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Knee Pain in Teen Athletes: When It’s Growing Pains, Overuse, or Something That Needs Evaluation

Princeton Sports and Family Medicine, P.C. Blog Knee Pain in Teen Athletes: When It’s Growing Pains, Overuse, or Something That Needs Evaluation

Knee pain is one of the most common complaints in teen athletes.

A soccer player feels pain after practice. A basketball player has pain with jumping. A runner notices knee soreness during longer workouts. A volleyball player has pain below the kneecap. A parent wonders if the pain is just from growing.

Sometimes knee pain in teenagers is related to growth. But “growing pains” should not become a catch-all explanation for every knee complaint.

Pain that happens during sports, changes movement, causes limping, or keeps returning deserves a closer look.

Teen athletes are often growing, training harder, playing on multiple teams, sleeping less, and dealing with school stress all at the same time. Their bodies can adapt, but they need enough time, recovery, strength, nutrition, and load management.

For athletes in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County, the goal is to identify the cause of knee pain early and help the athlete return safely.

Quick Takeaways

Why Teen Athletes Get Knee Pain

Teen athletes are not just smaller adults. Their bodies are still developing.

During adolescence, bones may grow quickly. Muscles and tendons may feel tight. Coordination may temporarily change. Strength may not keep up with body size right away. At the same time, sports demands often increase.

A teen athlete may be dealing with:

Knee pain often appears when the total load becomes more than the athlete’s body can currently tolerate.

This does not mean the athlete is fragile. It means the training plan and recovery plan need to match the athlete’s stage of development.

Are Knee Pains Just Growing Pains?

Sometimes parents are told that knee pain is “just growing pains.” That phrase can be misleading.

Classic growing pains are usually vague aches, often in the legs, often at night, and typically not located in one specific joint. They usually do not cause swelling, limping, weakness, or pain during sports.

Sports-related knee pain is different.

Knee pain should not be dismissed as growing pains if it:

If pain behaves like a sports injury, it should be evaluated like one.

Common Causes of Knee Pain in Teen Athletes

Knee pain can come from several different structures. The location and behavior of pain can offer clues.

Osgood-Schlatter Symptoms

Osgood-Schlatter symptoms often cause pain at the bump just below the kneecap, where the patellar tendon attaches to the shin bone. This area can become irritated in growing athletes, especially with running, jumping, sprinting, squatting, and stairs.

Athletes may notice:

This is common during growth periods. It is usually manageable, but the athlete may need activity modification and a structured plan.

Patellofemoral Pain or Runner’s Knee

Pain around or behind the kneecap may be patellofemoral pain, often called runner’s knee.

This can happen in runners, field athletes, dancers, basketball players, volleyball players, and many other athletes.

Symptoms may include:

Patellofemoral pain often involves load, mechanics, hip strength, quad control, and training progression.

Patellar Tendon Pain

Pain just below the kneecap may also come from the patellar tendon, especially in jumping athletes.

This may be more common in sports with repeated jumping, landing, cutting, or sprinting, such as basketball, volleyball, soccer, football, and track.

Tendon pain often responds best to progressive loading, not just rest.

IT Band Irritation

Pain on the outside of the knee may involve the IT band, especially in runners or field athletes who are increasing mileage, hills, or speed work.

The athlete may feel pain after a certain amount of running, especially downhill or later in practice.

Meniscus or Ligament Injury

Some knee pain comes from a specific injury. A twist, pop, collision, awkward landing, or sudden change of direction can injure the meniscus, ligaments, or other structures.

More concerning symptoms include:

These symptoms should be evaluated.

Red Flags: When Knee Pain Needs Prompt Evaluation

Parents should schedule an evaluation if the athlete has:

These signs do not always mean a serious injury is present, but they should not be ignored.

Why Playing Through Pain Can Backfire

Teen athletes often want to keep playing. They may worry about losing a starting spot, missing tryouts, disappointing coaches, or falling behind teammates.

That pressure is real.

But playing through worsening knee pain can make recovery longer.

If an athlete changes movement to avoid pain, they may overload another area. A knee problem can become a hip, ankle, back, or opposite-leg problem. An overuse issue can become more persistent. A small injury can become a larger one if the athlete keeps pushing.

The goal is not to stop every athlete for every ache. The goal is to avoid ignoring pain that is clearly getting worse.

What Parents Should Ask

Parents can help by asking specific questions.

Instead of only asking, “Does your knee hurt?” try:

The answers can help determine whether symptoms are mild, overuse-related, or more concerning.

Training Load Is Often the Missing Clue

Knee pain rarely happens in isolation. It often follows a change in load.

Training load includes:

Parents and coaches may each see only one part of the schedule. The athlete feels the total load.

A teen soccer player may have school practice, club practice, private training, weekend games, and strength work all in the same week. A basketball player may have club tournaments, skill sessions, lifting, and open gyms. A runner may increase mileage, add hills, and race before the body is ready.

When knee pain appears, the calendar often tells part of the story.

Growth Spurts and the Awkward Phase

Growth spurts can make knee pain more likely.

During a growth spurt, the athlete may become tighter, less coordinated, and less efficient for a period of time. The bones, muscles, tendons, and nervous system are all adapting.

The athlete may feel like they are suddenly worse at their sport. They may look awkward or stiff. They may complain of soreness in areas that were never a problem before.

This does not mean the athlete is weak. It means the body is changing quickly.

During this phase, training may need to be adjusted. The athlete may need more recovery, better warm-ups, strength work, mobility, and careful progression.

What Helps Overuse Knee Pain?

The right plan depends on the diagnosis, but many overuse knee problems improve with a combination of:

Rest alone may help pain temporarily, but if strength, mechanics, or training load are not addressed, symptoms often return.

The goal is to build capacity so the knee can tolerate the demands of the sport again.

When Is Physical Therapy Helpful?

Physical therapy can be helpful when knee pain is related to strength, mobility, movement control, or return-to-sport progression.

A physical therapy plan may address:

Physical therapy should not be a generic list of exercises. It should match the athlete’s pain pattern, sport, growth stage, and goals.

Does My Teen Need Imaging?

Not every teen with knee pain needs an X-ray or MRI.

Imaging may be considered when there is:

A sports medicine evaluation helps decide whether imaging is needed. The exam and history usually guide the next step.

Should the Athlete Stop Playing?

It depends.

The athlete may be able to continue modified participation if:

The athlete should stop and be evaluated if:

This decision should be individualized. When in doubt, it is safer to evaluate early.

Knee Pain Care Near Princeton, NJ

Teen athletes in Princeton, Lawrenceville, West Windsor, Plainsboro, Hopewell, Pennington, Robbinsville, and Mercer County often balance school sports, club teams, training, academics, and growth.

That makes knee pain common, but it does not make it meaningless.

The best care starts with a clear diagnosis and a practical plan. The goal is not only to reduce pain. The goal is to help the athlete return safely, move well, and reduce the risk of recurrence.

How PSFM Can Help

At Princeton Sports and Family Medicine, knee pain care for teen athletes starts with understanding the athlete’s sport, growth stage, training load, and symptoms.

Sports Medicine Services can help evaluate knee pain, diagnose the source of symptoms, determine whether imaging is needed, and guide return-to-play decisions.

Physical Therapy can help athletes improve strength, mobility, balance, mechanics, and confidence.

For runners and field athletes with repeated knee pain, the Run Stride & Performance Evaluation can help evaluate running mechanics and loading patterns.

PSFM Wellness can support long-term health, fitness, and recovery habits.

Fuse Sports Performance can help athletes build strength, speed, durability, and performance capacity after pain is controlled.

The right starting point depends on the athlete’s symptoms, diagnosis, and goals.

How to Help Prevent Knee Pain From Returning

Prevention is not about one perfect exercise. It is about a system.

Helpful strategies include:

Athletes should also learn that reporting pain early is not weakness. It is often what keeps them available later.

Questions to Discuss With Coaches

Parents may need to communicate with coaches if pain is recurring.

Helpful questions include:

Most coaches want athletes healthy. Clear communication helps.

Related Pages

FAQs

Is knee pain in teen athletes just growing pains?

Not always. Growing pains usually do not cause limping, swelling, focal joint pain, or pain during sports. Activity-related knee pain should be evaluated if it persists or worsens.

What causes knee pain below the kneecap in teens?

Pain below the kneecap may be related to Osgood-Schlatter symptoms or patellar tendon irritation. The location, exam, and activity pattern help determine the cause.

Can my teen keep playing with knee pain?

Maybe, if pain is mild, does not worsen, does not cause limping, and settles within 24 hours. The athlete should stop and be evaluated if pain worsens, causes swelling, or changes mechanics.

When should knee pain be evaluated?

Knee pain should be evaluated if it causes limping, swelling, instability, locking, catching, night pain, inability to bear weight, or symptoms that keep returning.

Does teen knee pain need an MRI?

Not always. Many causes can be evaluated with history and exam. Imaging may be needed if there is trauma, swelling, instability, locking, or persistent symptoms.

Can physical therapy help teen knee pain?

Yes. Physical therapy can help address strength, mobility, balance, mechanics, and sport-specific return to activity.

What sports commonly cause teen knee pain?

Knee pain can occur in soccer, basketball, volleyball, football, running, lacrosse, field hockey, gymnastics, dance, and other sports involving running, jumping, landing, or cutting.

Where can I get teen knee pain evaluated near Princeton, NJ?

Princeton Sports and Family Medicine evaluates teen athletes with knee pain, overuse injuries, and return-to-sport concerns in Princeton, Lawrenceville, and surrounding Mercer County communities.

The Bottom Line

Knee pain in teen athletes is common, but it should not automatically be called growing pains.

Pain that happens during sports, worsens with activity, causes limping, or keeps returning deserves a clearer explanation. The right plan depends on the diagnosis, training load, growth stage, and sport demands.

If your teen athlete has knee pain that is limiting practice, games, stairs, running, jumping, or daily activity, request an appointment with Princeton Sports and Family Medicine.

This content is educational only and is not a substitute for individualized medical advice. If an athlete has severe pain, rapidly worsening symptoms, inability to bear weight, significant swelling, instability, locking, fever, redness, warmth, numbness, weakness, chest pain, fainting, major trauma, or other concerning symptoms, seek urgent medical evaluation.

Author
Peter Wenger, MD Peter C. Wenger, MD, is an orthopedic and non-operative sports injury specialist at Princeton Sports and Family Medicine, P.C., in Lawrenceville, New Jersey. He is board certified in both family medicine and sports medicine. Dr. Wenger brings a unique approach to sports medicine care with his comprehensive understanding of family medicine, sports medicine, and surgery. As a multisport athlete himself, he understands a patient’s desire to safely return to their sport.

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