At age 19, Lauren Stewart underwent bilateral knee surgery to clear scar tissue that had accumulated after years of wear and tear as a competition gymnast."It was a dull, irritating ache," said Stewart. "I first noticed the pain while climbing Half Dome—it was eight miles up and eight miles down. I really felt it on the downhill part. For two days my knees hurt so bad."
Lauren is one of the thousands of teen-agers who suffer from knee injuries each year. The American Academy of Orthopedic Surgeons claims that an increase in participation in school athletics and community programs is driving the trend.
At the high school level there are 32 male and 27 female competitive sports with seven million teens participating across the country. Knee injuries are more likely to occur in sports like football, skiing, and gymnastics.
In Lauren’s case, 14 years of pushing her five-foot tall body through rigorous tumbling moves resulted in anterior knee pain and dead tissue behind the patella, or kneecap. An orthopedic surgeon performed arthroscopic surgery to remove the scar tissue that was causing the pain.
The procedure requires making a one-inch incision along the knee. Then a long instrument with a camera on one end is inserted through the incision. Another device is used to remove the scar tissue. The doctor watches a monitor to perform the surgery inside the knee.
After two months of rest, Lauren went back to competing for the University of Washington gymnastics team without any further complications.
Chronic anterior knee pain, such as Lauren’s, is common among teenage athletes—especially girls. The knee may become swollen and tender after activities that repeatedly flex the knee. This is often caused by improper training techniques, over-doing exercise, or even having knock-knees or abnormal hip rotation. Doctors usually prescribe ice, rest, and an exercise program to rehabilitate the knee.
Dislocation of the kneecap is also common in teenagers said Dr. Dan Zelazny, a clinical instructor in orthopedic sports medicine and trauma at New York Medical College. The kneecap can pop out of place as the result of a traumatic event, or it may occur in people who are double-jointed because their ligaments are more lax.
An orthopedist will either recommend surgery to repair the torn ligaments that are supposed to hold the kneecap in place, or they’ll suggest conservative management. This usually involves wearing a brace during physical activity after the first injury.
"If the kneecap pops out again, then the patient will go for surgery," said Zelazny.
Another source of pain in young athletes, especially those between the ages of nine and 13, is Osgood-Schlatter disease. It often appears as a bump on the knee. Other symptoms include swelling, tenderness, and an aching joint. Pain is usually exacerbated with exercise and eases during rest.
Dr. Zelazny said the disease usually goes away when the child stops growing, and there are no real long-term problems associated with Osgood-Schlatters.
"They used to tell kids no sports, but that has changed," said Zelazny. "Pain should be your guide. If it’s hurts, then stop. If it doesn’t hurt, then keep going," he said.
Experts offer some simple advice to help parents, coaches, and teens avoid knee injuries. They say young athletes should always wear proper protective gear. Athletes should warm up before playing and avoid physical activity when they’re tired.
The good news is, most teenage injuries usually receive a good prognosis for recovery.
"Kids are like tadpoles," said Zelazny, "because they have tremendous regenerative ability that adults don’t have."
