Topic Overview

What is Osgood-Schlatter disease?

Osgood-Schlatter disease is a knee problem that causes pain and swelling in the shin bone (tibia) just below the kneecap (patella). This is the spot where the patellar tendon attaches to a bony mound in the knee called the tibial tubercle.

Older children and teenagers often get Osgood-Schlatter disease during a growth spurt. Certain young athletes, such as runners, gymnasts, and those who play soccer, football, or basketball, are more likely to have this type of knee pain.

This problem can come back while your child is still growing, but it should stop when your child's growth spurt ends. Osgood-Schlatter disease may leave a painless bump on the bone that remains after the problem has gone away.

What causes Osgood-Schlatter disease?

Osgood-Schlatter disease is caused by too much stress on the muscles and tendons that support the knee. Repeated stress can cause the patellar tendon to pull away from the shin bone. This can make your child's knee hurt and swell. This kind of stress is more likely to happen during a growth spurt, when your child's leg bones are getting longer. Certain activities can also cause this to happen, such as running or sports that involve jumping (like basketball) or quick direction change (like soccer or football).

What are the symptoms?

Osgood-Schlatter disease usually affects only one knee, but it can sometimes affect both knees. The pain may come and go.

When your child has Osgood-Schlatter disease, he or she may have:

• Pain and tenderness in front of the knee.
• Mild swelling or a bump below the kneecap at the top of the shin.
• Pain that gets worse with exercise or activity.

How is Osgood-Schlatter disease diagnosed?

Your doctor will ask questions about your child's past health and do a physical examination to find out if your child's pain is caused by Osgood-Schlatter disease or some other problem, such as an injury.

The doctor will feel and move your child's knee as part of the physical examination. The doctor will look at the knee and check for tenderness, range of motion, and how stable the knee is. The doctor may check both knees even if only one hurts.

X-rays usually aren't done to diagnose Osgood-Schlatter disease, but they may be done to rule out other causes of knee pain.

How is it treated?

Your doctor may advise using ice to reduce swelling and an over-the-counter medicine to relieve pain.

Depending on how much your child's knee hurts, he or she may need to take a break from doing sports and other activities that put pressure on the knee. Or your child may need to spend less time doing the activity that causes pain or do it with less effort. Your doctor may want your child to do some exercises that help keep the leg muscles that support the knee flexible and strong.

How can you care for your child at home?

When your child has Osgood-Schlatter disease, he or she may find it hard to do certain activities or sports. But there are steps your child can take to feel better. Have your child:

• Spend less time doing the activity that causes pain, or have him or her do it with less effort. Or have your child take a break from activities that cause knee pain, such as squatting, kneeling, running, and jumping. Have your child switch to activities that don't stress the knee. Swimming and cycling are good activities to do because they put less stress on the knees.
• Put ice or a cold pack on the knee for 10 to 20 minutes at a time. Put a thin cloth between the ice and your child's skin.
• Prop up the sore knee on a pillow when your child ices it or anytime he or she sits or lies down. Keep the knee above the level of your child's heart. This will help reduce swelling.
• Wear a brace if the doctor suggests it. Follow the directions for its use. Wrapping the knee may reduce or prevent swelling.
• Wear knee pads or patellar straps to protect the knees during sports or other impact activities.

Ask your doctor if your child can take an over-the-counter medicine such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to relieve pain. Be safe with medicines. Read and follow all instructions on the label.

As the knee pain starts to go away, your doctor may have your child start doing exercises that help stretch and strengthen the leg muscles that support the knee. Your doctor or a physiotherapist will tell you when your child can start these exercises and which ones will work best for your child. Be sure that your child does each exercise slowly and eases off the exercise if he or she starts to have pain.

Stretching can loosen tight muscles and connective tissue that support the knee. Stretching before and after an activity can help keep your child's leg muscles flexible. Two that may help are quadriceps and hamstring stretches. Strengthening the thigh muscles (called the quadriceps) can help keep the knee stable. There are several strengthening exercises your doctor may have your child do that may help.