Why knee pain is rising in young athletes & how to prevent it

It’s not surprising when older athletes suffer injuries and regular aches and discomfort, but a rise in sport-related pain and injury in younger players is a troubling trend.

Knee pain is one of the most widespread chronic issues in young athletes today, and it can run the gamut from a long-term annoyance to a potentially more serious problem.

Endeavor Health orthopaedic surgeon and sports medicine specialist Jason Shin, MD, highlights common causes for knee distress and important prevention strategies for children and teens playing sports today.

Primary causes of knee pain in young athletes

There are three major culprits for non-traumatic knee pain in young athletes, explained Dr. Shin:

1. Overuse/growth-related factors
2. Intra-articular issues (damage to cartilage or soft tissue inside the knee)
3. Alignment/biomechanical

“Overuse injuries are so common today with kids playing one sport all year long in school, traveling leagues and other competitions,” said Dr. Shin.

Rest is important for all athletes and it’s critical for growing bodies, he added. Coaches, trainers and parents should help young players find a balanced approach and follow established guidelines for rest and breaks from training.

How growth spurts and specialization increase injury risk

Growth spurts mean that bones are growing faster than the muscles, tendons and ligaments and flexibility temporarily decreases, increasing the risk for injuries and knee pain, explained Dr. Shin.

“It’s better for younger athletes who are still growing to switch up their sports and activities, so they are using different muscle groups and not practicing the same repetitive motions over and over,” he said.

Common types and locations of youth knee pain

Knee pain comes in different forms and intensities:

• Anterior knee pain syndrome (or patellofemoral pain syndrome): Pain in the front of the knee — around or behind the kneecap — is common in runners and other athletes who play soccer, football, tennis and more.
• Tibial tubercle pain: Pain where the patellar tendon attaches to the bone is common in jumping athletes, like basketball and volleyball players.
• Deep joint pain: Pain deep inside the knee can be characterized as aching or sharp and is sometimes a sign of cartilage dysfunction or meniscal abnormality.
• Stress fractures: Fractures around the knee can occur in young track and cross-country athletes and other distance runners. While this was once more common in female athletes, it also happens in young male runners, said Dr. Shin.
• Kneecap mal-tracking: Discomfort resulting from weakness and dysfunction of core, hip and leg muscles.

Focus on prevention: Strategies for young athletes

There are several key strategies to prevent common overuse injuries:

1. Get adequate nutrition. Sufficient and healthy caloric input is critical. Distance runners in particular often are not taking in enough calories as there has been a sometimes-misguided emphasis on staying lean, said Dr. Shin.
2. Listen to your body. “It’s so competitive these days and there is so much sports specialization that kids don’t want to slow down or take breaks even when they are injured,” he said.
3. Don’t ignore swelling or mechanical symptoms. Recurring swelling or problems like clicking or catching accompanied by pain should always be evaluated by a physician
4. Address persistent pain. Pain that doesn’t resolve in a few days with activity modification should also be evaluated.

Seeking an evaluation and returning to play

While mild soreness after a tough practice is common, parents and coaches should be aware of persistent symptoms. Call your doctor if your child experiences:

• Persistent discomfort or pain, including night pain
• Clicking, popping or knee “locking”
• Visible joint swelling
• Limping

Getting a professional evaluation and diagnosis sooner rather than later means earlier treatment and a healthier return to play.

“A lot of these injuries can be treated with an appropriate amount of rest, a balanced approach to ramping up activities and physical therapy designed to strengthen muscles and correct imbalances,” said Dr. Shin.