Osgood-Schlatter Disease (knee pain)

Osgood-Schlatter Disease (or Osgood-Schlatter condition) is a common cause of knee pain in young athletes.  It most commonly affects males in their pre-teen and teenage years at the time of their growth spurt.  However, young female athletes are also at risk for this condition.  One or both knees may be affected.  Symptoms include pain, swelling and tenderness over the tibial tuberosity – the bony lump just below the knee joint where the large quadriceps muscle on the front of the thigh inserts into the top of the tibia bone via the patella (kneecap) ligament (see picture).  There may be associated tightness of the quadriceps muscle.   This condition is classified as an overuse condition, and is also referred to as tibial tuberosity apophysitis.    

Symptoms are most noticeable during activities such as running, jumping, kneeling and squatting; and thus is a common condition in athletes involved in basketball, volleyball, soccer, football, figure skating, track, ballet and gymnastics. 

The pain is thought to be due to tiny microfractures of the tibial tubercle secondary to overuse of the quadriceps muscle.  Sometimes there is a history of previous trauma. 

No diagnostic tests are usually required to make the diagnosis of Osgood-Schlatter Disease.  Sometimes x-rays are obtained of the knee joints, but this is usually to rule out other conditions that may mimic this condition.    

There is no specific treatment for Osgood-Schlatter Disease as this is generally a self-limiting condition with time.  Usually symptoms resolve in a few months, but may take up to 12 months.  Symptoms sometimes recur until your child stops growing.   For acute episodes of pain this should be managed with rest, ice (for 20 minutes every 2 to 4 hours), compression with an elastic bandage, and elevation of the leg (“RICE”).   Pain relievers such as Advil and Motrin (Ibuprofen) may also be helpful (see dosage calculator).  Your child may need to limit his activities till his symptoms have resolved. Stretches for the quadriceps and hamstring muscles may also help relieve the pain.  More severe cases may require the use of special knee braces and periods of complete rest from physical activity.  Severe cases may require the use of crutches until the pain has lessened.  Switching to activities that do not involve jumping or running such as cycling or swimming may also be helpful until symptoms resolve.  Corticosteroid injections are not recommended.   Rarely is surgery necessary. 

Exercises may be beneficial in the recover phase or after a period of rest to prevent a recurrence.  These include straight-leg raises, hamstring and quadriceps stretches in order to strengthen the quadriceps and hamstring muscles (see below).  Physical activities that require frequent deep knee bending should be avoided. 

Straight leg raise:

Hamstring stretch:

Following an episode of Osgood-Schlatter Disease some children are left with a “bump” over the tibia where the pain and swelling were located.  This may persist for life, but does not in itself interfere in any way with the function of the knee joint.