Osgood Schlatter Disease
What is Osgood-Schlatter disease?
Osgood-Schlatter disease is not really a disease. The name comes from the first two people to describe the issue. It’s not contagious, but it is very common in boys and girls 10 to 15 years old having growth spurts during puberty.
The problem is growing bones in active children. The strong quadriceps muscle in front of the thigh has all of its power directed to the knee. There, it courses over the kneecap (patella) and joins the shinbone (tibia) just above the growth plate at the top of the shin.
The growth plate is a relative weak point. When there are extra forces transmitted from the quadriceps, 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. The bump is called the tibial tuberosity.
The problem is more common in athletes, particularly those involved in baseball, running or soccer. The quadriceps muscle — and its contribution to Osgood-Schlatter — is used heavily and produces the most stress when the knee is extended during motion. That applies especially to times when defying gravity to run, kick, land from a jump or just walking down stairs. These are the times when the pain is usually the worst.
Osgood-Schlatter disease also tends to run in families.
The diagnosis usually is made from medical history and a physical exam. X-rays are made to rule out other explanations for the pain such as a broken bone.
If you wait long enough, growing will stop, and the lesion will heal, forming one solid piece of bone. Other courses of treatment include:
- Rest – If symptoms are significant, a period of complete rest from activity is recommended. This means no working out, no running and no jumping. Nothing but walking. When this is paired with an anti-inflammatory medication and quadriceps stretches, symptoms usually will calm down within a few weeks.
- Bracing and stretching – Stretching and bracing is the course of treatment for the years when symptoms show. The brace and stretching is to help lessen the pain. There are multiple knee braces that are helpful for symptoms. Most of these are available at sporting good stores, pharmacies and online. Others 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 patella tendon.
The quadriceps muscle should be stretched daily, especially before and after physical activity.
If your knees are hurting at the beginning of a practice or event, you should not participate. If it begins hurting during the event, it is OK to continue as long as the pain is not severe, and as long as it resolves within a few minutes with rest. The pain should resolve overnight most of the time. Ice is helpful to stop the pain once it starts.
If the pain continues in spite of treatment, activity should be limited to prevent the possibility of fracture at the irritation. If you break a bone, there is a sudden, severe pain, and you won’t be able to straighten the leg against gravity. Initial treatment is simply to immobilize the knee in a straight leg knee brace. Sometimes surgery is needed.
Less than 1 percent of children with Osgood Schlatter disease have fractures. Most of them were not performing the stretching exercises or using braces.
Connect with Norton Children’s Orthopedics of Louisville.
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