Why Does My Child Have Knee Pain? A Parent’s Guide
Hearing your child complain about knee pain can be concerning. Whether they’re an active athlete, starting to grow rapidly, or simply woke up with a sore knee its natural to wonder if something serious is going on.
The good news is that most knee pain in children and teenagers is not caused by a serious injury and often responds well to the right treatment. Understanding the possible causes can help you know when to seek care and how to help your child get back to doing what they love.
There can also be situations where knee pain is an emergency and we will discuss below.
Is Knee Pain Normal?
Knee pain is one of the most common reasons children and adolescents visit a physiotherapist or healthcare provider. As children grow, their bones, muscles, tendons, and joints develop at different rates. Bones grow faster than muscles which can cause some issues. Add sports and physical activity into the mix, and it’s easy to see why the knee can become irritated. While some aches are temporary, persistent or worsening pain should never be ignored.
The Most Common Causes of Knee Pain?
1. Osgood-Schlatter Disease (Growth Plate Pain)
One of the most common causes of knee pain in children between 10 and 15 years old is Osgood-Schlatter disease. We are still not sure why they call it a disease when it can be a normal physiologic process. It occurs when the patellar tendon repeatedly pulls on the growth plate just below the kneecap during periods of rapid growth.
Common symptoms include:
• Pain below the kneecap
• A tender or prominent bump on the front of the shin
• Pain with running, jumping, squatting, or kneeling
• Symptoms that improve with rest
Conservative treatment with rest, pain & anti-inflammatory medication, a patella strap, exercises and stretches can improve this pain dramatically. This will likely wax and wane over periods of rapid growth and usually disappears once your child is done growing.
2. Patellofemoral Pain Syndrome (Runner’s Knee)
Patellofemoral pain is another frequent cause of knee pain in adolescents. Most common in adolescent girls, instead of pain in one specific spot, children often describe a dull ache around or behind the kneecap.
It may worsen with:
• Running
• Climbing stairs
• Squatting
• Sitting for long periods (such as during school or car rides)
Weakness around the hips and core, changes in training, and poor movement mechanics often contribute to this condition. Specific exercises can help!
3. Tendon Irritation
Sports that involve jumping, sprinting, or quick changes of direction can overload the tendons around the knee. This may cause pain in:
• The patellar tendon (“jumper’s knee”)
• The quadriceps tendon
• The hamstring tendons
Fortunately, tendon pain often improves with appropriate exercise and gradual return to activity.
4. Injuries
Sometimes knee pain follows a specific injury.
These may include:
• Ligament sprains
• Meniscus injuries
• Patella dislocations
• Bone bruises
• Fractures
If your child felt a pop, cannot bear weight, has significant swelling, or the knee gives way, they should be assessed promptly. It is always okay to see your physiotherapist as a first line musculoskeletal healthcare provider. They can assess and guide your recovery process. If your child requires further assessment or imaging our Clinical Advisor Dr. Laxdal can help!
5. Overuse
Many young athletes now play competitive sports year-round without much rest. Shout out to all the dance, gymnastics, soccer and hockey/ringette parents!
Too much training, sudden increases in activity, or playing multiple sports at once can overload the growing knee. Often the solution isn’t to stop all activity but rather to modify training while addressing strength, flexibility, and movement patterns.
5. Infection vs Reactive Arthritis
If your child wakes up with a swollen knee for no reason, an infection or inflammatory process should be considered.
After a cough or cold your child can get swelling of the knee joint and cause a limp. This can be something called Reactive Arthritis and usually improve within a couple days with conservative management.
Conversely, they may be unlucky and develop a knee joint infection due to a cut or scrape or bacteria traveling through the blood. A knee joint infection is a medical emergency and should be evaluated at Winnipeg Children’s Hospital Emergency. The knee will be red, hot and swollen. Your child may have a fever or feel unwell.
Sometimes it is difficult to tell between reactive arthritis or an infection and it is always safest to get this checked quickly.
What About “Growing Pains”?
Many parents wonder if knee pain is simply growing pains.
True growing pains:
• Usually occur in both legs
• Often affect the thighs or calves rather than the knee itself
• Tend to happen in the evening or overnight
• Are gone by morning
• Do not cause limping or swelling
You can read more about growing pains here.
How Physiotherapy Can Help
As a first line healthcare provider your physiotherapist can determine the underlying cause of your child’s knee pain and develop a personalized treatment plan.
Treatment may include:
• Education about the condition
• Activity modification
• Strengthening exercises
• Balance and movement retraining
• Flexibility exercises
• Return-to-sport planning
• Injury prevention strategies
Rather than simply resting until the pain disappears, physiotherapy helps address the factors that caused the problem in the first place.
Can My Child Keep Playing Sports?
In many cases, yes. Complete rest is often unnecessary and may even slow recovery. The goal is to keep your child active while allowing the injured tissues to recover.
The Bottom Line
Most childhood knee pain is treatable and does not require surgery. Early assessment can often prevent small problems from becoming bigger ones and help your child return to school, sports, and play with confidence. If your child has ongoing knee pain, don’t wait until it begins affecting their daily activities. An assessment can provide answers, reassurance, and a clear plan for recovery.
We’re Here to Help
At Better Beyond Rehab, we work with children, adolescents, and young athletes every day. Our team provides evidence-based assessment and treatment for growth-related conditions, sports injuries, overuse injuries, and post-operative rehabilitation.
If your child is experiencing knee pain, we’d be happy to help them get back to moving with confidence.
Written By: Better Beyond Rehab Team
