Adolescent Anterior Knee Pain: A Brief Overview

Pain and popping/cracking in the front of the knee in older children and young adults

Julia Munn Hale, PA-C, MHS
Senior Clinical Research Coordinator, Pediatric Orthopaedics
Hospital for Special Surgery


Shevaun Mackie Doyle, MD

Shevaun Mackie Doyle, MD

Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Associate Professor of Orthopaedic Surgery, Weill Cornell Medical College

Symptoms

Generally, symptoms begin as a dull ache around and/or behind the kneecap in otherwise healthy, active adolescents (girls more commonly than boys). Patients sometimes hear cracking or popping in their knees, especially when they ascend or descend stairs, jump, or squat. Pain may increase with continuation of certain activities.
 
If a patient has swelling, a rash, warmth, severe pain, or redness in or around the knee, this is much more worrisome and needs urgent and possibly emergent evaluation by a pediatric orthopedist. Pediatric orthopedists are specialists who diagnose the causes of knee pain and provide appropriate treatment regimens to help patients get better.

The pediatric orthopedist will want specific questions answered about the patient, including the duration and quality of the pain as well as what aggravates and alleviates it. A complete history, physical examination, and x-ray evaluation will be performed.

Causes

The knee joint handles a lot of stress. Due to the knee’s complex anatomy, it is sensitive to many torsional (twisting) and tractional (pulling) forces which may occur from joint malalignment, overuse from excessive training, and/or muscle imbalances.

Treatment

Usually, adolescent knee pain is treated with rest from the offending activities, ice, non-steroidal anti-inflammatory drugs (Motrin or Advil), and physical therapy to stretch, strengthen, and stabilize the muscles of the lower extremity.

Avoiding Anterior Knee Pain

• Wear proper and securely fitted shoes designed for a specific activity.
• Engage in a good warm-up regimen that includes stretching prior to physical activity.
• Avoid prolonged squatting or kneeling.
• Decrease the duration and intensity of - or entirely avoid - activities that cause knee pain.

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