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What is knee pain in children?

Knee pain in children can be a result of many factors. Most commonly it is a result of overuse in active teenagers, but can also be caused by a specific trauma or condition.

It is quite common for children to complain of knee pain without having sustained any type of trauma or injury, especially active adolescents. A change in activity level or sport may be related to the onset of symptoms, usually the onset of knee pain will occur after a considerable delay.

What causes knee pain in children?

The most common reason for knee pain in children is due to overuse. The anatomy of a child’s knee joint is extremely sensitive to small problems in alignment, training, and overuse. Pressure may pull the kneecap sideways out of its groove, causing pain around kneecap. This is often referred to as anterior knee pain. In teenagers, a number of factors may be involved.

  • Imbalance of thigh muscles that support the knee joint
  • Poor flexibility
  • Problems with alignment
  • Using improper sports training techniques or equipment
  • Overdoing sports activities

A direct blow can also cause knee pain due to injuries to ligaments and tendons, these include:

  • anterior cruciate ligament injury
  • posterior cruciate ligament injury
  • Lateral collateral ligament injury
  • medial collateral ligament injury
  • Dislocated kneecap

There are other conditions that are common reasons for knee pain in children. These include:

  • Osgood-Schlatter’s disease
  • Sinding-Larsen Johansson syndrome
  • Juvenile Arthritis
  • Osteochondritis dissecans

There are lots of things that can cause knee pain in children. It is therefore important that you arrange an assessment for your child with a paediatric physiotherapist so that they can diagnose the exact cause and begin the most appropriate treatment.

What are the symptoms of knee pain in children?

Commonly in anterior knee pain the pain usually begins gradually, and worsens as activity levels increase. Pain might flare up when your child does activities that repeatedly bend the knee (jumping, running, and other exercises). Without treatment, your child might also develop thigh muscle (quadriceps) muscle weakness. Your child’s knees may begin to buckle or give way due to pain.

If the knee pain is a result of trauma your child might experience popping or crackling sounds in the knee when they climb stairs, stand up or walk. This might lead to them experiencing an unstable knee that may; click, lock or give way (instability). . This is usually a result of a ligament injury.

If your child has knee pain that is restricting their day to day activities; if they are unable to bear weight on the leg, or if the knee is red or swollen, then you should see your doctor as an x-ray or MRI scan may be needed.

What should I do if my child has knee pain?

Ice, rest, and rehabilitation are the usual treatments for children with knee pain.

  • Ice: To relieve swelling and inflammation, apply ice wrapped in a towel to your sore knee.
  • Rest: Until the tissues heal, stop doing the activities that make your knee hurt.
  • Rehabilitation: A physiotherapist will help ease the pain and reduce any swelling. The physiotherapist will then begin to rehabilitate your child’s knee to regain range of motion, strength, power, endurance, speed, agility, and coordination.

What shouldn’t my child do if they have knee pain?

Until they have been assessed by a physiotherapist your child should avoid any activity that brings about knee pain, locking, clicking, or giving way.

Physiotherapy for knee pain in children

A comprehensive knee assessment by one of our physiotherapists will help determine the cause of pain behind your child’s knee pain and rule out other problems.

The physiotherapist may also check:

  • 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

Following assessment the physiotherapist will implement appropriate treatments to treat the cause of your child’s knee pain. This will commonly include; strengthening exercises, stretching, advice regarding participation in sports, recommendations on any appropriate orthotics such as braces and insoles.

Does knee pain in children cause any long-term effects?

With the correct physiotherapy input most childhood conditions causing knee pain will resolve and will not result in any long term knee pain.

Causes of Hip Pain in Children

Your child uses their hips every day for walking, crawling, sitting, or standing. Because of this, hip problems can come up. This can make it hard for them to move the right way.

If your child has a hip problem, they may have hip pain, but they may also have pain in their knee or thigh instead. They might start to limp. Or they may be in too much pain to walk at all.

Your child’s hip could hurt for lots of reasons. It may be because of problems they were born with. Infections, injuries, and other things can cause it, too.

Transient Synovitis

If your child has this common cause of hip pain, they may limp and tell you their hip hurts after sitting for a long time. They'll also walk with their toes pointed outward. They may walk on the tips of their toes, have knee or thigh pain, or refuse to walk if the pain is very bad. Your baby will cry when you move their hip joint.

This problem is most common in preschool and elementary students. Boys get it more often than girls. Doctors don’t know why, but it happens a lot in children who’ve had a virus. It may be a side effect of the body's fight against it.

Your child’s pediatrician may prescribe anti-inflammatory medicine, sometimes with pain meds. Within a few weeks, they should feel better, without any lingering problems.

Hip Dysplasia

At baby well visits, doctors check the movements of your baby’s hips. This is because in some babies, one or both hips didn't develop quite right. Some babies are born with the problem. Others have it after they’re born.

It’s more common in girls. Doctors think the hormones babies get in the womb may relax the hips too much. It may be more common among kids born breech -- with their feet or hips first.

A doctor may put your baby in a soft brace that keeps their knees bent for several months. This usually takes care of the problem.

Arthritis

Different kinds of it can cause hip pain in children. The most common type is juvenile idiopathic arthritis (JIA). If your child has it, they may feel stiffness or have swelling in more than one joint. Their hips may be stiff as well. Your child may also have an unusual walk or have a fever for unknown reasons.

Doctors aren’t sure what causes JIA, but it may be linked to a virus. It’s most common in children before they hit puberty. Doctors often treat it with medicine and physical therapy.

Legg-Calve-Perthes Disease

If the rounded top of the thighbone (femoral head) that fits into the hip socket (pelvis) doesn’t get enough blood, the bone is more likely to break. It also won’t heal as well as a healthy bone would. This can cause your child to limp or have stiffness and pain in the hip, knee, or thigh.

Doctors don’t know why blood stops flowing to the hip joint in some children. It’s more common among kids up to age 8. Boys are more likely to have it. Doctors can treat it with crutches, a cast, physical therapy, or surgery.

Having Legg-Calve-Perthes disease after age 6 makes someone more likely to have hip problems as an adult.

Slipped Capital Femoral Epiphysis

This is a fracture along the growth plate under the ball joint in the hip. It's kind of like ice cream falling off the cone. This causes pain, sometimes in the hip but other times in the thigh or knee. Sometimes, your child may need crutches. Other times, they can’t walk or move their leg because the pain is so severe.

It’s more common in older children (from age 8 into teenage years) and those who are overweight. Boys get it more often. Surgery is a common treatment. Many children recover fully, but they’re more likely to have arthritis of the hip as adults.

Infections

A number of them can cause pain in your child’s hip. This may make them limp or give them trouble walking. One condition, called septic arthritis, can cause painful hip swelling and redness. It may be caused by bacteria (like a staph infection), a virus, or even a fungus. Other bacterial infections or Lyme disease (which your child may get from the bite of an infected tick) can also cause hip pain.

Antibiotics may be all that’s needed to treat some infections. Other times, your child may need a procedure to drain the infection from the joint.

Other Causes

Sometimes, an injury can cause hip pain. In rare cases, a tumor in the hip can cause it as well.