So your daughter has knee pain and you don' t know why. Over the past couple weeks we have seen a few younger girls coming into the clinic with knee pain. Parents are obviously concerned why their active and healthy daughter is having knee pain. If there hasn’t been an obvious event which caused the pain, like a slide tackle in soccer, then parents seem to be even more confused as to why this pain isn’t going away. If a physician has ruled out an ACL tear, a meniscus tear, or some other structural issue, then it is usually diagnosed as a tendonitis, strain, patellofemoral pain, or jumper’s knee. The question then follows,
“Can physical therapy help my daughter's knee pain?”
I truly believe that proper physical therapy is the best form of care for these patients.
Here is a quick overview of things to look at when addressing anterior knee pain (pain in the front of the knee) in your young active daughter.
1) How is her single leg stability?
One of the biggest culprits to knee pain in young girls is inadequate hip and core strength. It makes sense doesn’t it? If the hip joint, which is right above the knee joint, is not stable when they are running, jumping, dancing, or kicking, then the knee is going to be abused. The excess motion at the knee is eventually going to cause tissue pain, inflammation and possibly damage.
2) How is her ankle mobility?
In the same way that issues in the hip can cause havoc at the knee, the foot can do just as much damage. From a very simplistic view, if they have “low arches” then I would be 80% certain that their lack of arch support is causing most of the pain in their knee. Addressing this issue with strengthening and possibly arch supports would help. The foot and ankle not only have issues with too much movement, but also with stiffness. The calf muscles in your growing daughter will likely tend to be tight. This restricts forward motion of the leg over the foot and therefore alters the mechanics of the entire leg when walking, running, jumping, etc.
3) How is her running, jumping, and landing mechanics?
This third area addresses how well she integrates all her strength and mobility to move effectively. Is there something which can be done about the way she is running to decrease the amount of strain on the knee? Has the weakness in the hips led to an establishment of horrible jumping mechanics? I”ve seen some jump landing mechanics which make you cringe when you look at them in slow motion on video analysis.
If you add to these three a high volume of repetition with inadequate rest, then you have yourself the perfect recipe for knee pain in younger active girls. So if your daughter has pain in the front of her knee which isn’t going away on its own, you might want to have someone look at these areas and start her on her road back to pain free running and jumping.