HealthInfo Canterbury
Knee pain in children
Mamae ā-turi ki ngā tamariki
The knee is the largest and strongest joint in your body. It includes your thigh bone (femur), upper end of your shinbone (tibia), and your kneecap (patella). Ligaments and tendons inside your knee act like strong ropes to hold your bones together.
Tamariki (children) commonly get pain in their kneecaps or the front of their knees. It mostly happens during times when they're growing fast and when they're physically active.
This page talks about ongoing causes of knee pain such as chondromalacia patella (also called runner's knee) and Osgood-Schlatter disease. Other causes of pain at the front of the knee include general bone pain, broken bones and other soft tissue knee injuries.
Symptoms of knee pain in children
Your tamaiti (child) may feel a dull, achy pain that happens after physical activity. Other symptoms can include:
- pain during physical activity
- tight muscles at the front or back of their thigh.
- pain at the top of their shin bone (with Osgood-Schlatter disease)
- popping or crackling sounds when climbing stairs or standing up after sitting (with chondromalacia patella)
If the knee pain will not go away, it's important to see your general practice team. They will ask you questions about the symptoms your tamaiti child has and examine their hip and leg. They may arrange an X-ray, depending on what they think the cause might be.
Important
Take your tamaiti to see a doctor straight away if they:
- have a fever and significant swelling around one of the knee bones
- have pain at night for more than three nights
- refuse to put weight on the leg.
Causes of knee pain in children
Knees are complex with a large range of movement. The bones, ligaments and tendons are strong but forceful movements such as running or jumping can cause damage.
Osgood-Schlatter disease is caused by the patella tendon (or ligament) at the front of the knee pulling at the growth plate part of the tibia (shinbone) causing pain.
Chondromalacia patella is a softening of the protective covering (articular cartilage) on the underside of the kneecap (patella). It can be caused by muscles being too tight (especially the hamstrings and quadriceps), the knee cap being out of alignment, or an injury. It can also be present at birth.
Treating knee pain in children
Knee pain in tamariki children caused by chondromalacia patella or Osgood-Schlatter disease can usually be treated by reducing activity, and using physiotherapy and support such as strapping.
Very occasionally, your tamaiti may need surgery. If your surgeon thinks this is necessary, they will discuss the surgery and the risks and benefits with you.
Getting help for a child with knee pain
Your tamaiti may need simple pain relief. Make sure they take it regularly until they're comfortable. But never exceed the recommended dose for the weight of your tamaiti. Try paracetamol or an anti-inflammatory medicine such as ibuprofen.
If the knee of your tamaiti is sore and appears swollen, apply ice to the area for 20 minutes at a time. This helps to ease the pain and reduce the swelling. Wrap the ice in a damp towel or cloth – don't apply it directly to the skin or you could cause an ice burn.
The knee pain may happen again if you don't change the training routine or activity level of your tamaiti. It's important to strengthen the muscles around their knees, particularly their quadriceps and hamstrings. Physiotherapy can help.
There are other things you can do to help your tamaiti recover after knee pain. You can:
- get them suitable shoes designed for the physical activities they're doing
- encourage them to stretch before and after physical activity
- limit activities that have hurt their knees before
- limit activities that may be making their pain worse until they're free of pain. This may take weeks rather than once or twice
- limit the distance your tamaiti runs in training and competition.
Written by HealthInfo clinical advisers. Last reviewed June 2022.
SourcesReview key: HIBOW-85151
