Physical Therapy for Osgood-Schlatter Disease of the Knee

Growing Pains in Childrens' Knees

Photo of a doctor examining a young girl's knee.
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Osgood-Schlatter disease is a painful condition that affects the knee or knees of growing children. Physical therapy for Osgood-Schlatter disease can be an effective treatment to help improve mobility and decrease this painful condition.

If your child has pain in the front of one or both knees, he or she may be suffering from a condition known as Osgood-Schlatter disease. This condition affects children going through growth spurts, and is mainly considered "knee growing pains." The symptoms may prevent your child from enjoying normal activities such as running, jumping, or squatting.

Symptoms of Osgood-Schlatter Disease

Typical symptoms of Osgood-Schlatter disease may include:

  • Pain just below the kneecap in one or both knees in a child
  • Difficulty squatting and jumping due to knee pain
  • A noticeable bony bump in the front of one or both knees
  • Pain to palpation (touch) in the front of one or both knees

If your child complains of any of these symptoms, you should take him or her to the doctor. Your doctor can confirm (or rule out) the diagnosis of Osgood-Schlatter disease. Your child can then get started on the correct treatment for the condition. Physical therapy is often recommended to help your child get relief from knee pain from Osgood-Schlatter disease.

What Causes Osgood-Schlatter Disease?

Osgood-Schlatter disease is caused by irritation of the tribal tubercle, an area near the top of the shin bone where your patellar tendon attaches. There is a growth plate there where rapid bone growth occurs as your child ages. The patellar tendon arises from your quadriceps muscles as part of your kneecap. When a child goes through a rapid phase of growth--about age 10 to age 15--this tendon can pull abnormally on its insertion point on the shin bone. This can lead to pain and a noticeable bump just below the kneecap.

Children with Osgood-Schlatter typically have knee pain, and they may also exhibit a host of other signs, including:

Your child may have one or many of these signs. Checking in with your doctor if you suspect your child has Osgood-Schlatter disease is a good first step to getting the correct treatment.

Physical Therapy for Osgood-Schlatter Disease.

If your child is diagnosed with Osgood-Schlatter disease, he or she may benefit from working with a physical therapist. Your physical therapist will perform an evaluation to assess your child's condition. He or she can then make recommendations to properly treat the condition.

Specific tests and measures that may be taken during the physical therapy examination for Osgood-Schlatter disease may include:

  • Measures of knee, hip and ankle range of motion (ROM)
  • Palpation assessment
  • Measure of lower extremity strength
  • Functional tests for the lower extremity
  • Flexibility assessment

Your physical therapist will use the information gathered during the initial evaluation to devise a treatment program for your child. Be sure to ask any questions about your child's condition, and make sure you understand what is expected of your and your child during PT.

Treatment for Osgood-Schlatter disease may include various components. The most important component of your child's PT treatment is a solid exercise program for Osgood-Schlatter disease. Various PT treatments may include:

  • Stretching exercises. Many children with Osgood-Schlatter disease have tightness in one or more lower extremity muscle groups. Stretches for the hamstrings may be prescribed to allow your child's knee to fully extend. Research shows that patients with Osgood-Schlatter disease may have a decreased knee flexion ROM, likely due to tightness in the quadriceps muscles. Stretching the quads may be another exercise that may be performed. Tight calf muscles may also prevent normal motion from occurring around your child's knee during running activities, so calf stretches may be prescribed by your physical therapist.
  • Strengthening exercises. Your PT may recommend exercise to help improve the way your child's muscles support his or her knee joint. Strengthening for the quadriceps, hamstrings, and hip muscles may be prescribed.
  • Balance and coordination exercises. Some children with Osgood-Schlatter disease exhibit impaired balance or coordination. Your PT may recommend balance exercises--like the T-Stance--to help improve balance and decrease stress and strain to the knees during high-level activities like running and jumping.​
  • Pain relief modalities. Your child's physical therapist may use physical modalities such as heat or ice to help control the pain that your child is feeling. He or she may also use heat prior to stretching exercises to help improve the overall extensibility of the muscles to be stretched. Taping techniques, like the use of McConnell or kinesiology tape, may be used, but its effectiveness has not been proven. The best treatment for Osgood-Schlatter disease is an active exercise program that includes stretching, strengthening, and mobility. Passive treatments like heat, taping, or ice may feel good, but these will not help to change the overall condition. It's your child's active exercise and participation in his or her treatment that can help effectively treat Osgood-Schlatter disease.

Many people wonder how long a rehab program should be for Osgood-Schlatter disease. Everyone is different, and every person will have a different rehab program for their specific condition. In general, your PT program should be relatively short, and it may only include a few sessions to ensure that the exercises are done—and done properly.

Most cases of Osgood-Schlatter disease are self-limiting. This means that the knee pain will clear up eventually if not treated at all. Some cases last for about 12 to 24 months, but it can be shorter if a proper exercise program is started when the child is first diagnosed. That little bump on the front of your child's knee will likely remain permanently, but it should not cause any pain or functional limitation as your child ages.

First Steps to Take

If your child is diagnosed with Osgood-Schlatter disease, there are a few things you should do to start the right treatment. First, don't panic. Although your child may be complaining of knee pain, this symptom is typically short-lived and does not necessarily signify any significant danger or harm to your child or his knees.

When diagnosed with Osgood-Schlatter disease, your child may have to avoid aggravating activities for several weeks. This may include avoiding sports and other high-intensity activity. A brief rest period can help decrease knee pain from repetitive strain to the tibial tubercle and growth plate.

You should start on an active physical therapy program right away if your child is diagnosed with Osgood-Schlatter disease, Why? Because this can help your child gain control over his or her condition. A physical therapy program can help your child rapidly resolve his or her pain complaints and can help prevent future episodes of knee pain.

A Word from Verywell

If your child is complaining of knee pain and is diagnosed with Osgood-Schlatter disease, he or she may benefit from working with a physical therapist to learn how to best manage the condition. Your PT can show your child the right exercises to do to help improve mobility and decrease pain around the knees. That way, your child can get back to normal activity quickly and safely.

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Article Sources

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    Tzalach, A, et al. The correlation between knee flexion lower range of motion and Osgood-Schlatter's syndrome among adolescent soccer players. BJMMR. 11(2), 2016.