Knee Pain in Children: Why It’s Not Always Just “Growing Pains”

Children are on the go 24/7 running, jumping, hopping and just being kids. Knee pain is a common problem that children and adolescents can suffer from. There are many different reasons why knee pain can be present in the paediatric population. Most parents, and even a lot of unknowing doctors – call these ‘growing pains’. 

Unlike adults where most cases of knee pain come from degenerative changes or traumatic injuries, the underlying pathology may be congenital or related to growth, in the paediatric population. However, they are not ‘growing pains’.

One cause of knee pain is: Osgood Schlatter’s Disease

Osgood-Schlatter’s disease (OSD) is a common cause of knee pain in children. It is an injury that can be painful, but it is only temporary and has no long-term symptoms.

OSD develops during growth spurts and bone maturation in adolescents; the bones in the leg may grow faster than the leg muscles and tendons causing repeated traction on the tendon insertion and the attached growth plate. This causes a biomechanical imbalance by putting extra pressure on the growth plate, causing inflammation of the growth plate.

OSD presents as a traumatic, insidious anterior knee pain that is tender on the patellar tendon insertion site on the tibial tuberosity. It is characterised by activity – related pain that can worsen due to repetitive impact activities such as jumping, running and in sports such as basketball, volleyball, gymnastics and football.

When symptoms become more severe, they impact normal walking, stairs, and even discomfort at rest. These repetitive movements irritate the growth plate, causing inflammation, swelling, tenderness, and pain and a possible ‘classic OSD bony protrusion’.

Who is most likely to suffer from Osgood-Schlatter’s disease?

Osgood-Schlatter’s Disease is one of the most frequent causes of knee pain in children. It is normally associated with no specific injury and will just start either during or after a physical activity.

It occurs most commonly in children between the ages of 8-15 years old, however it can occur in younger children. It can occur in both boys and girls. Girls, typically experience it at a younger age than boys.

Children that participate in lots of sports that require running, jumping, or high impact landing are at greater risk. Children may not complain of a specific incident but instead complain that discomfort is gradually worsening over time. It can occasionally be activated by a knock to this area of the knee.

Three main risk factors: 

• Aged between 8-15 years old
• Involved in sports
• Actively growing or rapid growth spurts

Treatment for Osgood-Schlatter’s disease

Treatment for OSD in adolescents involves activity and footwear modification to reduce repetitive impact on the growth plate.

Ice and NSAIDS can be used as a way to help reduce pain and inflammatory symptoms. 

Most importantly stretches for the surrounding muscles to help increase muscle length, so the soft tissues are increased to the same length as their rapidly growing bones and stability and lower limb strengthening. Although there is a typical pattern to the treatment of OSD, there are features that do need to be tailored to each child and why we always recommend assessment by a paediatric physio, to ensure the most efficient treatment, as well as preventing it reoccurring. This is because the reoccurrence rate is very high when not treated correctly. A physio who has specialist knowledge of growth and development is always recommended when treating a child. Typical physio strategies are often not the appropriate course of action.

Is your child suffering from knee pain? Get them booked today with our specialist paediatric physio. If you would like to book an appointment get in touch. Book an appointment online.