What Is Osgood-Schlatter Disease?
Osgood-Schlatter disease (OSD) is an inflammation of the bone, cartilage, and/or tendon at the top of the shinbone (tibia), where the tendon from the kneecap (patella) attaches. It's really not a disease, but an overuse injury.
OSD is one of the most common causes of knee pain in adolescents. It can be quite painful, but usually goes away within 12 to 24 months. Most often just one knee is affected.
Who Gets Osgood-Schlatter Disease?
OSD usually strikes active adolescents around the beginning of their growth spurts, the 2-year period in which they grow most quickly. Growth spurts can begin any time between the ages of 8 and 13 for girls, and 10 and 15 for boys. OSD has been more common in boys, but as more girls participate in sports, this is changing.
Teens increase their risk for OSD if they play sports involving running, twisting, and jumping, such as basketball, football, volleyball, soccer, tennis, figure skating, and gymnastics. Doctors disagree about the mechanics that cause the injury but agree that overuse and physical stress are involved.
What Happens in Osgood-Schlatter Disease?
Growth spurts make kids vulnerable to OSD because their bones, muscles, and tendons are growing quickly and not always at the same time.
With exercise, differences in size and strength between the muscle groups place unusual stress on the growth plate at the top of the shinbone. (A growth plate is a layer of cartilage near the end of a bone where most of the bone's growth happens. It is weaker and more at risk for injury than the rest of the bone.)
What Are the Signs & Symptoms of Osgood-Schlatter Disease?
Most parents call the doctor after their child complains of knee pain over several months. The pain may be anywhere from mild and felt only during activity to severe and constant.
Other symptoms may include:
- pain that gets worse with exercise
- relief from pain with rest
- swelling or tenderness under the knee and over the shinbone
- limping after exercise
- tightness of the muscles surrounding the knee (the hamstring and quadriceps muscles)
Symptoms that aren't typical of OSD include pain at rest, thigh pain, or very severe pain that awakens kids from sleep or makes them cry. If your child has any of these symptoms, call your doctor.
How Is Osgood-Schlatter Disease Treated?
OSD usually goes away when the bones stop growing, typically when a teen is between 14 and 18 years old.
Until then, only the symptoms need treatment. Rest is the key to pain relief. It's the most active kids who are most likely to get OSD, and they can need a lot of encouragement to rest the affected area.
In mild cases, doctors advise that kids limit the activities that cause pain. They might be able to continue their sports as long as the pain remains mild. When symptoms flare up, a short break from sports might be necessary.
More severe cases require more rest, usually a total break from sports and physical activities. Active kids may find this very difficult, but the knee can't heal without rest. Some teens wind up with a cast or brace to enforce the doctor's orders. After a long time off, kids need to ease back into activity carefully, usually with physical therapy to learn stretching and strengthening exercises.
How Else Can I Help My Child?
After your child gets back in the game, shock-absorbent insoles can decrease stress on the knee. Applying moist heat for 15 minutes before or icing for 20 minutes after activity can minimize swelling. Wrestling gel pads and basketball knee pads (available at sporting goods stores) can protect a tender shin from bumps and bruises.
A good stretching program, focusing on the hamstring and quadriceps muscles, before and after activity is important. Your doctor might also suggest over-the-counter pain medicines, such as ibuprofen, or prescription anti-inflammatory medicines.
Long-term effects of OSD are usually minor. Some kids may have a permanent, painless bump below the knee. In rare cases, they may develop a painful bony growth below the kneecap that must be surgically removed. Some adults who had OSD as kids have some pain with kneeling.