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Osgood-Schlatter Disease

If your child is active in sports and starts experiencing knee pain, especially during growth spurts, they might be dealing with Osgood-Schlatter disease. This condition is a common cause of knee pain in young athletes, particularly those in high-impact sports like soccer and gymnastics. 

At Banner Children’s, we understand how important it is for young athletes to stay active and healthy. Our pediatric orthopedic specialists are here to help you navigate the condition with expert care and support. 

What is Osgood-Schlatter disease?

Osgood-Schlatter disease happens when the patellar tendon (which connects the kneecap to the shinbone) pulls on the growth plate at the top of the shinbone, called the tibial tubercle. This constant pulling causes pain, swelling and sometimes a bony lump to form on the knee.

The condition is most common during growth spurts or puberty, typically between the ages of 9 and 14. During puberty, bones, muscles and tendons grow quickly. 

It’s most often seen in children and teens who play sports that require a lot of running, jumping and quick changes in direction. Soccer, basketball, volleyball and gymnastics are common triggers of Osgood-Schlatter disease.

Causes and risk factors for Osgood-Schlatter disease

Osgood-Schlatter disease occurs due to overuse and strain on the knee joint.

During periods of rapid growth, a child’s bones grow quickly but the muscles and tendons may not keep up. This can lead to tightness in the quadriceps (front of the thigh) and hamstring muscles (back of the thigh), which puts extra strain on the knee joint, especially the tibial tubercle.   

When a young athlete participates in sports activities that involve a lot of running and jumping, the stress on the knee increases and the patellar tendon pulls more on the tibial tubercle. Over time, this can cause pain and swelling.

All children can develop Osgood-Schlatter disease, but the following factors can increase your risk:

  • Poor flexibility: Tightness in the hamstrings or quadriceps can put extra stress on the knee joint, increasing the risk of irritation at the growth plate.
  • Gender: Boys are more likely to develop Osgood-Schlatter disease than girls.
  • Sport specialization: Children specializing in or playing one sport are at greater risk for overuse and knee conditions.
  • Prior injury: Around half of children with the condition had a previous knee injury. 

Symptoms of Osgood-Schlatter disease

Osgood-Schlatter disease typically causes pain and swelling just below the kneecap, where the patellar tendon attaches to the tibial tubercle. The pain can range from mild to severe and usually worsens with physical activity, especially sports such as running, jumping or kneeling. It is usually felt in one knee but can sometimes occur in both knees. 

Other symptoms can include:

  • Tenderness or soreness around the knee
  • A visible bump or swelling at the tibial tubercle
  • Tightness in the quadriceps and hamstring muscles
  • Pain that eases with rest and worsens with sports activities

Complications of Osgood-Schlatter disease

While most children recover from the knee condition without long-term problems, some children may have complications like:

  • Chronic pain: In rare cases, knee pain may continue into adulthood, especially if the condition is not properly managed.
  • Painless bump: The bump on the tibial tubercle may remain after the pain goes away. It’s usually harmless but can cause some pain when kneeling.
  • Reduced flexibility or strength: Untreated Osgood-Schlatter disease can lead to tightness in the quadriceps or hamstrings, limiting flexibility and strength.
  • Tibial tubercle fracture: This can happen if the patellar tendon pulls too hard on the growth plate, causing the bone to crack. This is very rare but requires more aggressive treatment, such as a cast or surgery and a longer recovery time. 

How is Osgood-Schlatter disease diagnosed?

Your child’s primary care provider can usually diagnose Osgood-Schlatter disease based on symptoms and a physical exam. They will check for pain, swelling and tenderness around the knee and may ask about your child’s sports activities.

A bone x-ray may be taken to get a clearer view of the tibial tubercle and rule out other possible causes of knee pain, such as fractures or infections. 

Treatment of Osgood-Schlatter disease

Osgood-Schlatter disease is treated with a combination of rest, ice and stretching exercises. The goal is to reduce pain and swelling while allowing the knee to heal. 

Treatment can vary depending on the severity of the pain and your child’s level of physical activity. 

Rest and activity modification

Rest is key to reducing the stress on the knee and allowing it to heal. Your child may need to take a break from sports activities or reduce their level of participation. This doesn’t mean they have to stop all physical activity, but high-impact sports like running or jumping should be limited. 

Ice and anti-inflammatory medications

Apply ice to the knee to reduce pain and swelling. Ice packs can be used for 15-20 minutes several times a day, especially after physical activity. 

Over-the-counter (OTC) anti-inflammatory medications like ibuprofen or acetaminophen (Tylenol) can help manage pain and reduce swelling. 

Stretch and strengthen

Stretching and strengthening exercises for the quadriceps, hamstrings and calf muscles can reduce knee strain and improve stability. A physical therapist can teach your child specific stretches to help ease tension in these muscles. These exercises may include seated hamstring stretches or standing quadriceps stretches. 

Knee supports or braces

Knee braces help relieve some of the pressure on the knee and protect the tibial tubercle during sports activities. In some cases, knee taping can also provide support. 

Gradual return to sports

Once the pain and swelling have improved, your child can gradually return to sports activities. It’s important to ease back into sports slowly, starting with low-impact activities and gradually increasing intensity. Continue to do stretches and strength exercises to help prevent symptoms from returning. In almost every case, surgery is not necessary. 

Long-term outlook

The good news is that Osgood-Schlatter disease usually goes away on its own as your child finishes growing. The pain typically lasts several months, but in some cases it can continue for up to two years. 

With proper care and rest, most children with Osgood-Schlatter disease make a full recovery and can return to their normal activities without any long-term issues. 

Preventing Osgood-Schlatter disease

While it may not be possible to prevent Osgood-Schlatter disease entirely, there are steps young athletes can take to reduce their risk of developing it. 

  • Stretch regularly: Stretch the quadriceps and hamstring muscles before and after sports activities to keep the muscles flexible and reduce strain on the knees. 
  • Strengthen muscles: Strengthening the muscles around the knee can help protect the knee joint and reduce the risk of injury. Good exercises include squats, glute bridges and step-ups.
  • Use proper technique: Learn proper running, jumping and landing techniques to help reduce knee stress. A sports or athletic trainer can help guide your child on proper form to prevent injuries.
  • Avoid overtraining: Participating in sports without enough rest increases the risk of developing Osgood-Schlatter disease. Your young athlete needs to get enough rest and avoid overtraining.
  • Schedule regular sports physicals: Sports physicals are an important part of keeping your child safe and healthy while participating in sports. Schedule a physical before your child hits the court or field to make sure they’re cleared to play.

When to see a health care provider

If your child has knee pain and swelling that doesn’t improve with rest, ice and OTC medications, it’s a good idea to see their primary care provider. The provider should also check out chronic pain that affects your child’s ability to participate in sports or other activities.

If your child is diagnosed with Osgood-Schlatter disease, the provider can help create a treatment plan that works for your child. 

How we care for Osgood-Schlatter disease

At Banner Health, we offer personalized care plans for Osgood-Schlatter disease that focus on reducing pain, improving mobility and ensuring your child can safely return to sports and activities they love. Let us help your child stay strong and healthy through this phase of growth and development.