We often think of knee pain as something for adult “weekend warriors” who overdo it or for older adults with arthritis. But knee pain also hits teens and preteens who are active in sports.

“Knee cap pain is one of the most common problems I see in teens and preteens,” says Mark Halstead, MD, sports medicine specialist at St. Louis Children’s Hospital.

He says knee pain in that age group can be from overuse, an imbalance in muscle strength and flexibility, or from Osgood-Schlatter disease, a growth-related disease.

“Pain from Osgood-Schlatter disease is very specific,” Dr. Halstead explains. “It’s an irritation of the growth area that causes pain just below the knee cap where a bony raised area usually develops. The bones grow fast but the muscles don’t always keep up. The pain is very localized and the area is tender to the touch. Treatment can help though so don’t just wait for your child to grow out of it.”

Parents shouldn’t shrug off knee pain as “growing pains” either, Dr. Halstead cautions. “Too many kids are over-labeled with growing pains. A first or second grader may have real growing pains that cause them to wake up at night but that’s not a diagnosis that should be given to a teen or adolescent. It’s important to get to the real cause of the pain.”

Dr. Halstead says sports that include running and jumping most frequently cause general knee pain. “Kids who play on multiple teams or multiple sports at the same time are more prone to knee pain. They may need to take activity down a notch for awhile. Our goal as sports medicine specialists is to help children continue to participate in sports but in a safe and pain-free way.”

Treatment Keeps Kids in the Game
To treat overuse pain, it’s important to stretch before exercising and to ice the knees after playing sports. A strap may be used to take pressure off the area. “Medications aren’t usually helpful for knee pain, although anti-inflammatory medications may reduce the pain of Osgood-Schlatter disease,” Dr. Halstead says. “But sometimes rest is needed. Physical therapy may help too, depending on the cause of pain.”

Playing sports can result in more serious knee injuries such as a torn ACL (anterior cruciate ligament). “Girls are more susceptible to tearing their ACLs because of the way they jump and land — their knees tend to buckle inward,” Dr. Halstead explains. “Through physical therapy, we can retrain girls to jump more appropriately to avoid injury. We also focus on strength training for the hips and thighs to better protect the knees.”

When to Get Knee Pain Evaluated

  • If pain lasts longer than two weeks
  • If pain affects performance
  • If pain causes limping
  • If the pain is all the child thinks about while playing a sport
  • If a knee injury occurs

“It’s important to listen to pain and don’t blow it off,” Dr. Halstead says. “No one should be forced to play through pain. Don’t pop ibuprofen to mask the pain. A child’s pain should be evaluated to get to the root of the problem.”


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