Osgood-Schlatter Disease

A graphic of the side of a knee with a raised bony lump

What is Osgood-Schlatter Disease?

Osgood-Schlatter Disease is a common knee pain felt in growing adolescents, especially those who are active and play a lot of sport. It's inflammation of the area just below the knee where the patellar tendon from the kneecap attaches to the shin bone. It will often feel like a bony bump and occurs from growth spurts during puberty as the bones, muscles and tendons are all changing quickly. 

Causes & risk factors

In most cases, physical activity can aggravate the child's tendon by placing more stress on it. High impact activities that include a lot of jumping, running or bending of the knee like basketball, netball, gymnastics, athletics, ballet etc. cause their thigh muscles (quadriceps) to pull tightly against the kneecap and patellar tendon, which then pulls on the shin bone. This repeated action causes the tendon to become tight and inflamed near its bone attachment (just below their knee). This results in pain and swelling at the area, and in some cases, the body attempts to close the growth plate (cartilage found at the ends of bones in children) with new bone, which can result in a lump in the area.

Considering the most common cause of the condition is high intensity exercise, there are certain factors that can increase your child's risk of developing the condition:

  • Exercise. Active children, particularly those who play high impact activities that involve a lot of jumping, running and agility (fast changes in direction) are more susceptible to the condition. 
  • Age. Osgood-Schlatter's tends to affect adolescents going through growth spurts. Boys are usually 12-14 and girls 10-13 as girls start to go through puberty earlier. 
  • Gender. The condition is traditionally more common in boys than girls, however this gender gap has reduced now that girls are much more involved in sports.
  • Injury. Prior knee injuries could increase your child's risk of developing the condition. 
  • Flexibility. Tightness in the quadriceps muscles can increase the tension on the growth plate. 

    Symptoms

    If your child starts to experience a combination of the following symptoms, then they may have Osgood-Schlatter Disease. 

    • Pain in the front of the knee, below the kneecap, usually worsening during particular high impact activities like running & jumping. 
    • Pain in one or both knees
    • Pain that eases with rest
    • Swelling below the kneecap 
    • Tenderness below the kneecap 
    • Redness and warmth below the kneecap 
    • A bony bump may or may not be present

    These symptoms usually disappear when your child's bones stop growing.

    Diagnosis

    Osgood-Schlatter's disease can usually be diagnosed by a physical examination. The podiatrists will take into account their age and daily activities, then examine the knee to look for pain, swelling, tenderness and redness. 

    If a complete diagnosis can not be made upon physical examination of the knee, they may order X-rays, an ultrasound or an MRI to rule out any other possible causes of your child's pain. 

    Treatment

    Osgood-Schlatter disease can typically resolve on it's own if you modify your child's activity, perform stretches and ice the area. If your child is still experiencing pain, our podiatrists can create an individualised treatment plan that will help reduce painful symptoms. 

    This may include a combination of the following:

    • The RICE protocol - rest, ice, compression & elevation
    • Strengthening and stretching exercises to strengthen and stretch the quadriceps muscles and hamstrings
    • Assessing their current footwear to ensure they're providing good support and keeping the feet aligned. Depending on this, the podiatrist may make recommendations for new footwear
    • If possible, adapting the activities the child is currently doing or stopping completely for a couple of weeks so the symptoms can subside, then slowly re-introducing the activity
    • Custom prescribed foot orthotics may be recommended to correct any alignment problems in the feet, that could be having an impact on the condition.

        Osgood-Schlatter disease should resolve within 12 months, however your child's knee may continue to feel uncomfortable until the bones finish growing.

        What can happen if I leave Osgood-Schlatter's disease untreated?

        It's uncommon for there to be complications with Osgood-Schlatter's, however, if your child tries to exercise through the pain with no sort of treatment to combat it, the condition could worsen by the quadriceps pulling even tighter against the kneecaps and patellar tendon.

        Where this tendon attaches to the shin bone, the area can become inflamed and micro-fractures of the bone could occur. Your child's body will repair the fractures by creating extra bone tissue, which can result in a bony bump becoming present below the kneecap, which may never resolve. 

        Prevention

        Your child could help to prevent Osgood-Schlatter's by: 

        • Doing a proper warm up before playing sports that will help to loosen their quadriceps, hamstrings and calf muscles
        • Stretching the muscles post sports/exercise
        • Use appropriate sports equipment for the activity
        • Ensure a proper technique is being used
        • Participating in sports that put less stress on your child's knees eg. swimming
        • Getting them to participate in a range of sports instead of 'specialising' in one. 
        • Wearing supportive, athletic shoes with good shock absorption

        FAQs

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