14 Jan Knee Pain In Kids: A Parents’ Guide
Learning that your child has started to experience knee pain – or having them deal with persistent knee pain that won’t go away – can feel concerning for any parent. As parents ourselves, we absolutely understand. You want to know why it’s happening, what you and your child should be doing (and avoiding) to help, and you’d like to know if it could be something serious that needs urgent attention – or even if it’s worthwhile getting them seen by their podiatrist or doctor.
First – we completely agree that your child should not be limping, grasping their knee in pain, or unable to keep up with their friends on the sports field or during social outings. If your child’s symptoms don’t sound or feel right, trust those instincts. While this is not a replacement for an in-person consultation, today we thought we’d share some common reasons for knee pain in kids that our podiatrists see and treat, including what you can do to help.
Common Causes Of Knee Pain In Children
Let’s start by going over the common causes of knee pain in kids. Here are a few you should know about:
Knee Pain During The Day and Night: Growing Pains (Osgood Schlatter’s)
When we hear about knee pain that persists both day and night, one of the problems we’ll always investigate is growing pains. Specifically, a type of growing pain called Osgood Schlatter’s Disease that affects the knees.
Don’t worry about the term ‘disease’ – Osgood Schlatter’s is a temporary, growth-related condition that typically occurs in growing children, usually between the ages of 7 and 15. It is especially common in active children who engage in sports involving running, jumping, or rapid changes in direction, such as soccer, basketball, and gymnastics. Boys are slightly more likely to develop Osgood Schlatter’s than girls, though this may be due to their tendency to experience growth spurts at different ages.
Osgood Schaltter tends to develop because a child’s bones, muscles, and tendons grow at different rates during periods of rapid growth. As the quadriceps muscle pulls on the kneecap (patella), it creates tension on the patellar tendon, which attaches to the tibial tuberosity – a vulnerable area of bone just below the knee where the growth plate is located. This repeated pulling can lead to inflammation and pain at the growth plate, particularly during physical activities. Over time, the body may respond by laying down extra bone at the site, which can result in a visible or palpable bump on the shin just below the knee.
The pain caused by Osgood Schlatter’s often worsens with activity, particularly movements that place strain on the knees, such as running, squatting, kneeling, or climbing stairs. In some children, the pain may be accompanied by swelling or tenderness around the affected area. While the pain usually subsides with rest, it can sometimes linger during the night or when the knee is pressed against a surface, making it uncomfortable for children to kneel or sleep on their side.
It’s important to note that Osgood Schlatter’s is not permanent. While it can disrupt a child’s daily activities, it typically resolves once the child’s bones have matured and growth has slowed. Unfortunately, it’s difficult to predict if this will take weeks, months or years, hence why many parents seek treatment to help accelerate their child’s recovery and the resolution of their symptoms.
Patellofemoral Pain (Runner’s Knee)
Patellofemoral pain occurs where the patella (kneecap) meets the top of the femur (thigh bone) – hence the name patellofemoral. It is often referred to as ‘runner’s knee’ because it is often seen in runners. Still, it can actually affect anyone of all ages and activity levels, including our kids. Pain is typically felt at the front of and around the kneecap, occurring as an overuse injury where the kneecap moves out of alignment as the knee bends and straightens, damaging the joint.
We help children overcome runner’s knee by understanding what is causing their patella to mistrack and solving this. For example, it may be a tight or imbalanced muscle, alignment problems with the lower limbs, or their running technique. As this knee pain has similar symptoms to other causes of knee pain, such as patellar tendonitis, it’s important to have your child assessed and diagnosed so the best course of treatment can be started.
Knock Knees (genu valgum)
Knock knees, medically known as genu valgum, occur when a child’s kneecaps are positioned close together while standing with their ankles a regular distance apart. This inward alignment can cause the knees to turn toward one another, making them more likely to knock together during walking or running. While knock knees can sometimes occur without causing pain, they are also a potential source of discomfort and knee pain in children.
Pain associated with knock knees may arise due to the uneven distribution of forces across the knee joint. The inward angle places added strain on specific structures within the knee, resulting in inflammation, discomfort, or fatigue during physical activity. Children may also experience associated symptoms, such as tripping and falling more frequently, which can lead to additional injuries or discomfort.
In younger children, knock knees are often part of normal development and tend to improve naturally as the legs straighten by the age of six to seven. However, when pain is present or the inward alignment persists beyond this age, it may indicate a structural or functional issue that requires attention. Persistent knock knees can contribute to abnormal wear and tear on the knee joint, increasing the risk of ongoing pain or degeneration over time.
It’s important to note that knock knees can sometimes be asymmetrical, with one knee more affected than the other. This uneven alignment can place additional stress on one side of the knee joint, leading to localised pain or discomfort. In these cases, the misalignment may also impact other joints in the leg, such as the hips, ankles, or feet, creating a broader pattern of discomfort.
Parents should monitor any pain or difficulties associated with their child’s knock knees, including signs such as swelling, limping, or changes in walking patterns. If the pain is persistent or interferes with daily activities, booking in with a podiatrist is recommended.
Knee Pain Caused By The Hips
It often surprises parents to learn that their child’s knee pain may be caused by their hips—specifically, weaknesses or imbalances in the muscles around the hip joint. This connection occurs because several hip muscles, such as the gluteus medius, play a critical role in controlling the position and movement of the knees during activities like walking, running, and jumping.
When these hip muscles are not strong or balanced enough to provide proper support and alignment, the thigh can rotate inward abnormally. This inward pull changes how forces are distributed through the knee joint, placing extra strain on the knee structures, including the kneecap. Over time, this strain can lead to pain and discomfort in the knees, especially during physical activities.
Pain caused by hip muscle weakness can manifest as discomfort around the front of the knee, beneath or around the kneecap, or on the inner or outer sides of the knee, depending on which areas are under increased stress. You may notice that your child struggles more during activities that require stability or balance, such as climbing stairs, squatting, or running, as these movements demand greater control from the hips to keep the knees properly aligned.
This type of knee pain is more common in very active children or those with rapidly growing bodies, as growth spurts can temporarily disrupt the balance between muscle strength and coordination. In some cases, you might also notice other signs, such as a noticeable inward collapse of the knees during movement, which is a visual indicator of a lack of hip muscle control.
Recognising that the source of your child’s knee pain may actually stem from their hips can feel unexpected, but it highlights how interconnected the body is. Booking in with a podiatrist to help address these underlying factors is essential for understanding the root cause of the pain and ensuring your child can move comfortably and confidently in their daily activities.
Signs Your Child Should See A Podiatrist
Having knee pain that persists, is aggravated by activity, and comes and goes without ever truly resolving is the biggest sign for us that something is going wrong with the knee, and that a podiatric assessment is needed. This is because pain never happens for no reason – it is our body’s warning sign that something is going wrong and that damage is either occurring or that it will if left unmanaged. Other signs include:
- Knee problems are interfering with your child’s ability to do the things they love
- The knee feels weak or like it is giving out
- Limping and the knee not being able to support your child’s weight
- The kneecap feels like it is sliding out of place
- Stiff, restricted knee joints that don’t get better after two days
- A popping or clicking sound from the knee that causes pain
- The knee is swollen, and you’re not sure why or the swelling isn’t easing
If you have previously been told that nothing can be done for your child’s knee pain, or the cause has been uncertain or undetermined, we’d like to invite you into our clinic for a second opinion with our trusted, experienced health professionals.
You can book your appointment with our podiatrists by calling us at 06 370 4057 or using our online booking system here.