Knee Pain

Knee pain is a common presenting complaint with children and there are many possible causes. At Children’s Orthotics, our team of experienced paediatric orthotists understand the importance of identifying the underlying cause to guarantee the best treatment plan possible.

Common Conditions Related to Knee Pain

Conditions commonly related to knee pain are usually broken down into 4 compartments, the anterior (front of the knee), medial (inside the knee), lateral (outside the knee) and the posterior (back of the knee) part of the knee.

Anterior Knee Pain:

Medial Knee Pain:

Lateral Knee Pain:

Posterior Knee Pain:

Common Causes of Knee Pain in Children and Adolescents

Knee pain can also develop as a result of medical conditions such as arthritis, gout and infection.

Risk Factors of Knee Pain

Previous Injury - Previous injury has been suggested as the greatest risk factor for future or re-injury. Previous injury can affect changes along the kinetic chain, i.e. proprioceptive deficits, reduced range of motion, excessive flexibility and scar tissue accumulation.

Sudden growth - The knee absorbs large amounts of pressure with every step, typically one-and-a-half times your own body weight. That pressure plus growth, can cause knee pains commonly known as growing pains.

Body Weight - Excessive weight places more strain on the joints, especially on the cartilage that protects the ends of your bones from rubbing together. Extra body fat also sometimes increases chemicals in your blood that inflame your joints. Maintaining a healthy body weight can be crucial in reducing the chances of sustaining a knee injury.

Hypermobility - Children who have hypermobile joints are often more susceptible to knee pain. This is normally due to the additional stress placed on the hard structures of the knee joint due to the lack of control offered from the child’s hypermobile muscles, ligaments and tendons. It is more common for children with hypermobility to have more movement in their knee caps and they can be at higher risk of knee cap (patella) dislocation.

Repetitive injury - Regular kneeling or squatting for activities such as skiing, snowboarding or wake boarding can increase the opportunity for knee pain.

Sports - Knee pain is very common in contact sports, particularly those that involve twisting and high impact. Common knee problems associated with sports injuries include sprains, strains, tendonitis or ligament ruptures.

Treatment Options for Knee Pain

Knee bracing - Knee bracing has proven to be an effective tool in helping knee pain, it is important to understand that knee braces may cause pain or further injury if not worn properly, that is why it is important to seek professional advice before using a knee brace.

Surgery - In some cases, the knee injury may be too severe to treat with orthotic devices. Further surgery may be needed to help an injury or a symptom of a condition

Physiotherapy - Overall, physiotherapy is beneficial for the knee. The manipulation of the muscles, tendons and tissues allows the pressure on the knee to be released as the muscles soften and relax. Physiotherapy also works towards strengthening the weakened areas to aid in recovery and prevent future knee pain.

Medication - Medication for pain and anti-inflammatory is regularly prescribed to assist with pain management. In some cases, regular movement is advised over rest. Medication can assist in aiding movement by managing the levels of pain felt whilst ambulating.

Insoles - Pain that presents at the knee may be a result of biomechanical problems elsewhere, such as the foot and ankle. By using insoles to correct the alignment at the foot and ankle, it can also help the knee.

How Can Children’s Orthotic help in Treatment of Knee Pain

ACL bracing - The ACL brace (anterior cruciate ligament) reduces and prevents excessive rotation of the knee, provides proprioceptive feedback, and can be used to limit the range of motion post-surgically. The ACL also helps to limit the amount of movement at the knee joint, which is thought to decrease force through the ligament

PCL bracing - The PCL brace (posterior cruciate ligament) prevents the tibia from moving backwards in relation to the femur, as well as some rotational forces. As the knee bends, there is an increased force on the PCL, the brace uses a ratchet system that applies a counteractive force proportional to the angle of flexion at the knee.

MCL/ LCL bracing (medial/ lateral collateral ligament) - Children’s Orthotics have a range of ‘off the shelf’ and custom knee bracing solutions for MCL/ LCL injuries. The bracing can be made of strong carbon fibre in the case of ligament tears or ligament ruptures. Alternatively we have softer but supportive bracing fro MCM/ LCL sprains.

Patella stabilising brace - The patella (knee cap) stabilising braces are often used for patella tendonitis or patella dislocations. Patella dislocations can occur when the kneecap has veered off the patellar groove. This may be a result of underlying hypermobility or rotational type injury. Children's Orthotics can provide a range of bracing which cup and hold the patella stable to prevent further dislocations. In the case of patella tendonitis, a patella strap brace helps compress the patellar tendon and aims to alleviate on the tendon. Alternatively, a combined stability brace may help reduce knee stress in the short or long term.

What Might The Assessment Procedure Involve

In the first instance, an appointment would be made with an orthotist in which a full initial assessment would be conducted. Your orthotist will ask you questions about your child’s daily activities, medical history and the specifics of the knee pain.

The paediatric orthotist will undertake a gait examination and watch them walk, paying attention to movements at their affected joints and making observations of how their body moves. Following this, your child’s treatment options and goals will be discussed and a prescription made. Any devices that are required will be fabricated using materials chosen specifically to meet their requirements and then a fitting session arranged. All of our prescriptions and fittings are followed by a review to ensure that the treatment is effective and any adjustments can be made.

To get in touch or arrange an appointment, you can call us at 0330 088 3949 or email office@orthotics.co.uk.