Osgood Schlatter Disease (Kids Knee Pain)

Osgood Schlatter Disease

Osgood Schlatter Disease (OSD) describes the inflammation of the growth plate just below the knee in children. Despite its name, it is not so much a disease as it is a painful growth-related condition. It is clinically referred to as tibial tuberosity apophysitis because of the location of the growth plate at the tibial tuberosity, which is the bony bump at the top of your shin-bone (tibia) and just below the knee. Growth plates are located on the ends of growing bones and will eventually turn into solid bone when we reach full maturity. Until they do, they are vulnerable to irritation from stress, tension and impact forces. OSD is an example of a ‘growing pain’, the most common of which occurs at the growth plate at the back of the heel bone (Sever’s Disease).  

What causes Osgood Schlatter’s Disease?

The painful symptoms of Osgood Schlatter Disease are caused by abnormal tension and forces at the top of the knee that irritate or damage the growth plate and cause it to become inflamed. Damage occurs because the area of growing bone is vulnerable as it’s still developing and is not yet solid bone, so is unable to withstand the tensile forces or high load that it can be exposed to. This is often thought to be caused by the repetitive pull from the quadriceps on the tibial tuberosity, where it inserts after crossing the knee as the patellar tendon. Other contributing factors may include:

• Tight muscles around the knee and shin bone
• Repetitive high-impact activities, such as running and jumping
• Faster rate of growth of the femur relative to the quadriceps muscles
• Injury to the knee and/or tibia

What are the symptoms?

Symptoms tend to present during times of growth, particularly between the ages of 8 and 15. OSD can affect one or both knees and typically affect active kids. Symptoms can include:

• Pain and tenderness just below and around the knee at the tibial tuberosity
• Inflammation at the front of and just below the knee
• Pain exacerbated by sporting activities such as running
• Pain exacerbated by movements that bend the knee, such as walking on stairs
• Pain on palpation of the knee and in kneeling

How is it treated?

While mild cases of Osgood-Schlatter Disease may resolve fairly quickly, others may suffer from painful symptoms for years. OSD has shown to respond well to conservative treatment. Treatment starts with addressing the present painful symptoms, which is often achieved using the PRICE principles (protection, rest, ice, compression and elevation). Following this, treatment focuses on addressing the cause of the problem to stop the symptoms returning. This may include:

• Orthotics to address any biomechanical or alignment issues within the feet or legs that may be contributing to excess tension on the tibia
• Footwear assessment to ensure the shoes are helping and not hindering recovery
  
• Stretching  to address tight muscles and reduce their strain
  
• Strengthening  weak muscles
  
• Gait training to assess and help correct any running and walking technique abnormalities that may be contributing to the onset of symptoms
• Education around the importance of warming up before activity and tips on helping reduce the strain from the quadriceps to the tibia

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