did you know
KIDS'
KNEE
PAIN
Is It Osgood-
Schlatter
Disease?
By Michele DeMaio, PTA
When my son was 12
years old, he would
wake up in the middle
of the night crying and
complaining of knee
pain. He had started
to run track in middle
school, and he started
to get a little bump
just below his knee cap
at the top of his shin
bone. Our pediatrician
called it “growing
pains” and said it
would go away.
He recommended
that my son do some
stretches and ice
after track practice.
Eventually it did
resolve once track
season was over, and
he didn’t have any
problems after that.
What I found out later
is that this wasn’t
growing pains at all —
it was a common
sports injury
known as “Osgood-
Schlatter disease.”
WHAT IT IS
Although it sounds scary because of the word “disease,” Osgood-
Schlatter is one of the most common causes of knee pain in
adolescents. It’s an overuse injury that tends to pop up in active
adolescents, usually between the ages of 10 and 15. I use the term
“pop up” because many times a bump will appear along the top
of the shinbone (or tibia). This area is where the tendon from the
quad muscles attaches at the knee to the shinbone.
It has also been referred to as “jumper’s knee,” as it’s more
common in sports that involve ballistic activation of the quadriceps
muscles during jumping or running. “Ballistic activation” basically
means the muscles contract at high velocities for a short period of
time. This includes activities like soccer, volleyball, basketball, high
jump, ballet, and gymnastics.
This condition can continue into adulthood. In rare cases, if a
bone fragment in this area continues to cause pain, it may require
surgical removal. Osgood-Schlatter disease typically resolves in
several months, but the bump along the tibia may never go away.
CAUSES
The long bones of the arms and
legs have areas which are open
to allow for growth in these
bones. This area, known as the
“growth plate,” is made up of
cartilage that hasn’t completely
ossified (hardened) into bone.
As children go through growth
spurts, the tendons of the
muscles begin to stretch and
pull along the attachment site
of the bones. During sports that
involve a lot of running, jumping,
and bending, the thigh muscles
(quadriceps) pull on that tendon
connecting the kneecap to the
shinbone. Repeated stress to
this area can
cause inflam-
mation at the
site of the
attachment. In
more extreme
cases, the
tendons may
start to pull
away from the attachment site
on the bone. As the body tries
to close that gap with new bone
growth, a lump may appear.
•
shinbone at the growth
plate; when this becomes
inflamed, a little bump may
pop up here.
Decreased flexibility in
the hamstrings, hip flexors,
and quadriceps muscles
due to growth spurts.
TREATMENT
Early treatment usually consists
of rest from sports or gym
activities, icing the area, anti-
inflammatory medications,
and stretching exercises.
Playing through the pain may
exacerbate these symptoms,
and recovery may take longer.
Physical therapy is also an
important part
of treatment
to help work
on flexibility of
the muscles.
Once the pain
reduces, kids
may begin a
strengthen-
ing program with a focus on
returning to sports, gym, and
full activity. Physical therapists
can provide a comprehensive
home exercise program, as well
as work on strengthening of
the lower extremities and core,
suggest appropriate footwear
or orthotics, and assess form
during sports-specific drills and
jumping. Therapists can teach
young athletes how to appro-
priately control the landing on
jumps and how to reduce the
impact through their joints.
It’s an overuse
injury that tends
to pop up in active
adolescents.
THE EARLY SYMPTOMS
Kids with Osgood-Schlatter
disease may experience
• Pain that increases with
sports or activity.
• Pain that may awaken them
at night; this is often called
“growing pains.”
• Swelling and / or tender-
ness along the top of the
Osgood
Schlatter Disease
is more common
in sports that
involve jumping
or running.
PREVENTION
Research has shown that
when athletes do dynamic
stretches prior to beginning
their sports, it has been
effective in decreasing injury.
Kids should do a pre-sport
warm up to prepare their
muscles and get good blood
flow and flexibility prior to
any running or jumping
activities. Static stretching
after their sport, once the
muscles have been warmed
up, is effective as well. It’s
also important to cross
train. Year-round focus on
one sport with high impact,
repetitive motions may set
kids up for an injury.
enhance magazine | NOVEMBER 2017
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