Knee Pain in Young Athletes: Causes and Management Strategies

Knee problems

I am a member of the table tennis school team and occasionally run track.
Suddenly, my knees started to hurt in middle school, and I couldn't pinpoint the exact location of the pain; it was just very painful, so I went to see a doctor.
I had an X-ray done, which showed no issues.
The doctor mentioned that my ligaments in both legs were quite loose, but it might just be due to my young age.
It was likely just growing pains, and I was prescribed painkillers and advised to rest.
After resting for a year and a half, it seemed like there were no major problems, and I didn't pay much attention to it.
However, in October of last year, my right knee started hurting again.
I consulted a different doctor who also noted that my ligaments were loose, but the right leg was even looser.
Another X-ray showed no issues, and this year I was referred to a major hospital for an MRI.
The report indicated that there were no problems with the cartilage or ligaments, but there was internal inflammation and fluid accumulation.
The doctor advised against aspiration and suggested that it should be allowed to absorb on its own, along with rest and no exercise.
However, I have competitions coming up, so the doctor told me to wear a knee brace or elastic bandage while exercising and to ice my knee after workouts, followed by heat therapy.
Previously, my condition was quite stable, but occasionally, while walking (especially downhill or down stairs), my leg would suddenly feel weak, although it would recover quickly.
Standing for a while would also cause some pain, but there was no pain when at rest or during running.
Recently, the situation has been worsening.
Is it really just a matter of resting? But I already rested for a year and a half in middle school, and it didn’t help.
Does resting even work? What is actually wrong with my leg?

Sparkler, 10~19 year old female. Ask Date: 2018/06/10

Dr. Shi Guozheng reply Orthopedics

It could be ligament inflammation or an issue with the patella; you may want to consult another physician for further evaluation.

Reply Date: 2018/06/10

More Info

Understanding knee pain in young athletes is crucial, especially given the increasing participation of youth in sports. Knee pain can arise from various causes, particularly in adolescents who are still growing and developing. In your case, it seems you have experienced a series of knee issues that have persisted despite previous rest and medical evaluations.

Causes of Knee Pain in Young Athletes
1. Growth-Related Issues: Adolescents often experience growth spurts, which can lead to conditions like Osgood-Schlatter disease, characterized by pain below the kneecap due to inflammation of the patellar tendon where it attaches to the tibia. This is common in active teenagers and can cause intermittent pain, especially during physical activities.

2. Patellar Tendonitis (Jumper's Knee): This condition is prevalent among young athletes involved in sports that require jumping or running. It results from overuse and can lead to pain in the knee, particularly below the kneecap.

3. Ligament Laxity: As noted in your case, having "loose" ligaments can predispose you to knee pain. While some degree of ligament laxity is normal in adolescents, excessive laxity can lead to instability and pain, especially during dynamic activities.

4. Internal Inflammation: Your MRI results indicating internal inflammation and fluid accumulation suggest that there may be an underlying issue that needs to be addressed. This could be due to overuse, improper biomechanics, or even minor injuries that have not fully healed.

Management Strategies
1. Rest and Activity Modification: While you have already taken a significant period off from sports, it is essential to listen to your body. If certain movements or activities exacerbate your pain, it may be necessary to modify your training regimen. Gradually reintroducing activities can help assess what is tolerable.

2. Physical Therapy: Engaging in a structured physical therapy program can be beneficial. A physical therapist can provide exercises to strengthen the muscles around the knee, improve flexibility, and correct any biomechanical issues that may contribute to your pain. Strengthening the quadriceps, hamstrings, and calf muscles can provide better support to the knee joint.

3. Use of Supportive Gear: As advised by your doctor, using knee braces or supports during activities can help stabilize the knee and prevent further injury. This is particularly important if you are experiencing instability or sudden weakness.

4. Ice and Heat Therapy: Applying ice after activity can help reduce inflammation and pain. Heat can be beneficial before activities to warm up the muscles and improve flexibility. Alternating between ice and heat may also provide relief.

5. Gradual Return to Activity: When you feel ready to return to sports, do so gradually. Start with low-impact activities and slowly increase intensity and duration. Pay attention to your body’s signals and avoid pushing through pain.

6. Consultation with Specialists: If your symptoms persist despite conservative management, it may be worthwhile to consult with a sports medicine specialist or an orthopedic surgeon who can provide further insights and possibly recommend advanced imaging or interventions.

Conclusion
Knee pain in young athletes can be multifactorial, and while rest is essential, it is not always the sole solution. A comprehensive approach that includes physical therapy, activity modification, and proper support can significantly aid in recovery. It’s also crucial to maintain open communication with your healthcare providers to ensure that your concerns are addressed and that you can return to your sports safely and effectively. Remember, your long-term health is more important than immediate competition, so prioritize your recovery.

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