Knee pain is common among adolescents, especially in physically active teens. Most cases of pain are due to overuse, but knee pain can result from medical conditions and skeletal growth.
In some cases, knee pain can stem from a problem with the hip known as slipped capital femoral epiphysis (SCFE).
This article explores possible causes of knee pain in teens, their symptoms, and treatment.
Patellofemoral pain syndrome (PFPS) is a broad term for knee pain in front of the knee and around the kneecap or nonspecific knee pain. It is also called runner’s or jumper’s knee. It often happens because of knee joint overload.
Adolescents experience PFPS at higher rates than any other age group.
Its most common causes include:
- repeated stress or overuse of the knee
- sudden change in physical activity
- improper use of equipment or sports training techniques
- changes in playing surface or footwear
- bone alignment problems or bone deformities
The most common symptom of PFPS is a dull, aching pain
Other common symptoms include:
- pain when climbing stairs, running, squatting, or jumping
- pain on the front of the knee after sitting for a long time
- knees popping or cracking when standing up after prolonged sitting or climbing stairs
The treatment for PFPS is usually conservative and
- taking medications for pain
- making activity changes, such as switching to low impact activities
- maintaining a moderate weight
- doing physical therapy
Patellar tracking disorder, or patellar maltracking, is a
Muscle imbalances or weakness and poor alignment of the legs in relation to the hips and ankle may also cause changes in the kneecap’s location, leading to knee pain.
Common symptoms include:
- pain in the front of the knee, especially when kneeling, jumping, going downstairs, or squatting
- popping, grinding, or a catching sensation in the kneecap with bending or straightening the knee
- knee buckling or suddenly giving out
The treatment for patellar tracking disorder is similar to PFPS:
- following the RICE method
- limiting activity
- taking over-the-counter pain relievers to manage pain and swelling
Once the knee pain subsides, a person can start improving their lower extremity strength and flexibility with the help of a physical therapist.
A person with severe instability may need surgery.
Patellar dislocation is another
Symptoms of kneecap dislocation include:
- knee pain and deformity
- knee gives out
- feeling a pop in the knee
- swelling immediately after injury
The immediate treatment of a dislocated kneecap is correcting the dislocation. The mainstay treatment is conservative if there is no damage to other structures. This includes:
- applying cool packs
- taking pain medications
- taking nonsteroidal anti-inflammatory drugs (NSAIDs) for swelling
- modifying activity
- using a brace for the short term
- doing physical therapy
If there is recurrent instability, the person may need surgery.
Knee bursitis is the inflammation of tiny fluid-filled sacs near the knee joint. Common causes include:
- prolonged pressure
There are two types of bursitis: acute and chronic. Of the two, only acute bursitis causes pain. Chronic bursitis is often painless.
Bursitis usually heals on its own. The RICE method can help improve symptoms. Padding a superficial bursa and wearing properly fitting clothes may also help reduce pressure on the bursa.
Sometimes a doctor may need to drain a bursa. A person with recurrent bursitis may need to see a rheumatologist because there may be an underlying problem, such as arthritis.
Patellar tendinitis, commonly called jumper’s knee, is a painful condition caused by small tears in the patellar or quadriceps tendon. It often occurs in sports that require strenuous jumping.
Pain and tenderness localized on the inferior tip of the patella is the characteristic symptom of patellar tendonitis. Other symptoms include:
- pain with prolonged sitting, squatting, or stair climbing
- pain from prolonged knee flexion
- tenderness behind the kneecap
Nonsurgical treatments for jumper’s knee
- activity modifications
- sports training
- physical therapy
When there is a partial tendon tear, a person experiences pain during rest and activities, which may indicate the need for surgery. Doctors may opt to repair the tendon surgically, either by removing damaged tissue and reattaching the tendon or through knee arthroscopy.
Osgood Schlatter disease, or osteochondrosis, is a common cause of knee pain among growing adolescents.
Adolescents with the condition may
The condition is self-limiting.
The following can help relieve symptoms:
- using cool packs
- taking pain relievers
- restricting activity
- doing stretching exercises, in some cases
Osteochondritis dissecans causes a small piece of bone and its overlying cartilage to detach and crack due to a lack of blood supply. It commonly affects the knee, elbow, and ankle.
Osteochondritis dissecans can have no symptoms. When it does cause symptoms, mild pain may occur in the affected joint.
People with loose fragments may notice the
- joint pain
- joint instability
- joint locking
In stable lesions, doctors prefer conservative treatments, such as protected weight bearing and immobilization. If these do not help, drilling techniques can
Unstable lesions typically need arthroscopy.
Sinding-Larsen Johansson syndrome is a temporary condition due to injury in the growth plate of the knee. It affects children during their rapid growth spurt.
Children and teens with the condition may complain of the following:
- tight quadriceps
- pain and swelling at the bottom of the kneecap
- increased pain with high impact activities
- palpable bony prominence at the base of the patella
As with other self-limiting causes of knee pain, the following treatments may relieve symptoms:
- activity modification
- RICE method
Knee strain involves damage to the muscles or tendons around the knee. Sprains affect the ligaments.
The most common symptom of an ACL tear is a sudden pop and feeling of the knee giving out at the time of injury.
Other possible symptoms include:
- loss of range of motion
- mobility problems
Depending on the severity of the injury, a doctor may recommend nonsurgical approaches, which can include bracing and physical therapy, or surgical reconstruction of the knee to restore its internal structures.
Knee pain can occur in adolescents for various other reasons, such as:
Children and teens can avoid knee pain from injuries and overuse by:
- wearing proper shoes and using recommended equipment for the sport and activity
- doing proper warmups and cooldowns
- doing regular strength training to support muscles
- observing proper body mechanics, especially while performing high impact activities
- managing weight and avoiding obesity, which can put strain on the knees
Most knee pains are easily manageable at home. However, it may be necessary to seek medical help if any of the following are present:
- increasing or severe pain
- change in color of the leg or foot
- knees look deformed or out of shape
- inability to move the knee
- inability to walk or stand
- signs of infection, such as redness, fever, swelling, and pus drainage
Here are some questions people often ask about knee pain in teens.
Can knee pain be caused by puberty?
Puberty itself does not cause knee pain, but some conditions more commonly occur during puberty. These include Osgood-Schlatter disease and Sinding-Larsen-Johansson disease.
Knee injuries are also common among adolescents due to increased involvement in sports and physical activity.
Can Osgood-Schlatter go away?
Osgood-Schlatter disease is a self-limiting disease. It typically goes away on its own once the child’s bones stop growing.
Can hip problems cause knee pain?
Slipped capital femoral epiphysis (SCFE) is when the ball of the thighbone slips off the top of the bone. It can cause pain in the hip, groin, thigh, or knee.
SCFE often affects teens or preteens who are still growing. Risk factors include excess weight and thyroid problems. It usually needs urgent surgery.
Knee pain commonly affects adolescents. It can occur for various reasons, such as overuse injuries, ligament tears, and growth-related conditions.
It can also be referred pain from a hip problem, such as SCFE. A doctor will likely suggest an X-ray of the knees and hip to check for other problems.
Treatment depends on the underlying cause. A doctor will typically recommend conservative treatment first. It is essential to seek medical help if symptoms worsen or do not improve.
Preventive measures can help avoid injuries. These measures include doing proper warmups and cooldowns, wearing appropriate equipment and footwear, and practicing regular strength training.