Osgood-Schlatter Disease

Osgood-Schlatter disease is a painful enlargement of the bump of the shin bone (tibia) just below the knee. This bump is called the tibial tuberosity. The tendon that attaches the kneecap to the shin bone attaches at the tibial tuberosity. Osgood-Schlatter disease is most often seen in children between the ages of 10 and 15 and usually appears during a period of rapid growth.

Osgood-Schlatter disease is caused by overuse of the knee in normal childhood and sporting activities. It is possible that muscles are too tight in the front of the thigh, the back of the thigh, or in the calf.

Your child will complain of a painful bump below the kneecap. You or your child may notice a bony enlargement at the top of the shin bone. The pain will sometimes come and go and usually is gone by the time your child has stopped growing.

Your child's health care provider will examine the knee and review your child's symptoms. Your child may need an x-ray. X-rays show an enlarged tibial tuberosity. An x-ray may also show irregular or loose bony fragments from the tibial tuberosity.

Your child may need to rest or do activities that do not cause knee pain. Ice packs should be put on the knee for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away. If the knee is swollen, it should be elevated by placing a pillow under it. Your child's health care provider may prescribe a special padded brace. He or she may prescribe an anti-inflammatory medicine and may recommend exercises.

As your child gets older and past the growth spurt, symptoms of Osgood-Schlatter disease go away and there is usually no longer a problem. It commonly takes about 6 to 24 months from the start of the symptoms. The best way to avoid the pain of Osgood-Schlatter disease is to use exercise to build muscle strength and avoid overtraining.

Your child will always have a bump even after the pain has gone away. It is possible for your child to sometimes have pain in the area of the bump even after he or she is an adult. Adults with persistent pain from bony fragments around the knee need to have the fragments surgically removed.

Everyone recovers from an injury at a different rate. Return to your activity will be determined by how soon your child's knee recovers, not by how many days or weeks it has been since the injury has occurred. In general, the longer your child has symptom. The goal of rehabilitation is to return your child to normal activities as soon as is safely possible. If your child returns too soon he or she may worsen the injury.

Your child may safely return to his or her sports or activities when, starting from the top of the list and progressing to the end, each of the following is true:

• Your child's tibial tuberosity is no longer tender.
• The injured knee can be fully straightened and bent without pain.
• The knee and leg have regained normal strength compared to the uninjured knee and leg.
• Your child is able to jog straight ahead without limping.

Osgood-Schlatter disease may be difficult to prevent. The most important thing to do is to have your child limit activity as soon as he or she notices the painful bump on the top of the shin bone. Proper warm-up and stretching exercises of the thigh, hamstring, and calf muscles may help prevent Osgood-Schlatter disease.