Pain in Children Series (pt 2) – Niggling Knee Pain

This is Part 2 of the Pain in Children Series, by Caitlin Hagdorn.

See Part 1; Pain in Children here;

In our last blog covering pain in children, we discussed niggling pain; the type that comes on over time and doesn’t have a necessarily clear cause or mechanism of injury. Today I want to talk to you about a very common type of niggling pain in children; knee pain.

Knee pain can come in many shapes and forms. There are a lot of anatomical causes of niggling pain in the knee, for example;



For children, if pain has come on gradually and without a specific mechanism of injury (a fall or accident of any kind), then it is unlikely they have damaged anything, however it is more likely that there are a few factors contributing to their pain. In this case, we discuss the pain as a syndrome as opposed to a specific structural issue. 

Syndrome = a group of signs and symptoms which consistently occur together and cause pain.

These contributing factors can include some or all of the following;


  • Tightness of the muscles or tissues attaching to the knee cap (quadriceps, ITB),
  • Weakness of the muscles attaching to the knee cap (quadriceps),
  • Poor motor control around the knee (and hip) = poor squat, running, jumping technique,
  • Physical load (please see the Pain in Children Blog linked above),
  • Psychological, emotional, or mental factors,
  • Growth.

Some of the aspects above are controllable and others are not. As physiotherapists we can assist with changing the top four aspects and can assist in identifying the fifth if it is part of the overarching problem.

It is important to recognise that just because there is not a specific structure that we are concerned is damaged, it is does not mean that their pain will not be harmful long-term, and it certainly means we need to approach this with care and concern.

It is common for children to experience pain. 

It is not normal. 

It is not something they should have to endure for the sake of their sport or leisure.

The good news is that we at Midland Physiotherapy see children with niggling knee pain every week. It is a common and very treatable type of pain.

If you would like some advice or assistance with treatment, please call our friendly team on (08) 9274 1482 today!

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