Understanding Anterior Knee Pain in Teenagers: Growth, Puberty and How Physiotherapy Can Help
Knee pain is one of the most common reasons teenagers stop enjoying sport or activity. For some, it shows up as a dull ache at the front of the knee. For others, it’s sharp pain below the kneecap or at the bony lump on the shin.
If you’re a parent watching your child struggle with pain, you may be wondering: Is this just growing pains? Should they rest? Will it get better on its own?
The truth is: most anterior knee pain is related to changes during growth and puberty. And while many families are told “don’t worry, they’ll grow out of it” or encouraged to adopt a wait-and-see approach, research shows this can leave teens with ongoing pain, loss of confidence, and reduced participation in the activities they love. The good news? With the right support, it can be managed — and your child can stay active.
Why Teenagers Get Knee Pain
Teenagers are not “small adults.” Their bodies are going through:
Rapid growth spurts → bones grow quickly, but muscles and tendons take longer to catch up.
Hormonal changes → especially in girls, the pelvis widens, changing how the thigh bone and kneecap align.
Busy sporting loads → training, school sport, and competitions stack up, often without enough rest.
Developing neuromuscular control → coordination and strength take time to “catch up” to longer limbs and changing body shapes.
All of these factors put extra pressure on the knee.
Common Types of Anterior Knee Pain in Teens
1. Patellofemoral Pain (more common in girls)
Caused by changes in pelvic width and the Q angle (the pull of the thigh muscles on the kneecap).
A wider pelvis during puberty increases the Q angle, pulling the kneecap slightly sideways.
This can irritate the tissues around the knee and cause pain with running, jumping, or climbing stairs.
2. Osgood-Schlatter Disease (more common in boys, but can affect both genders)
Pain and swelling just below the kneecap, at the tibial tuberosity (the bony lump on the shin).
Caused by repeated pulling of the strong patellar tendon during growth spurts, especially in active kids.
3. Sinding-Larsen-Johansson Syndrome
Pain at the bottom tip of the kneecap where the tendon attaches.
Similar to Osgood-Schlatter, but higher up.
Often worse with sprinting, jumping, or kicking.
The Problem With, “They’ll Grow Out of It”
Many young people are told by well-meaning adults or clinicians that knee pain is “just growing pains” and to simply wait for it to pass. While some pain may ease as the growth plates close, this wait-and-see approach can have real consequences:
Ongoing pain that lasts months or even years.
Reduced participation in sport, dance, or even everyday activities like climbing stairs.
Loss of confidence in their body and a fear of movement.
Missed opportunities at a key stage when physical activity is essential for health, fitness, and social connection.
The message that they’ll “grow out of it” can leave teens feeling dismissed and unsupported, at a time when reassurance, clear answers, and active management make all the difference.
What Makes Knee Pain Worse?
Too much, too soon → big increases in sport or training loads.
Hard playing surfaces or poor footwear.
Weak gluteal and core muscles → less pelvic control means more load on the knees.
Fatigue → tired muscles can’t protect growing joints as well.
How Physiotherapy Can Help
Physiotherapy is about much more than rest or ice. We focus on active recovery that supports your teenager through growth and puberty:
Assessment and Diagnosis
We identify if pain is coming from the kneecap, the growth plate, or both.
Clear diagnosis = relief for teens who often feel dismissed.
Strength and Conditioning
Build strength in gluteals, quadriceps, hamstrings, and core.
This supports pelvic and knee alignment, reducing strain on painful areas.
Movement Retraining
Teach safe landing, squatting, and running techniques.
Correct knee valgus (inward drift) and improve control.
Load Management
Balance training, games, and recovery so the knee has time to adapt.
Adjust sport loads without necessarily stopping everything.
Education and Empowerment
Helping teens understand why pain is happening reduces fear.
We teach them that pain does not mean long-term damage.
The focus shifts from what they can’t do → to what they can do.
What Parents Can Do
Take pain seriously – it’s not “just growing pains.”
Seek help early – the earlier we start, the quicker recovery is.
Encourage balance – rest days, cross-training, and sleep are as important as practice.
Back your child’s confidence – reassure them their body is strong and adaptable.
Conclusion
Anterior knee pain in teenagers is common, but not something to ignore. Whether it’s related to pelvic changes in girls, or tendon pain from rapid growth in boys and girls, physiotherapy offers safe, practical solutions.
By avoiding the wait-and-see approach and giving teens the tools they need, we reduce pain, restore confidence, and keep them engaged in sport and activity during one of the most important growth stages of their life.
