Good news: Osgood-Schlatter disease (OSD) is far less frightful
than its name. Though it's one of the most common causes of
knee pain in adolescents, it's really not a disease, but an
overuse injury
. OSD can be quite painful - but usually resolves itself within 12
to 24 months.
What Is Osgood-Schlatter Disease?
Osgood-Schlatter disease is an inflammation of the
bone
, cartilage, and/or tendon at the top of the shinbone (tibia),
where the tendon from the kneecap (patella) attaches. Most often
only one knee is affected. OSD usually strikes active adolescents
around the beginning of their growth spurts, the approximately
2-year period during which they grow most rapidly. Growth spurts
can begin any time between the ages of 8 and 13 for girls, or 10
and 15 for boys. OSD has been more common in boys, but as more
girls participate in sports, this pattern is changing.
Teens increase their risk for OSD if they play sports involving
running, twisting, and jumping, such as basketball, football,
volleyball, soccer, tennis, figure skating, and gymnastics. Doctors
disagree about the mechanics that cause the injury but agree that
overuse and physical stress are involved.
Growth spurts
make kids vulnerable because their bones, muscles, and tendons are
growing quickly and not always at the same time. With exercise,
differences in size and strength between the muscle groups place
unusual stress on the growth plate at the top of the shinbone. (A
growth plate is a layer of cartilage near the end of a bone where
most of the bone's growth occurs. It is weaker and more
vulnerable to injury than the rest of the bone.)
Most parents call the doctor after their child complains of
intermittent pain over several months. The pain may be anywhere
from mild and felt only during activity to severe and constant.
Other symptoms may include:
- pain that worsens with exercise
- relief from pain with rest
- swelling or tenderness under the knee and over the
shinbone
- limping after exercise
- tightness of the muscles surrounding the knee (the hamstring
and quadriceps muscles)
Symptoms that
aren't
typical of OSD include pain at rest, thigh pain, or very severe
pain that awakens kids from sleep or makes them cry. If your child
experiences any of these symptoms, talk to your doctor.
How Is It Treated?
OSD usually goes away by age 18 or when a teenager's bones
mature. Until then, only the symptoms need treatment. Rest is the
key to pain relief. Parents find it a cruel irony that the most
active kids are most likely to get OSD - and also the ones least
likely to rest the affected area.
In mild cases, doctors advise that kids limit the activities
that cause pain. They might be able to continue their sports as
long as the pain remains mild. When symptoms flare up, a short
break from sports might be necessary.
After your child gets back in the game, shock-absorbent insoles
can decrease stress on the knee. Applying moist heat for 15 minutes
before or icing for 20 minutes after activity can minimize
swelling. Wrestling gel pads and basketball knee pads (available at
sporting goods stores) can protect a tender shin from bumps and
bruises. A good stretching program, focusing primarily on the
hamstring and quadriceps muscles, before and after activity is
important. Your doctor might also suggest over-the-counter pain
medicines, such as ibuprofen, or prescription anti-inflammatory
medicines.
More severe cases require more rest, usually a total break from
sports and physical activities. Active kids may find this very
difficult, but the knee cannot heal without rest. Some teens wind
up with a cast or brace to enforce the doctor's orders. After a
prolonged time off, kids will need to ease back into activity
carefully, usually with
physical therapy
to learn stretching and strengthening exercises.
Long-term consequences of OSD are usually minor. Some kids may
have a permanent, painless bump below the knee. In rare cases, they
may develop a painful, bony growth below the kneecap that must be
surgically removed. About 60% of adults who had OSD as kids
experience some pain with kneeling.
Sports Safety
Sports and exercise offer many benefits, but also the risk of
injury. According to the National Youth Sports Safety Foundation,
sports activities are the second most frequent cause of injury for
both male and female adolescents.
Although OSD cannot be prevented, its impact can be minimized by
following sports safety guidelines:
- Parents and coaches must teach young athletes to protect
their bodies as their skills develop.
- Trained coaches should supervise sports programs.
- Kids should warm up and stretch for 15 to 30 minutes before
and after activities.
- Injured children should never be encouraged to "play
through the pain."
- Always remember that sports exist for the emotional and
physical good of the kids, not the team or interested
adults.
Reviewed by:
Peter G. Gabos, MD
Date reviewed: November 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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