pain is usually described as a dull ache which gets sharper with activity. The pain is made worse by activities that involve bending the knee. This includes walking up and down stairs, skiing, or any activity involving squatting, sitting or kneeling. Your child may also complain of stiffness, especially after long periods of sitting.

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Soft Tissue Knee Injuries

Symptoms: Soft tissue knee injuries are also common in physically-active kids since its the result of excessive pressure on the knee muscles, ligaments and tendons.

When to consult a doctor: If your kids knee condition worsens, you may consult your doctor. But soft tissue knee injuries may be treated with ice packs, bandage compression, elevation and rest.

What Is Anterior Knee Pain Commonly Known As Runner’s Knee

Teenagers who participate in sports often develop an achy pain in the kneecap. This prolonged pain in the front of the knee, called anterior knee pain, is fairly common in young athletes and is typically aggravated with physical activity.

This condition is also known as patellofemoral pain, chondromalacia of the patella or “runner’s knee” and is due to abnormal tracking of the kneecap.

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Tips To Prevent Knee Pain In Kids

  • Make sure your child does proper warm-up exercises before doing any physical activities or sports. Hamstring stretch and Quadriceps stretch can help then finishing up with relaxing exercises.
  • Provide your child with the proper sports shoes to support them during any physical activities.
  • It is best to avoid any physical activity that requires too much knee bending like running upwards. This helps reduce any pressure on the knees which could lead to an injury.
  • For overweight children, it may help to avoid any knee pain if they lose weight to reduce excessive pressure on their knees.

This article was first published in theAsianparent.

What Problems Will Occur


The knee can sometimes look swollen however the anterior knee pain will not usually cause any structural damage. In most cases it is safe for your child to continue their regular physical activity. Anterior knee pain usually disappears completely when your child stops growing, or changes their activities for a period of time.

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When Should I Get My Teens Knee Pain Evaluated By A Healthcare Provider

Make an appointment to see your healthcare provider if:

  • Your teens pain has lasted longer than two weeks or anytime theres an increase in pain level.
  • Your teens knee is red, swollen or warm to the touch.
  • Your teen cant put weight on their leg they limp.
  • Your teens knee locks and cant move.
  • Your teens kneecap feels like it slides out of place or the knee looks twisted.
  • Your teen has knee pain during or after activity.
  • Theres painful popping or clicking sound in your teens knee.
  • Your teens knee doesnt have strength or full range of motion.
  • Your teens pain wakes them up at night.

Last reviewed by a Cleveland Clinic medical professional on 04/30/2021.


Causes And Treatment For Knee Pain In Children

Knee pain may indicate a number of issues. Here are some of the most common causes.

1. Growing Pains

What causes growing pains is not clear, and there is no evidence that child’s growth is painful. Some experts believe that growing pains are linked to restless leg syndrome, but it may also happen due to overuse from activities such as climbing, running and jumping during the day.

Symptoms: The most common symptom is throbbing feeling in the legs. The pain usually occurs in the calves, in the front of the thighs or behind the knees. Some children also experience headache or abdominal pain during episodes of growing pains.

Treatment: While there is no treatment for these pains, they improve on their own within a couple of years. Even if they do not go away, they become less painful after the first year. Massaging your child’s legs may help ease some discomfort.

2. Jumper’s Knee

Kids that play sports with lots of jumping and squatting may overuse the patellar tendon, which results in the development of Jumper’s knee. Excessive squatting puts serious pressure on the patellar tendon and causes injury to the fibers of the tendon. This leads to inflammation and pain. Abnormal alignment of the lower limbs may be a cause of Jumper’s knee. It means that kids who are flat-footed or knock-kneed may develop this condition.

Doctors may also prescribe anti-inflammatory medicine to reduce knee pain in children. Your child may even have to wear knee straps and sleeves for support.

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Knee Pain In Children: Part I: Evaluation

Dr Wolf has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.

Pediatr Rev

Michael Wolf Knee Pain in Children: Part I: Evaluation. Pediatr Rev January 2016 37 : 1824.

Clinicians who evaluate knee pain must understand how the history and physical examination findings direct the diagnostic process and subsequent management.

After reading this article, the reader should be able to:

Obtaining a thorough patient history is crucial in identifying the cause of knee pain in a child . For example, a history of significant swelling without trauma suggests bacterial infection, inflammatory conditions, or less likely, intra-articular derangement. A history of swelling after trauma is concerning for potential intra-articular derangement.

A report of warmth or erythema merits consideration of bacterial infection or inflammatory conditions, and mechanical symptoms should prompt consideration of intra-articular derangement.

Nighttime pain and systemic symptoms are associated with bacterial infections, inflammatory conditions, benign and malignant musculoskeletal tumors, and other systemic malignancies. A history of rash or known systemic inflammatory conditions, such…

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