Osgood-Schlatter Disease

Conditions Basics

What is Osgood-Schlatter disease?

Osgood-Schlatter disease is a knee problem that causes pain and swelling in the shinbone (tibia) just below the kneecap (patella). This is the spot where the patellar tendon attaches to a bony mound in the knee called the tibial tubercle.

Older children and teenagers often get Osgood-Schlatter disease during a growth spurt. Certain young athletes, such as runners, gymnasts, and those who play soccer, football, or basketball, are more likely to have this type of knee pain.

This problem can come back while your child is still growing, but it should stop when your child's growth spurt ends. Osgood-Schlatter disease may leave a painless bump on the bone that remains after the problem has gone away.

What causes it?

Osgood-Schlatter disease is caused by too much stress on the muscles and tendons that support the knee. Repeated stress can cause the patellar tendon to pull away from the shinbone. This can make your child's knee hurt and swell. This kind of stress is more likely to happen during a growth spurt, when your child's leg bones are getting longer. Certain activities can also cause this to happen, such as running or sports that involve jumping (like basketball) or quick direction change (like soccer or football).

What are the symptoms?

Osgood-Schlatter disease usually affects only one knee, but it can affect both knees. It may cause pain and tenderness in front of the knee or mild swelling or a bump below the kneecap at the top of the shin. The pain may come and go. It may get worse with activity.

How is it diagnosed?

Your doctor will ask questions about your child's past health and do a physical exam to find out if your child's pain is caused by Osgood-Schlatter disease or some other problem, such as an injury.

The doctor will feel and move your child's knee as part of the physical exam. The doctor will look at the knee and check for tenderness, range of motion, and how stable the knee is. The doctor may check both knees even if only one hurts.

X-rays usually aren't done to diagnose Osgood-Schlatter disease, but they may be done to rule out other causes of knee pain.

How is Osgood-Schlatter disease treated?

Osgood-Schlatter disease doesn't require medical treatment. Your doctor can suggest home care to help relieve symptoms. A doctor or physical therapist can teach your child exercises to help stretch and strengthen the leg muscles that support the knee. Surgery is rarely recommended.

How can you care for your child?

• When your child has pain, rest the sore leg.
• Put ice or a cold pack on the knee for 10 to 20 minutes at a time. Put a thin cloth between the ice and your child's skin.
• Give acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain. Read and follow all instructions on the label. Do not give two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• Let your child play sports and be active. This will not cause any long-term problems. If your child plays a sport with a lot of squatting or kneeling, they may have too much pain. Help them find a different position on the team or try a different sport until their pain is better.
• Have your child wear knee pads or patellar straps when playing sports or doing activities that put pressure on the knee.
• Have your child do simple stretches. This will help keep your child's legs flexible. Here are two that may help.
  • Quadriceps stretch: Your child lies on their side with one hand supporting the head. Your child bends the upper leg back and grabs the ankle with the hand. Then your child stretches the leg back. Hold the stretch at least 15 to 30 seconds, and repeat 2 to 4 times. Then your child should change sides and stretch the other leg.
  • Hamstring stretch: Your child sits on the floor with the right leg extended out straight, the knee slightly bent, and the toes pointing toward the head. Your child bends the left leg so that the left foot is next to the inside of the right thigh. Your child leans forward from the hips, and reaches for the right ankle. Your child should not try to touch their forehead to the knee. Hold the stretch at least 15 to 30 seconds, and repeat 2 to 4 times. Then your child should change sides and stretch the other leg.