Osgood-Schlatter Disease and Knee Growing Pains

Full Length Of Girl Looking At Knee While Sitting On Field
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Osgood-Schlatter disease is a common condition in children often referred to as growing pains of the knees. Osgood-Schlatter disease is the result of rapid growth and pulling of the tendons on the growth plate of the knee in adolescents.

The Apophysis of the Knee

An apophysis is a growth plate—an area of the bone where the bone is rapidly growing in children and adolescents. This tibial tubercle apophysis is located at the front of the knee joint, right where the patellar tendon. This is a strong tendon that is attached to the powerful quadriceps muscle in the thigh. Every time the quad muscle contracts, it pulls on the patellar tendon, and thus on the tibia. Therefore, a lot of force is transferred directly to that growth center called the apophysis.

When young children and adolescents are very active with sports, this repetitive pulling on the tibial apophysis can cause inflammation to that growth center of the bone. This is referred to by several names, all of which refer to the same process. These names include Osgood-Schlatter disease, traction osteochondritis, or apophysitis. 

Is Damage Being Done?

While there are inflammation and irritation to the apophysis taking place, this damage is not permanent. People who have Osgood-Schlatter notice the tibial tubercle is more prominent, and this may persist later in life, but generally does not cause any problem. 

The typical signs of Osgood-Schlatter include:

  • Pain on the front of the shin, just below the knee joint
  • The prominence of the tibial tubercle
  • Swelling and tenderness of the tibial tubercle
  • Pain during, but more commonly in the hours after, sports activity

Treatment Options

Treatment of Osgood-Schlatter is best accomplished with rest. By avoiding activities that cause irritation to the apophysis, the inflammation usually subsides without other treatment. The hard part is keeping a young athlete from their favorite sport while their knee pain is calming down. The usual treatment steps include:

  • Rest: Avoiding strenuous activity, particularly running and jumping, are the keys to effective treatment. Full resolution of symptoms may take over a year, so it's not unusual for kids to have symptoms that persist beyond a short period of rest. The good news is once the symptoms are controlled, they can usually be managed by limiting sports activities and treating with the other methods described.
  • Ice: Application of ice to the area of tenderness and inflammation can be very helpful. Kids should ice as soon as they end their athletic event or practice, and help to prevent the inflammation from worsening.
  • Anti-Inflammatory Medications: Medications should be taken under the direction of a pediatrician, but they can be effective for controlling symptoms. These medications should not be used before or during athletics, as it will prevent kids from recognizing when they have done too much activity.
  • Knee Brace: Some knee braces can be helpful to take some of the stress off the tibial tubercle and the apophysis. These should be worn during sports activities to prevent painful symptoms.
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  1. American Academy of Orthopaedic Surgeons. Osgood-Schlatter Disease (Knee Pain). Updated May 2015.