Osgood-Schlatter Disease is a common overuse injury that affects children and teenagers. It causes a painful lump just below the kneecap, typically as a result of repetitive use of the joint. Most often, it happens in children that are active in running sports like soccer, volleyball, ballet, basketball, and figure skating. The condition occurs during puberty when the child is experiencing growth spurts and is seen more frequently in boys.
When participating in activities that require a lot of jumping, running, and bending, the thigh muscles tug on the tendon connecting the child’s shinbone and kneecap. The repeated stress can sometimes pull the tendon away from the shinbone, which causes the swelling and pain that is associated with Osgood-Schlatter disease. A bony lump appears when the body attempts to compensate by filling the space with new bone growth.
Every child experiences Osgood-Schlatter disease differently. In some cases, discomfort may be mild and appear only during certain activities like jumping and running. Other children will experience constant pain that can become debilitating.
The condition is usually seen in only one knee but may be present in both. Pain and swelling can last anywhere from a few weeks to several months. A bony lump may persist into the child’s adult life, but it does not often interfere with knee function.
This disease is thought to be caused by the muscles in the front part of the thigh being pulled. The quadriceps and the patellar tendons are joined, and these tendons go through the knee and into the shin. The contraction of the quadriceps pulls these tendons away from the top part of the shin bone where the growth plate is located. This stress and pulling is what causes the swelling and pain of this disease. Strenuous activities that include jumping, running, bending or using stairs can aggravate the condition. Young people who play sports often get this disease. It is common in young people who play soccer, basketball, and football as well as those who are engaged in ballet or gymnastics. For some kids, the body will try to repair the gap caused by the tendon pulling away from the bone, and that creates a visible, bony lump on that part of the shin.
In most cases, Osgood-Schlatter disease will go away on its own without medical care once the child reaches an age where the bones have finished growing. In the meantime, various home treatments and over-the-counter medications can help relieve symptoms. Some children benefit from stretching exercises and physical therapy.
Following RICE (rest, ice, compression, elevation) can go a long way in alleviating pain and swelling, as can acetaminophen and NSAID pain relievers like ibuprofen and naproxen. Children should also be encouraged to wear kneepads or tendon straps while participating in sports.
If a child has already had Osgood-Schlatter disease, there are several ways to prevent it from occurring again. The child’s doctor can demonstrate some exercises that can be performed at home to make the hamstrings and quadriceps stronger. Stronger muscles in these areas can prevent the pulling of the patellar tendons. In addition, a physical therapist may be needed for regular sessions of these exercises. Some parents and coaches recommend continuing to play with the pain, but this can aggravate the condition and cause the pain to last longer. Ending the sport or other physical activity for a while until the pain is gone can be effective at preventing its reoccurrence. Once the child takes up the activity again, use ice on the knee after practice to keep the area from swelling and becoming painful. Staying flexible is another way to prevent reoccurrence. Stretching exercises that allow the muscles to loosen can keep the quadriceps from pulling at the tendons and causing pain.