Story by: Kim Huston on September 20, 2019
Young athletes can be at risk for Osgood-Schlatter disease during growth spurts. Don’t worry, it’s not contagious: The condition is an extremely common pain in the front of the knee. It’s not the normal “growing pains” that may be more familiar to parents. Osgood-Schlatter usually occurs in children ages 10 to 15 who play certain sports. How does this overuse condition develop?
Osgood-Schlatter disease can be considered an overuse injury in the knee, caused by running, jumping and quick direction changes in sports –– think soccer, track, cross-country, basketball, ballet, baseball, softball and gymnastics.
The problem is growing bones in active boys and girls. The strong quadriceps muscle, in front of the thigh, directs all of its power toward the knee. It goes over the kneecap (patella) and joins the shinbone (tibia) just above the growth plate at the top of the shin. It is used heavily and produces the most stress when the knee is extended during motion.
The growth plate is a relative weak point. When there are extra forces transmitted from the quadriceps during activity, this point becomes irritated and may rise up away from the underlying bone. The result is a painful, bony bump on the shin just below the knee, called a tibial tuberosity.
Osgood-Schlatter disease also is caused by the fact that the bones at the knee grow faster than the quadriceps and patellar tendon do, causing the patella tendon to pull at the tibial tuberosity.
Osgood-Schlatter disease usually appears in just one knee, but can develop in both. Some children may experience mild pain, especially during certain movement such as running and jumping. For other kids, the pain may be constant and nearly debilitating.
Younger children also can have a similar problem, called Sinding-Larsen-Johansson syndrome, where the patellar tendon pulls at the inferior pole of the patella. Both can be treated with three to four weeks of complete rest and stretching. Cases that do not respond to this treatment may need formal physical therapy.
We treat sports-related orthopedic issues in children to help minimize any pain or issues that can stay with them into adulthood.
“Treating Osgood-Schlatter generally means a child needs to cut back on activity, especially jumping and sprinting,” said Kent L. Walker, D.O., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville. “For children with severe symptoms, they may need a period of complete rest from their sport, including working out. When paired with anti-inflammatory medication and quadriceps stretches, symptoms usually calm down within a few weeks.”
If you wait long enough, growing will stop when a child reaches full adult height, and the lesion will heal, forming one solid piece of bone. Other courses of treatment include bracing and stretching. There are multiple knee braces that are helpful to lessen pain. Most of these are available at sporting goods stores, pharmacies and online. There are knee sleeves and sleeves with a hole for the kneecap. The patient may wear a Cho-Pat strap, which wraps around the leg at the soft area between the bump and the kneecap. This soft area is the patellar tendon.
The quadriceps muscle also should be stretched daily, especially before and after physical activity.
A pediatric orthopedist can make a diagnosis based on medical history and a physical exam. X-rays can help rule out other explanations for the pain, such as a broken bone.