Patient Education


Pediatric Physiotherapy


Pediatric Musculoskeletal Pain

6.1-14.6% of children and adolescents will experience musculoskeletal (msk) pain; pain due to inflammation or micro damage to muscle, tendon, ligament or bone.  This can be of traumatic cause or mechanical, the latter being the result of cumulative wear and tear. Cumulative wear and tear may be the result of overtraining or stress overload – when tissues are subjected to undue strain due to altered mechanics i.e. altered alignment or muscular imbalances or simple overuse.

Amongst adolescents, 32.8 % of msk pain is due to knee arthralgia or knee joint pain, of mechanical origin, meaning a traumatic event did not occur.

Chondromalacia patella or patellofemoral pain syndrome are the most common causes of this pain. Both of these disorders develop due to:

  • Altered biomechanics at the foot/ankle, most commonly over-pronation of the subtalar joint or collapse of the inside arch of the foot leading to altered weight distribution through the entire lower extremity.  ***This is often driven by poor muscle stability at the hip joint negating the need for orthotics in children***
  • Altered biomechanics at the spine/pelvis/hip.  Weak core abdominal strength may be a factor.
  • Muscle issues categorized as “stiffness/inflexibility” or “weakness”.

 See more in depth information on this topic here:

The American Academy of Orthopedic Surgeons specifies in its guideline pertaining to children and physical activity that pain during exercise is not normal for children and warrants a consultation with the pediatrician.

What is the solution?

An in depth physical and biomechanical exam, often including a video gait analysis can determine factors that are contributing to the problem.  These can often be corrected with a rehabilitative exercise program.


Other common Musculoskeletal Pediatric conditions include:

Back Pain in Children/Adolescents


Patellar Tendonosis in Adolescents