Osgood-Schlatter Disease and Knee Growing Pains

Osgood-Schlatter disease is a common condition in children and adolescents. Often referred to as growing pains, it results from tendons pulling on the knee's growth plate during rapid growth of the knee.

The Apophysis of the Knee

An apophysis is a growth plate—an area where bone is rapidly growing in children and adolescents. In Osgood-Schlatter disease, the apophysis is located at the front of the knee joint, right where the patellar tendon attaches to the tibia. This is a strong tendon that is also 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 the apophysis.

When young children and adolescents are very active with sports, this repetitive pulling on the tibial apophysis can cause inflammation in that growth center of the bone. This process is called Osgood-Schlatter disease or traction apophysitis.

Is Damage Being Done?

While inflammation and irritation to the apophysis are taking place, this damage is not permanent. People who have Osgood-Schlatter disease may notice the tibial tubercle (a bump on the kneecap) is more prominent. This may persist later in life, but it generally does not cause a problem. 

The typical signs of Osgood-Schlatter disease include:

• Pain on the front of the shin, just below the knee joint
• Prominence of the tibial tubercle
• Swelling and tenderness of the tibial tubercle
• Pain during, but more commonly in the hours following, 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 the following:

• 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 that once the symptoms are controlled, they can usually be managed by limiting sports activities and treating with the other methods described below.
• 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, which will help 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. However, these medications should not be overused before or during athletics, since they can 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 can be worn during sports activities to help reduce painful symptoms.