What is Osgood-Schlatter?
Osgood-Schlatter is the name given to pain and swelling at the lower part of the knee that occurs in children and adolescents who are going through puberty (ages 10-15). Osgood-Schlatter also occurs most often in children who participate in sports that involve running, jumping and quick changes of direction. These sports often include soccer, basketball, figure skating and ballet. The reason that pain and swelling is felt below the kneecap is because this is the area where bone growth occurs. This area of bone is called the tibial tuberosity. As kids perform jumping, running and cutting activities, the thigh muscles that attach to this area pull on the bone. Too much stress on the growing bone causes the pain and swelling. The pain often worsens with activity and eases with rest. Osgood-Schlatter may also occur during a growth spurt, since the tendon may not be able to keep up with the growth of the lower leg. This causes the tendon to become to short, and it constantly pulls at the tibial tuberosity.
Diagnosis of Osgood-Schlatter
Your primary care doctor or physical therapist can help determine if you or your child has Osgood-Schlatter by first performing a thorough history. Questions included in the history will allow them to get a clear picture of aggravating/ easing factors, duration, and daily/ recreational activities. These questions will also allow the doctor to rule out other serious injuries, such as fracture. The largest complaint that individuals with Osgood-Schlatter report is knee pain, which can vary in intensity between people. Some children have only mild pain while performing certain activities, especially running and jumping. For others, the pain can be nearly constant and cause them to avoid all recreational activities. This knee pain also usually occurs in one knee, however it can develop in both in about 30% of cases. Other signs and symptoms of Osgood-Schlatter include:
- Knee pain that lasts for weeks to months
- Enlarged bump below the kneecap
- Swelling below the kneecap
A physical exam that includes pressing around the knee to see exactly where the pain is occurring, as well as comparing this to the other knee. The doctor may also ask you to tighten your thigh muscle, the quadriceps, to see if this causes any increase in pain. This test puts added pressure on the tibial tuberosity, and will cause pain if Osgood-Schlatter is present.
Treatment of Osgood-Schlatter
The good news is that Osgood-Schlatter usually gets better without any formal treatment, and symptoms typically decrease after the child’s bones have stopped growing. If symptoms are severe enough, though, over-the-counter pain relievers and physical therapy can help to manage the pain.
A physical therapist will be able to educate you and your child on their prognosis of how long symptoms should last. The PT can also help to determine if any recreational activity needs to be held off on or modified for the time being while symptoms persist. Education on proper form during running, jumping, and cutting may further help to reduce stress on the knee. The PT may use modalities such as ice to help reduce any swelling. Hands on treatment will allow the physical therapist to stretch the muscles around the knee joint and work out any muscle knots that may be in the surrounding tissues. If there is any swelling in the area, the PT can also use hands on therapy to help it decrease. Also in physical therapy, your child can be given exercises that target the flexibility of the thigh muscles, the quadriceps and hamstrings. By working to stretch out these muscles, it will help to decrease the stress being placed on the tibial tuberosity. Strengthening exercises will also help to ensure muscle balance around the knee, as well as help take additional stress off the actual knee joint throughout movements, and allow for proper movement of the kneecap. Finally, a physical therapist can help provide you with orthotics, if necessary, to help keep the foot and lower leg in proper alignment. For more information on physical therapy visit www.totalperformancept.com.
