Osgood What?

Many of you parents out there may be familiar with knee pain due to Osgood Schlatter's disease because your child is experiencing it, or you experienced in the past as a child.  It is definitely one of the most common causes of knee pain in kids (not due to falling or trauma).

I talked about what apophysitis is a few weeks ago, and Osgood Schlatter's is the most well known form of it.  Again, an apophysis is a growth plate that provides a point for a muscle/tendon to attach.  And apophysitis is due to chronic traction of a tendon at its origin or insertion.  Continuous stress at the apophyseal site leads to local swelling and pain.  Stress at the knee comes from things like running, jumping, or squatting.

When Osgood Schlatter's disease occurs, kids develop a bump that you can feel just below their kneecap. The bump is painful to touch.  Pain is worse with running and things like walking up stairs, hills, or any incline.  It is especially painful when a child with Osgood Schlatter's falls on his or her knee.

If you think your child has Osgood Schlatter's it is important for he or she to stretch, stretch, and stretch.  Specifically stretch the calf muscles, hamstrings, and quad muscles.  Icing the knee (right over the bump) at least two times a day and taking an age appropriate dose of ibuprofen is also helpful.  Sometimes kids with chronic or severe Osgood Schlatter's need formal physical therapy.

Bracing with a knee strap (which goes between the kneecap and the bump that forms with Osgood Schlatter's) can also be helpful.  The strap theoretically compresses the patellar tendon and lessens the traction on the apophysis where the pain is.

Osgood Schlatter's disease typically resolves when the apophysis (or growth plate) below the kneecap closes.  However, in some kids, the problem can become chronic and those kids require surgery.  This doesn't occur until high school age or beyond because you have to give the apophysis a chance to close.  There are also experimental treatments with injection for moderate to severe Osgood Sclatter's, which may become a more common treatment in the future.

It doesn't harm a kid to play with knee pain due to Osgood Schlatter's, but it may prolong the course of recovery.  The best thing to do is try a course of rest and rehab to try to eliminate the pain before going back to a sport 100%.

Rachel Brewer, MD