What is Osgood-Schlatter disease?

Osgood-Schlatter disease is painful inflammation that affects kids and teens where their kneecap (patella) connects to their shin bone (tibia). Healthcare providers also sometimes call Osgood-Schlatter disease growing pains.

Osgood-Schlatter disease affects children who are still growing — it’s especially common in kids going through a growth spurt. A growth spurt can make lots of parts of your child’s body more sensitive to stress and strain, including their:

• Muscles.
• Bones.
• Ligaments.
• Tendons.

This rapid growth is normal and healthy, but it can make these tissues more likely to be irritated by repeated, everyday stress. If your child uses their knees a lot (like playing the same sport often), overuse can irritate their joints. This irritation may cause pain and swelling.

Visit a healthcare provider if your child has knee pain that doesn’t get better after a few days of rest.

What are Osgood-Schlatter disease symptoms?

The most common symptoms of Osgood-Schlatter disease include:

• Knee pain (especially just below your child’s kneecap at the top of their shin).
• Swelling (inflammation).
• A feeling of tenderness (especially to touch).
• Tight muscles in your child’s legs (usually the quadriceps muscles in their thighs).
• A hard, painful bump on or just below your child’s kneecap.
• Osgood-Schlatter pain usually builds up and gets worse over time, but it can happen suddenly. Your child might have pain in one or both knees. The pain will usually get worse during and after physical activities.

What causes Osgood-Schlatter disease?

Osgood-Schlatter disease is a type of repetitive strain injury. As the name suggests, repetitive strain injuries are caused by doing the same motion or activity repeatedly until it starts to hurt your body. Doing lots of intense physical activity (especially the same kinds of motions often) can put lots of pressure on your child’s knees. Providers call this overuse.

Osgood-Schlatter disease happens when kids overuse their patellar tendon — the tendon that connects their kneecap to the shin bone. Your child’s quad muscle in their thigh squeezes (contracts) to move their knee. Specifically, the quad pulls at the top of their patellar tendon. The tendon attaches their kneecap to their shin bone at a small, bony bump called the tibial tubercle.

The tibial tubercle covers the growth plate at the top of your child’s shinbone. Kids and teens have a special section of bone called a growth plate at the ends of some of their longer bones. The growth plate is exactly what it sounds like — a special area that helps bones grow longer and develop into the correct size and shape. Growth plates harden into solid bone when a child has finished growing.

Activities like running, jumping, climbing or training for a sport can all cause Osgood-Schlatter disease. This extra stress and overuse cause swelling and irritation that spreads into their growth plate, which causes the pain and tenderness in your child’s knee.

What are the risk factors?

Any child can experience Osgood-Schlatter disease, but kids between the ages of 11 and 14 are more likely to. That’s because that age range is usually when kids experience the most growth spurts.

Playing sports that require kids to run and jump a lot can increase their risk, including:

• Basketball.
• Volleyball.
• Soccer.
• Football.

How do healthcare providers diagnose Osgood-Schlatter disease?

A healthcare provider will diagnose Osgood-Schlatter disease with a physical exam. They’ll examine your child’s knee and the area around it. Tell your provider when your child first noticed symptoms like pain or tenderness, and if they play sports or do any physical activities that might have caused their symptoms.

Your provider will lightly press on the front of your child’s knee. If that spot is tender or painful, there’s a good chance your child has Osgood-Schlatter disease. They might ask your child to do some movements with their knee, including:

• Walking.
• Jumping.
• Kneeling.

These motions might hurt, but there's no risk they can injure or damage your child's knee. Your child should feel safe to say when or if anything hurts too much to do, or if they don’t feel comfortable.

Providers don't usually need any imaging tests to diagnose Osgood-Schlatter disease, but your provider may use a knee X-ray to take pictures of your child’s knee, growth plate and the bones around them.

What are Osgood-Schlatter disease treatments?

Most children with Osgood-Schlatter disease only need at-home treatments, including:

• Rest: Your child should avoid the sport or activity that caused the irritation in their knee. Your provider will suggest how long your child should avoid playing sports. It might only be a few weeks, but may be a month or two.
• Icing: Put ice or a cold pack on your child's affected knee for 10 to 15 minutes at a time a few times a day. Wrap the cold packs in a thin towel to avoid putting them directly on your child’s skin. You can also massage an ice cube on the painful area. Rub the ice in a circular motion on your child’s knee for three to five minutes for even faster pain relief.
• NSAIDs: Over-the-counter (OTC) medication like ibuprofen or naproxen relieves pain and reduces swelling. Don''t let your child take NSAIDs for more than 10 days in a row without talking to your provider.
• Physical therapy: Stretching their quad muscles can help relieve tension on your child's patellar tendon. Your provider may give them stretches to do at home or suggest you meet with a physical therapist. Your physical therapist will give your child exercises to strengthen the muscles around their affected knee to support it better.

How can I prevent Osgood-Schlatter disease?

You might not always be able to prevent Osgood-Schlatter disease, especially if your child is an athlete. But the best way to prevent it is to make sure your child is safe when they’re physically active. During sports or other physical activities, they should:

• Wear the right protective equipment.
• Never play through the pain if their knee hurts during or after physical activity.
• Give their body time to rest and recover after intense activity.
• Stretch and warm up before playing sports or working out.
• Cool down and stretch after physical activity.

What can I expect if my child has Osgood-Schlatter disease?

Kids and teens with Osgood-Schlatter disease almost always recover with no lasting health effects. It doesn't cause any permanent damage to their bones or knee joint. Children grow out of the condition as their growth plates harden into adult bone and they strengthen and stretch the muscles around their knees.

How long does Osgood-Schlatter disease last?

How long your child experiences symptoms depends on how severe the Osgood-Schlatter disease is to begin with, the cause and how well they can avoid putting more stress on their knee. Which sports they play or other physical activities they do can also affect how long Osgood-Schlatter disease lasts. Most kids need at least a few weeks of rest.

Your provider will tell you how long your child should avoid playing or training. Don't let your child resume playing sports before your provider says it’s safe, even if they start to feel better. Their knee needs time to heal. Returning to sports or physical activities too soon can make the pain come back.

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When should I see my healthcare provider?

Visit a healthcare provider if your child has symptoms like pain or swelling that don't get better with a few days of rest and at-home treatments. Tell your provider if Osgood-Schlatter symptoms come back (recur) after your child resumes playing sports or physical activities.

To seek an expert consultation for any orthopedic condition.

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