Stress injuries to the bone and physis of the knee are common in the active adolescent patient and can be broken down into bone stress injuries (BSIs) and chronic physeal stress injuries. BSIs result from prolonged, repetitive bone loading, whereas chronic physeal stress injuries develop from repetitive loading to the apophysis or epiphysis. Most stress injuries of the knee resolve with relative rest but will occasionally need surgical intervention in more severe cases. Early and accurate identification is paramount for optimal management and to avoid long-term consequences.