Osgood-Schlatter disease is a common cause of knee pain in growing adolescents. It involves inflammation of the area just below the knee where the patellar tendon attaches to the shinbone (tibia). This condition typically occurs during growth spurts when bones, muscles, tendons, and other structures are changing rapidly.

Common Symptoms

• Pain: Localized pain and tenderness just below the knee.
• Swelling: Mild to moderate swelling at the tibial tubercle.
• Bump: A visible or palpable bony bump at the tibial tubercle.
• Pain with Activity: Pain worsens with running, jumping, and kneeling.
• Stiffness: Tightness in the surrounding muscles, particularly the quadriceps.

Cause & Anatomy

• Growth Spurts: Rapid bone growth can increase the tension on the patellar tendon.
• Physical Activity: Activities involving running, jumping, and rapid changes in direction (e.g., soccer, basketball, gymnastics).
• Overuse: Repeated stress and overuse can cause inflammation at the tibial tubercle.

Anatomy of the Knee

• Patellar Tendon: Connects the kneecap (patella) to the shinbone (tibia).
• Tibial Tubercle: The bony prominence on the shinbone where the patellar tendon attaches.

Risk Factors

• Age: Typically affects children and adolescents aged 9-16 years.
• Gender: More common in boys, though the gender gap is narrowing as girls participate in sports.
• Activity Level: High levels of physical activity and sports participation.

Diagnosis

• Assessment of symptoms, activity level, and medical history.
• Physical examination to evaluate pain, swelling, and tenderness.
• X-rays: Typically used to rule out other conditions and to visualize the tibial tubercle.
• Ultrasound or MRI: Rarely needed but can provide more detail if the diagnosis is uncertain.

Prevention

• Proper Warm-Up: Engage in proper warm-up exercises before physical activity.
• Stretching: Regular stretching to maintain flexibility, particularly of the quadriceps and hamstrings.
• Gradual Increase in Activity: Gradually increase intensity and duration of physical activity to avoid overuse.

Non-Surgical Treatment

• Rest and Activity Modification: Reduce or avoid activities that exacerbate symptoms. Engage in low-impact activities like swimming or cycling.
• Ice and Compression: Apply ice packs to the affected area to reduce pain and swelling. Use a compression bandage if necessary.
• Medications: Over-the-counter pain relievers like ibuprofen or acetaminophen.
• Physical Therapy: Stretching exercises to improve flexibility, particularly of the quadriceps and hamstrings. Strengthening exercises for the quadriceps, hamstrings, and surrounding muscles.
• Protective Gear: Use of a patellar tendon strap or knee brace to reduce strain on the tibial tubercle.

Recovery & Prognosis

• Symptom Duration: Symptoms can last from a few months to two years, typically resolving once the growth plate closes.
• Activity Modification: Gradual return to full activity as symptoms allow, with emphasis on avoiding activities that cause pain.
• Long-Term Outcomes: Most adolescents recover completely with no long-term issues, although some may have a persistent bony bump.

Complications

• Chronic Pain: Rare cases where pain persists into adulthood.
• Bone Spurs: Development of bone spurs or a persistent bony prominence.

FAQ’s

Can Osgood-Schlatter disease affect both knees?
Yes, it can affect one or both knees, though it is more common for symptoms to be more pronounced in one knee.

Will my child outgrow Osgood-Schlatter disease?
Most children outgrow the condition as they complete their growth spurts and the growth plates close.

Can my child continue playing sports with Osgood-Schlatter disease?
It depends on the severity of symptoms. Modifying activity to avoid pain and working with a healthcare provider for guidance is important.

Are there long-term effects of Osgood-Schlatter disease?
Most adolescents fully recover, though some may have a residual bump or occasional pain. Rarely, persistent pain can occur into adulthood.

When should I see a doctor for my child’s knee pain?
If the knee pain is severe, persistent, or associated with significant swelling, instability, or if it limits daily activities, consult a healthcare provider.