Why does my child’s knee hurt? Common causes of anterior knee pain explained

 

What are the common causes of anterior knee pain in children?

There are several reasons your child may start to feel pain the front of their knee, known as anterior knee pain. Here are some of the most common causes and how they can be managed.

Patellofemoral pain syndrome (PFPS)

Also known as ‘runner’s knee’, this is a frequent cause of anterior knee pain in children. It occurs when the kneecap (patella) stops gliding smoothly over the femur, leading to irritation and discomfort. 

Children who engage in lots of repetitive activities such as running, jumping or squatting are particularly at risk and it’s often caused by muscle imbalances and poor biomechanics too.

What are the symptoms of runner’s knee?

• Dull, aching pain around the kneecap
• Pain that worsens with running, climbing stairs or prolonged sitting
• No swelling or redness

What are the best treatments? 

• Rest and modifying activities that cause pain
• Strengthening exercises for the quadriceps and hip muscles
• Proper footwear and orthotics (shoe inserts) can help

Osgood-Schlatter disease

• Osgood-Schlatter disease is a common condition in children aged 10 to 15, particularly during growth spurts. It happens when repetitive activities like football, gymnastics or basketball cause irritation at the growth plate where the patellar tendon attaches to the shinbone (tibia).

What are the symptoms of Osgood-Schlatter disease?

• Pain and swelling just below the kneecap
• A noticeable lump at the front of the shin
• Pain that worsens with activity and improves with rest

What are the best treatments?

• Rest and ice to reduce inflammation
• Stretching and strengthening exercises
• Temporarily changing your activity levels

Sinding-Larsen-Johansson syndrome

Sinding-Larsen-Johansson syndrome is a condition that affects the lower part of the kneecap rather than the shin. It’s caused by repetitive stress on the patellar tendon, and we often see it in children going through rapid growth spurts.

What are the symptoms of Sinding-Larsen-Johansson syndrome?

• Pain at the lower part of the kneecap
• Increased discomfort with jumping or kneeling
• Swelling in some cases

What are the best treatments?

• Rest and physiotherapy
• Ice application for pain relief
• Gradual return to activity

Growth-related knee pain

As children grow, their bones, muscles, and tendons lengthen at different rates, which can sometimes lead to temporary discomfort. Growth-related knee pain is usually mild, and it can naturally develop without there being an injury.

What are the symptoms of growth-related knee pain?

• Aching pain in both knees, particularly at night
• No swelling, redness, or warmth
• Pain that improves with gentle stretching

What are the best treatments?

• Warm baths or gentle massage
• Over-the-counter pain relief if necessary
• Reassurance that it’s temporary

When should your child see a doctor for knee pain?

Anterior knee pain in children is common you can usually effectively manage it at home with rest, physiotherapy, and simple lifestyle modifications. While most cases resolve with home treatments, it’s important to consult a paediatric orthopaedic surgeon for a proper diagnosis and treatment plan if:

• The pain is severe or persistent
• There is significant swelling, redness, or warmth around the knee
• Your child has difficulty walking or bearing weight
• The knee pain follows an injury or fall

By understanding the causes and taking appropriate action, you can help your child stay active and pain-free.