Young children and teenagers very often complain of discomfort in the knee joint. This fact should cause concern among parents. After all, pain indicates the development of some pathology. An advanced disease that has become chronic will cause not only many problems, but also a severe deterioration in health.
Causes Causes of knee pain in children are most often provoked by heavy loads on the musculoskeletal system and features of posture, which is associated with a shift of the center of gravity forward or backward, rotation of the femur inward or outward due to weakness of the muscles of the thighs or lower legs.
There are two types of posture associated with improper load on the feet:
- Valgus deformity - knees falling inward or X-shaped legs is caused by flat feet, weakness of the tibialis posterior muscle and gluteal medius muscles.
- Varus deformity - Club feet or O-shaped feet are caused by walking on the outside of the foot due to weakness of the adductors and calf muscles.
This problem arises quite often in our lives. There are many reasons for pain in the knee area. Therefore, it is extremely important to make a correct diagnosis in order to prescribe appropriate therapy. Knee pain can occur as a result of sprained ligaments surrounding the knee, muscle tears, arthritis of the joint itself, inflammation of the periarticular bursae (bursitis), or patellar syndrome.
Let's start with x-rays
When a child complains of pain in an arm or leg without previous falls or other memorable events, a traumatologist will first of all still suspect a bruise or sprain. If after the prescribed 5-7-day treatment the pain persists, you need to take an x-ray, which will show most of the bone problems. Parents must understand: the examination begins with an x-ray! If a tumor is suspected, an additional examination can be performed using a computed tomography (CT) scanner or MRI.
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Treatment of the knee joint
Our center has specialists who know how to help if your child has problems with the knee joint. The standard treatment that a child will receive in most clinics will consist of physiotherapeutic procedures and corticosteroid injections (injections in the knee). However, such therapy brings only temporary relief, since it does not have any effect on the cause of the pain.
One of the differences that you can see with us is that we try to find out WHY the knee hurts and based on this we carry out therapy. This way of working allows you to achieve lasting and long-term results. We are confident that standard therapy brings only temporary relief and after some time the pain will return again.
An unexpected find
The most common bone disease in children 10–18 years old is metaphyseal fibrous defect. This is a neoplasm consisting of fibrous connective tissue, which is most often found in large tubular bones and is often unexpected, without preliminary complaints from the child. Large lesions are subject to urgent surgical treatment, small ones are monitored by taking comparative X-rays every six months and monitoring the decrease or increase in the bone tissue defect. During this time, the patient is prescribed a serious restriction of physical activity - a difficult test for fidgets. But the result is worth it: often defects completely disappear by the fifth year of control. Of course, subject to following medical recommendations! Otherwise, the result may be a fracture in the sore spot. And then it is impossible to avoid the installation of metal structures to fuse the bone, and then a new operation to remove them.
Disease prevention is a healthy diet and moderate exercise.
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Causes of pain
During growth peaks, body proportions may change unevenly. The bone grows faster than the muscles that support it develop; the tendons do not have time to “get used” to the new sizes. In addition, the development of tissues occurs faster than the development of the network of vessels that nourish them. The vessels become thinner, bone and muscle tissues receive less oxygen. All this is the result of hormonal surges. Such phenomena lead to painful sensations, especially at night.
This is not a pathology, but in order not to lose sight of the real disease, pay attention to the teenager’s condition: observe how often pain appears and whether there are other symptoms.
Cyst
If a child experiences sharp pain when moving, but there is no reason to suspect a fracture, it is necessary to check whether it is a cyst - the second most common disease of this type during surgical interventions.
Cysts most often affect the knee and shoulder joints in children over 10 years of age who lead an active lifestyle. A cyst is a cavity in the bone, usually filled with fluid. Unfortunately, it is rarely detected by simply treating the pain with tolerable pain; it is often diagnosed at the same time as the fracture. During the course of the disease, bone walls can become thinner to the point of an eggshell, so fractures occur not only when falling from a swing-carousel, but also during normal daily movements, even stretching in bed in the morning.
So a teenager or toddler’s complaint of sharp, unexpected pain in an arm or leg is not necessarily caused by a sprain or bruise. An x-ray will again help make a diagnosis.
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Knee pain in children
General information
The knee is the largest joint in the body. The top and bottom bones of the knee are separated by two discs (menisci). The femur and lower leg bones (tibia and fibula) are connected by ligaments, tendons and muscles. The surface of the bones inside the knee joint is covered with articular cartilage, which absorbs shock and provides a smooth, gliding surface for the joint to move. A bruise or injury to the knee is the most common cause of lameness.
Active older children often have muscle and ligament sprains that heal without intervention after some time. Knee pain in children can be associated with damage to various structures (cartilage, tendons, periarticular bursae).
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Knee pain in children is uncommon. In rare cases, a child's knee pain has a serious cause, such as rheumatoid arthritis, ligament or cartilage damage, infection, blood disorder, or other conditions. More often, knee pain in a child is associated with a minor injury and goes away quickly.
Causes of knee pain in children
Damage (injury) is the most common cause of knee pain. Sudden (acute) injuries can be caused by a direct blow to the knee or by abnormal twisting, bending of the knee, or falling onto the knee. Pain, bruising, or swelling may be severe and develop within minutes of the injury. Nerves or blood vessels may become compressed or damaged during injury. You may feel numbness, weakness, coldness, or tingling in your knee or lower leg. They may be pale or blue. Acute knee injuries include:
- Dislocations, sprains, or other injuries to the ligaments and tendons that connect and support the kneecap.
- Ruptures of the elastic cartilage discs of the knee joint (menisci).
- Ligament ruptures. The most commonly injured ligament in the knee is the tibial collateral ligament.
- Displacement (luxation) of the patella. This type of displacement most often occurs in girls between 13 and 18 years old. Pieces of bone or soft tissue (joint muscle) when fractured or displaced can become stuck in the joint and interfere with its movement.
- Dislocation (dislocation) of the knee joint. This is a rare injury that requires great force. This is a serious injury and requires immediate medical attention.
Knee fractures most often occur as a result of an abnormal force, such as falling on the knee, severely twisting the knee, a large force that bends the knee, or when the knee hits an object with force.
Damage due to overload
Overuse injuries occur when repetitive motion or repeated or long-term pressure is placed on the knee. Activities such as climbing stairs, cycling, jogging or jumping put stress on joints and other tissues and can lead to irritation and inflammation. Damage due to overload includes:
- Inflammation of the small bags of fluid that cushion and lubricate the knee (bursitis).
- Inflammation of the tendons (tendinitis) or small tears of the tendons (tendinosis).
- Thickening or wrinkling of the joint ligaments (fibrin film syndrome).
- Pain in the front of the knee from overuse, injury, excess weight, or problems in the kneecap (patellofemoral pain syndrome).
- Irritation and inflammation of the band of fibrous tissue that runs on the outside of the femur (iliotibial band syndrome).
The patella is an additional bone in the thickness of the tendon of the anterior group of thigh muscles. The base of the kneecap slides along the corresponding groove of the femur. During movements caused by the work of muscles and tendons, the kneecap moves slightly to the sides. Some unevenness of the bone or uneven force of the muscles, tendons, or ligaments can alter the normal movement of the kneecap. This causes knee pain that gets worse with physical exertion.
ligament injuries are common in adults, but they are rare in children because their ligaments are relatively stronger than their bones and their muscles are relatively weaker. Therefore, with a strong impact, fractures are more likely than ligament rupture. As bones become stronger during adolescence, knee injuries become more similar to those seen in adults. Such injuries are especially common in children involved in alpine skiing, tennis, skating, and football.
Treatment
Although knee pain is most often associated with changes in adjacent tissues, it can sometimes occur with hip . Call your doctor if your child:
- the skin around the knee(s) is swollen and hot to the touch;
- elevated temperature;
- pain or swelling occurs after an injury
- pain persists for a long time (more than 2 days) or periodically recurs;
- movement in the knee joint is limited or there is abnormal mobility.
If you suspect your child has injured ligaments in their knee, you should seek professional medical help.
On the empty place?
There are also complaints of pain for no reason, supposedly out of nowhere. And then it turns out that this is primary chronic recurrent osteomyelitis. A disease that occurs in children aged 7–8 or 12–14 years. Simply put, inflammation of the bone.
Pain that appears supposedly without an obvious reason should prompt parents to take the child at least to a surgeon at a local clinic. Here, too, you cannot do without radiography or CT. Orthopedists warn: until an accurate diagnosis is established, do not agree to physical therapy, guided by the principle “it won’t get worse.” In this case, it will. Osteomyelitis is a serious infectious disease that does not always respond to conservative treatment methods. In case of prolonged persistent pain, surgical removal of the source of inflammation will be required.
Prevention of primary chronic recurrent osteomyelitis is as follows: curing all chronic inflammatory diseases in the body - nasopharynx, intestines, kidneys, and so on.
How we are working
When you come with your child, a diagnosis will be carried out. In addition to standard orthopedic tests, functional movement testing will be performed, as well as gait analysis. This is necessary to determine the cause of the pain or injury. Having found the cause, we can carry out appropriate therapy.
In case of knee joint problems, it is very important to evaluate the patient’s walking, since this type of activity is of great importance in everyday life.
Once you find the problem, you can cure it, thereby achieving long-term results. This means that the problem will not reoccur on its own, and will also reduce the risk of possible injury.
For therapy we use the following:
- PNF
- Mulligan
- Kinesio taping
- Vibraplatforms
- Functional training
- Proprioception training
For more information about the condition of your child's knee, consult a specialist.