Causes of Knee Pain in Kids

11 May

Knee pain accounts for at least one-third of musculoskeletal complaints in the pediatric
population seen in healthcare clinics, including chiropractic offices. This is especially common
in active children during the growth spurts of early adolescence. Let’s review some of the most
common causes of knee pain in kids and teens and how they are typically managed.
Patellofemoral pain syndrome, or kneecap pain, is the most common cause of knee pain
in children and adolescents. Pain typically arises from behind the patella and worsens with
activities involving knee flexion, such as climbing stairs, squatting, or prolonged sitting. On
examination, pain may be reproduced with a single-leg squat, often with inward knee collapse.
Treatment includes both weight-bearing and non-weight-bearing exercises targeting the posterior
hip and quadriceps. Manual therapy and movement retraining may be used to restore normal
joint mechanics. Treatment may include a foot orthotic if excessive ankle pronation is
contributing to pain.
Osgood-Schlatter disease (OSD) is inflammation of the growth plate at the tibial tubercle
just below the kneecap, often producing a prominent bump that can irritate the patellar tendon
during running, jumping, squatting, and kneeling. Treatment typically includes patient education,
activity modification, exercise therapy, and use of an infrapatellar strap. Sinding-LarsenJohansson syndrome is similar to OSD but involves the bottom of the patella rather than the
tibial tubercle. Management follows a similar approach.
Patellar tendinopathy, or jumper’s knee, results from cumulative microtears due to
repetitive jumping, landing, and sprinting. Management includes reducing high-load activities
(while avoiding complete rest), gradually reloading the tendon as symptoms improve, and
performing strengthening and flexibility exercises for the quadriceps and hamstrings. Manual
therapy and biomechanical corrections may also help improve loading patterns.

In cases such as juvenile idiopathic arthritis, chiropractors may work in coordination with
the child’s medical physician or rheumatologist to provide supportive care—such as gentle
manual therapy and soft tissue techniques—to improve mobility and reduce muscle tension.
The good news is these conditions generally respond well to conservative management,
helping most children return to their normal activities without the need for invasive treatment.

Brent Binder, D.C.

4909 Louise Dr. Suite 102

Mechanicsburg, PA 17055 (717) 697-1888

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