Understanding activity-related knee, hip and back pain in kids
Kids who run, jump and train hard can feel pain far from their feet. A sore knee, an achy hip or a tight lower back after soccer, basketball, track or dance is a common reason for a visit. Parents often notice it when a child slows down, avoids a favorite sport or complains after practice.
The body works as one chain. The feet meet the ground, and everything above them, including the ankles, knees, hips and back, reacts to how the feet move. Flat feet, high arches, tight calves or weak hip muscles can all change how force travels up the leg. Over time, that extra stress may show up as pain in a joint higher up. Growing bones can add to the problem, because muscles and tendons may be tight while the body grows.
At Run Doctor, we are a sports medicine practice. Dr. Kate Cryderman has a special interest in biomechanics, and Dr. Lawrence Maurer has years of experience with athletes. We examine your child from the ground up, including a gait and movement check. We look for the root cause of the pain, so your child can get back to the sport they love as safely as possible.
Signs and symptoms
- Knee pain during or after running, jumping or squatting
- Hip pain or a pinching feeling in the front or side of the hip
- Low back pain that grows with sport or long sitting
- Limping or favoring one leg
- Pain that eases with rest and returns with play
- Tight calves, thighs or hips
- Feet that roll in or out during sports
- Shoes that wear down unevenly
Common causes
Foot position and flat arches
Feet that roll in a lot may twist the leg and add strain to the knee and hip. Some kids with flat feet have more leg fatigue.
Tight or weak muscles
Tight calves, hamstrings or hips, and weak core or hip muscles, may change how a child moves and strain a joint.
Growth spurts
When bones grow fast, muscles and tendons may feel tight. This can raise stress on the knee, hip and back.
Too much, too soon
Playing on several teams or jumping into a new season can overload young joints. Rest days matter.
Shoes and playing surfaces
Worn or poorly fitting shoes, and hard courts or fields, can add stress to the whole leg.
How we diagnose it
We begin by asking about your child's pain, sports, training load, shoes and any past injuries. Then we examine the feet, ankles, knees, hips and lower back. We test flexibility and strength, and watch your child stand, walk, run and squat. A video gait analysis may show how the feet and legs move during activity. We may suggest an X-ray or other tests, or ask another specialist to see your child, if the pain does not fit an overuse pattern. We never diagnose from one sign alone.
Biomechanical exam and gait analysis are part of how we work.
Treatment options
We start with conservative care. Surgery is only discussed when it is the best option for you.
- 1
Activity changes and rest
We help you find the right balance. Your child may do less of the sport that hurts, while staying active in other ways.
- 2
Stretching and strengthening
Targeted exercises for the calves, hips and core may help the body share the load. We keep the plan short and doable.
- 3
Shoe review
We check your child's sport and everyday shoes. A better fit and the right support may lower strain.
- 4
Custom orthotics
If the way the feet move adds stress up the leg, a custom orthotic may help. We only suggest one after an exam and gait check.
- 5
Return-to-sport plan
We help you build a gradual plan to return to play. We explain warning signs to watch for along the way.
When to see a podiatrist
- Pain that lasts more than a week or two
- Pain that is getting worse
- A limp or pain that wakes your child at night
- Pain that stops your child from playing
- Swelling, locking or giving way of the knee
- Hip or back pain after a fall or hit
- You want a sports and movement check for your child
Prevention tips
- Warm up and stretch before play
- Rotate sports and take rest days
- Replace worn-out athletic shoes
- Increase training slowly
- Build core, hip and leg strength with simple exercises
- Tell a coach or parent early when something hurts
Frequently asked questions
Can foot problems really cause knee, hip or back pain?
They may add to it. Feet are the base for the whole leg, and the way they move can change the load on the joints above. We look at the full picture.
Does my child need to stop sports?
Not always. Many kids can stay active with changes. We tell you what is safe and what to hold off on.
Will my child need an X-ray or MRI?
Not always. An exam often gives us a good answer. We suggest tests when the pain is not typical or does not improve.
Do you treat back and hip pain?
We look at how the feet and legs may add to it, and we can guide you on next steps. If a problem is outside our care, we help you find the right specialist.
What should we bring to the visit?
Bring your child's everyday shoes and sport shoes. Worn soles tell us a lot. Wear comfortable clothes that let us see the legs.
Related care
This page is general information. It is not medical advice and it does not replace an exam. If you have severe pain, an open wound, fever, or sudden numbness, get urgent care. Last updated.