Sidelined with Knee Pain? How to Keep Your Teen Happy and Playing.
Besides Shin Splints there is another top injury from fall sport participation that gets in the way of your tween or teen enjoying his/her sport and that is knee pain. The top culprits could be Patellofemoral Dysfunction or Osgood-Schlatter Disease. But before you rush your child off to the doctor to get that knee pain labeled, and potentially told that he/she should stop playing, there are some very important first steps that can be taken to address your child’s complaints.
The first issue is that as parents we must pay attention to the marvel and lightning fast development of a tween or teen’s body from the age of 10 to 18. They not only move fast on the field but their bodies are changing rapidly and likely all the “parts” of their leg, (bones, muscles and tendons), have not caught up to each other. When the soft tissue of their legs have not lengthening to accommodate the new bone length, the areas of muscle/tendon insertion on the bone can pull at the bone, causing discomfort.
A secondary issue is the problem of your child doing very little physical activity over the summer but then expect they can tolerate 60-90 minutes of running, jumping and sprinting. Unfortunately, unless you encouraged your child to get out and do some conditioning this past summer, there is not much you can do for him/her now as the fall season is here. The leg muscles then strain and become very tight in the process of adapting to the abrupt change in activity. This tightness then shortens the muscle group, creating that pulling at the muscle/tendon insertion on the bone and/or also causing uneven force production at the knee joint which can cause pain at the knee cap.
So in summary…there is the issue of your child’s body changing and that sets up an awkward tug-of-war in the soft tissue tension in the leg muscles, but you also have the issue that your child has done nothing about it over the summer nor conditioned him/herself to get back in the game. No worries, as all is not lost…you may be able to help your child fix this!
What can you do now for your child?
1. Encourage pre-activity dynamics and have your child foam roll the legs, front and back from hips to ankles. Post-Activity, while your child’s body is still warm, he/she can foam roll again and then do static stretches to both the front and back muscles of the legs, from the hips down. Have him/her take their time with the static stretches with holds for at least 30 seconds, performing each stretch 3-5 times.
2. Ice the knee following activity to the region of pain, both to the front of the knee and back of the knee, extending the ice pack (frozen peas or corn) well above and below the knee by 8-10 inches. Don’t just plop a tiny ice pack on the child’s knee cap. This will do nothing to assist with reducing the inflammation of the knee. Inflammation in the knee, even at the tiniest amount, can cause changes in how the leg muscles function, further altering the knee’s mechanics, causing further pain.
3. Footwear---In my prior post about Shin Splints I reviewed the importance of footwear. If you didn’t catch my post here it is again: Check your child’s shoes and replace them well before season start, and break them in slowly to allow your child’s feet to adjust to the change in pressure from stiffer sneakers or cleats. If your child is wearing last year’s sneakers/cleats—make sure they are not causing abnormal rolling in of the ankle/foot and allowing the child’s feet to somewhat flatten. Hand-me-downs sometimes feed into poor foot posture and therefore cause stress on the lower leg muscles. A new pair of sneakers and shoes can often offset these issues. Just remember to break them in slowly as to ward off blisters and sore feet.
4. If the discomfort continues to be severe despite stretching, icing and change of footwear, talk to the school’s athletic trainer to see if your child can do stationary cycling, swimming, or rowing to maintain his/her cardiovascular fitness until the knee inflammation reduces. Running may just need to be avoided all together for a small period of time to reduce inflammation to a manageable level.
5. Tape and Bracing: This is a tough one to advise in a post. Tape and Bracing can help dramatically change the leg’s tolerance to activity. This is best applied by a trained professional so as to not waste your money on neoprene knee sleeves that slip down and fall off. They may offer a minimal level of comfort but may just band-aid and mask the bigger issues of obtaining proper mobility and strength in the leg—these issues still need to be addressed or the problem will persist or just come back. In regards to taping, taping can be assessed for effectiveness by a trained professional and the application can easily be learned by your son or daughter pre-sport.
If the knee pain continues despite these efforts, then a visit to a physical therapist can help. Physical Therapy may include deeper tissue and hands-on work to balance and stretch the leg muscles. A therapist can apply tape to facilitate pain free activity for strengthening of the leg’s muscles which can assist with improving their tolerance to exercise. This can all be done in a very short period of time if the issue is addressed sooner than later. Allowing activity, such as running while having pain, can alter tissue tension further, creating greater compensations in the strength and movement patterns of the legs, and potentially set your child up with a persistent and chronic knee pain issue.
If your child suffers from knee pain and you would like some advice, give me a call at 860-507-7365 or email me at firstname.lastname@example.org to set up a free discovery visit to see if physical therapy is appropriate for your child.