Why Does My Child Get Knee Pain?

Foot health  •  Thu 5 Sep 2019

With the start of the spring/summer sports season rapidly approaching, it’s a common time for kids to start experiencing knee pain which can greatly reduce their ability to participate in their favourite sports.

So, it’s the perfect time to discuss children and knee pain and give you some advice on common childhood knee complaints.

There are many conditions that can be attributed to your child’s knee pain so here are just a few of the most common that we see every week in our clinic.

1. Osgood Schlatters

Osgood Schlatters is a condition that commonly affects adolescents with greater proportion of males compared to females.

This condition is usually seen after your child has gone through a growth spurt and is has recently increased their activity levels particularly in jumping and running sports.

Children with this condition commonly experience pain and swelling just below the knee cap where the knee cap tendon joins the shin bone (the tibial tuberosity).

Essentially what occurs in Osgood Schlatters is that tight thigh muscles are pulling excessively though the knee cap and knee cap tendon on the top of the shin bone which results in this area becoming inflamed, swollen and painful.

In advanced cases, Osgood Schlatters can be associated with tiny microfractures in the top of the shin bone.

Treatment options for Osgood Schlatters include:

• taping
• physical therapy
• icing
• foot orthoses to reduce load and abnormal movement at the knee.

2. Growing pain in the knee

Bones grow at a faster rate than the muscles so, as children experience growth spurts, this can mean muscles like the calf and thigh muscles can become tight and uncomfortable and refer pain to the knee.

Kids with growing pains typically experience generalised pain, often described as an ache that can be felt at night as well as during the day.

The best way to reduce this discomfort is regular muscle stretches, massage of the affected muscle and use of appropriate footwear.

3. Patella-Femoral Pain Syndrome

Patello-femoral pain syndrome can also result in knee pain.

In this condition, it is believed that the patella-femoral joint (where the knee cap sits over the thigh bone) becomes overloaded and/or the patella moves out of ideal alignment.

Commonly kids with patella-femoral pain syndrome will experience pain with activities that load the joint including jumping sports, stair climbing and squats.

Treatment for this condition is multifactorial includes

• footwear changes
• taping/strapping
• physical therapy
• muscle strengthening
• foot orthoses.

4. Biomechanical Problems

For some children, the way they move (their biomechanics) plays a large part in the development of knee pain.

When walking normally, the foot rolls in (or pronates) just after the heel contacts the ground. 

This is a normal part of our walking cycle that has evolved to help us to adapt to the variations in the ground underneath our feet. 

As the foot rolls in, the lower leg tends to rotate inwards until the middle part of our walking/ running cycle where the upper leg begins the rotate outwards.

This allows us to begin to swing the other leg forward.

However, if this rolled in foot position is maintained for too long or occurs too quickly, a twisting force can be created in the knee.

This twist at the knee, which is a joint that really only wants to bend, puts a lot of stress on the ligaments about the knee which can cause pain.

It is important to manage any abnormal biomechanical loading forces in the knee to ensure it is working in it's optimal function and allow for pain-free movement.

The Importance of Footwear in Knee Pain

One of the most important factors to consider if your child is experiencing knee pain is what sort of footwear they are using.

For example, does it provide adequate support and is it appropriate for the activities they are involved in?

The wrong types of footwear (unstable, poorly cushioned, inappropriate for a type of sport) can contribute to the wrong sorts of stress and load being applied to the knee joint which can cause pain.

Talking to one of our Podiatrists is a great way to get personalised advice about what types of shoes would be best for your child given their activity levels and the sports they are involved with.

Over Training Is Not Good for Children

Another important factor is how much activity/sport your child is participating in.

It’s a great idea to have your child participating in a range of different sports as it means they can activate and strengthen different muscle groups and develop a wider range of physical skills.

There is a lot of research that confirms kids who specialise in one sport too early rather than participating in a wide range of activities, tend to have a greater risk of injury and tend to burn out and leave sports altogether.

The best thing to do is to involve your children in a number of different types of sports and activities that help then to develop a wide range of physical skills and body strength.

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