Expert’s Corner: A guide to managing knee injuries in athletes


Knee pain and injuries are common among young athletes. Although some parents may think to bring their child to the emergency department (ED) when a knee injury occurs, there are many cases when the injury is better managed by either a primary care provider (PCP) or an orthopedic specialist.

The following guide will help you manage knee pain in athletes and provide guidance on when to refer your patient to an orthopedic specialist.

Conditions to manage at the primary care office

As sports specialization continues to increase for young athletes — particularly in high school and college — the incidence of overuse conditions of the knee is rising. Common injuries such as patellar tendinitis (Jumper’s knee), Osgood-Schlatter disease, Sinding-Larsen-Johansson syndrome, plica syndrome, iliotibial band syndrome and patellofemoral pain can usually be treated with:

  • rest/activity moderation/cross training
  • stretching/warm-ups prior to activity
  • frequent icing
  • NSAIDs
  • physical therapy
  • soft knee braces

Patients who respond to treatment and do not exhibit any swelling of the knee should continue to be monitored in the PCP’s office. But if symptoms persist or swelling is a concern, consider x-rays to rule out osteochondritis dissecans and possibly making a referral to an orthopedic specialist.

When to seek the expertise of an orthopedic specialist

Significant acute knee injuries can occur across any level or type of sport — from pickup basketball to premier league soccer. For young athletes, proper treatment may be the difference between a quick recovery and permanent damage.

Some symptoms of a knee injury that may warrant a referral to an orthopedic specialist include:

  • unreduced dislocation
  • obvious deformity
  • possible open fracture
  • high-energy mechanism
  • laceration involving the knee
  • signs of septic knee
  • knee effusion in case of structural injury

Other issues to be aware of that may require referral to an orthopedic specialist include:

  • contusions that don’t heal within 10-14 days with rest and activity limitation
  • knee sprains that don’t improve with crutches and a knee immobilizer/hinged knee brace within 10-14 days
  • suspected structural injuries such as an ACL tear, MCL/LCL tear, meniscus tear or reduced patellar dislocation

Recognizing the signs of an injury that could result in long-term damage can make a significant difference in how a young athlete recovers. For both physicians and their patients, quality care is always the priority. Boston Children’s understands that, which is why we partner with physicians to assist in providing the best care possible for your patients.

Learn more about Boston Children’s Sports Medicine Division. For fast access to appointments for your patients, call Boston Children’s Orthopedic Urgent Care at 617-355-6021.