Osgood-Schlatter Disease (OSD) is a common cause of knee pain in active adolescents. Historically, it was more often diagnosed in boys between the ages of 10-19, however as more girls are starting to participate in sports at an early age, that is changing. Patients will typically experience pain and swelling just below the kneecap, most notably after performing activities that involve running or jumping. Children who often participate in sports and activities which require consistent running and jumping are at a higher risk for developing OSD. It is typically described as a “painful bump” just below the knee cap.
SOURCE OF PAIN: OSD is caused by a pulling of the patellar tendon on the tibial tubercle which is located on the shin bone (tibia). Growth spurts make kids more vulnerable due to the rapid changes in bone, muscle, and tendon growth which may not occur at the same time. When certain muscles are stronger than others, this will place unusual stresses on the growth plate, which is a layer of cartilage where the bone grows. This cartilage is rapidly changing in the several years of bone growth throughout adolescent years. The area of “soft” cartilage in children becomes “hardened” as the child grows and becomes solid bone by full maturity. The growth plate at the bottom of the femur (thigh bone) serves as a place where tendons attach muscle to bone. The quadricep muscles form into the “patellar tendon” which attaches to the tibial tubercle. When a child is constantly activating their quadriceps muscle while performing sports, this pulls on the patellar tendon and subsequently on the tibial tubercle. This repetitive pulling can cause inflammation at the growth plate which can lead to a more prominent tibial tubercle.
- Pain that worsens with exercise
- Swelling or tenderness under the kneecap
- Tightness of the quadricep and hamstring
- Ice: Ice the knee for 15-20 minutes at the area of pain immediately after activity will help to decrease swelling
- Rest: Take a short break from the activity and give it time to rest.
- Stretch: Tightness in the quadricep and hamstring can be alleviated by performing stretches before and after activity.
If pain continues after trying these treatments, you may benefit from further evaluation by a physical therapist. A physical therapist will evaluate you and develop a plan of care. Your program will be a combination of strengthening the leg muscles and stretching to reduce tightness and restore any lost range of motion. Knee pain caused by OSD is treatable and should not limit you from doing what you love!