Osgood-Schlatter Disease

Children reaching adolescence have plenty of concerns to worry about. Adolescence brings about change everywhere from personality to growth spurts to puberty.

Many teens and pre-teens who participate in frequent sports may have an extra physical issue to deal with around this age. A condition called Osgood-Schlatter disease, which causes pain and a lump below the kneecap, often strikes active adolescents just as they begin growth spurts.

What exactly is Osgood-Schlatter disease, and how can parents of children suffering from it help manage their pain? Let’s break it down.

Osgood-Schlatter Disease Basics and Causes

Osgood-Schlatter disease (OSD) affects the area of the leg where the shin connects to the knee, typically in the form of inflamed bone, tendon or cartilage in that area. It’s a classic overuse injury that is aggravated with any strenuous activity. This is part of the reason it can be hard to get rid of (it often takes one to two years).

OSD has two primary causes:

1. Growth spurts in adolescents, which naturally put strain on connector areas of the body like the knee.
2. Frequent participation in sports involving lots of running and jumping such as football, basketball, tennis, volleyball, soccer and more.

These activities place even more pressure on the knees right as the adolescent body is stretching itself out.

Adolescent boys tend to see symptoms of OSD more than adolescent girls, though a large part of this has been related to the number of boys who participate in sports compared to the number of girls. As this gap has evened out in recent years, cases of OSD have begun to do the same.

Symptoms

Symptoms of OSD aren’t life-threatening, but they can be annoying and painful. Some of the most common symptoms include:

Pain: Degrees vary from case to case, ranging from occasional, minor pain to constant, severe pain. In most situations, pain grows worse during or immediately after physical activity, and relaxes during longer periods of rest.
Limping: Children often limp after playing sports. Parents of children who don’t want to leave the field need to be diligent in looking for this, as kids may try to hide it.
Swelling: Swelling and tenderness in the area connecting the knee and shinbone are common.
Muscle Tightness: Generally in the muscles near the knee, primarily the hamstrings and quadriceps.

If these symptoms spread to other parts of the leg, or if they become so severe that your child is in frequent pain during long rest periods or at night while trying to sleep, medical attention is recommended. Most parents have already talked to their doctor before these more severe symptoms ever pop up.

Treatment

Despite the aggravation of the condition, treating it is a pretty straightforward, low-risk process. Many cases simply correct themselves without any treatment at all, in fact.

For those that don’t, resting the affected knee (OSD is typically only present in one knee at a time) is usually the first course of action. It can be difficult to get active children to stay off their feet for long periods of time, but in most cases it’s preferable to the pain they’re experiencing.

In some mild to serious cases, a tips for treatment and basic prevention include:

Heating and Icing: Heating before activity and icing afterward can limit symptoms of OSD.
Shoe Insoles: Many kinds of orthotics or shoe inserts can help with the kind of support a child’s legs need.
Pads: Gel pads or standard knee pads protect the knees from heavy impact.
Stretching: Good stretches for both the knees and other surrounding areas, both before and after activity, can go a long way.

In extreme cases (especially with kids who have trouble following doctors’ orders and staying off the field), a doctor might recommend a cast or a brace on the affected leg. Some of these same children might need physical therapy if they’ve spent a long time away from physical activity.

The vast majority of OSD cases are resolved by the time growth spurts end (usually between 14 and 18 years old), though many can leave a few signs behind. About 60 percent of adults who had OSD as kids will have trouble kneeling throughout their lives, and a much smaller number will carry a lump on their knee that sometimes requires low-risk surgery to remove.

Michael Carlson, MD

Orthopedics is rewarding for me because it allows me to help patients with injuries and get them back into action quickly. My classes in anatomy initially sparked my interest in medicine and also led me to choose orthopedics as a specialty. I love meeting people of all ages in my practice—I see kids, athletes, adults and retirees. I enjoy being able to understand people’s unique situations and trying to help them recover. I try to spend time with my patients to help understand their goals and work together to come up with a treatment plan based on those goals and their distinct medical history.