Osgood Schlatter's disease (knee pain)

What is Osgood-Schlatter's disease (knee pain)? Osgood-Schlatter disease is one of the common causes of **knee** pain in growing teenagers. This condition involves irritation of the area just below the knee, where the patellar tendon attaches to the tibia. Osgood-Schlatter disease often occurs during a growth spurt, when bones, muscles, tendons, and other structures are changing rapidly. Because physical activity puts extra stress on bones and muscles, children who participate in running and jumping sports are more prone to this condition. However, less active teenagers may also suffer from this problem. In many cases, simple measures such as rest, ice, over-the-counter pain relievers, and stretching and strengthening exercises can reduce pain and allow a return to daily activities. ### Explanation of Osgood Schlatter's disease The bones of children and teenagers have a special area called the growth plate. These growth plates are the cartilaginous areas near the ends of the bones. When the child is fully grown, these plates become hard bone. Some of these growth plates become tendon junctions; Tendons are the tough tissues that connect muscles to bones. A bony projection called the tibial tubercle covers the growth plate at the end of the tibia. The muscles in the front of the thigh (called the quadriceps) are attached to this ridge. When the child is active, the quadriceps muscles pull the patellar tendon, which puts pressure on the tibial tubercle. In some children, this repeated stretching leads to irritation of the growth plate. The prominence of the tibial tubercle may be seen or felt very clearly. ### Osgood Schlatter's symptoms The symptoms of this disease are usually aggravated by activities such as running, jumping and other sports. In some cases both knees have symptoms, although one knee may have more pain. Symptoms include the following: - Pain and sensitivity in the area of the tibial tubercle (below the knee) - Swelling in the area of the tibial tubercle - Tight muscles in the front or back of the thigh ### Examination by an orthopedic specialist When visiting the office, your surgeon or orthopedic specialist (for example **Dr. Kukbi**) will perform an examination during one session: - Your child's symptoms and general health will be discussed. - A detailed examination of the knee is performed to determine the cause of the pain. This examination involves applying pressure to the tibial tubercle, which will be tender or painful in children with Osgood-Schlatter disease. - The child may be asked to walk, run, jump or kneel to see if these movements cause pain. - Osgood-Schlatter disease is diagnosed based on history and physical examination. X-rays are usually not necessary for diagnosis and are only requested when the orthopedic specialist is concerned about another cause of knee pain. Osgood Schlatter treatment Treatment of Osgood-Schlatter disease focuses on reducing pain and swelling. - In severe cases where the child limps or has a lot of pain even at rest, it may be necessary to limit sports activities for a while so that he can start stretching and strengthening exercises. - The intensity of pain may continue until the closure of the growth plate. The goal is for the pain to become a mild discomfort that does not prevent the child's sports activities and disappears quickly after the end of the activity. - It is important to know that continuing sports activity **alone** will not cause long-term damage to the knee. The child can - as long as he has tolerance - participate in the activities. If the pain makes the activity no longer enjoyable for the child, or the child does not decide to participate because of the pain and has completed all the above treatment methods, he should be referred to an orthopedic specialist to discuss the modification of the activity and newer treatment methods. Anticipated treatment may include: - Stretching exercises: Stretching the muscles in the front of the thigh (quadriceps) and back of the thigh (hamstring) can help reduce pain and prevent recurrence. These should be done 3 to 4 times a day. - Non-steroidal anti-inflammatory drugs (NSAIDs): drugs such as ibuprofen or naproxen that reduce pain and swelling. - Using ice: the inflamed area can be cooled with a cold pack for 20 minutes each time, several times a day, especially after physical activity. Ice should not be applied directly to the skin. - Patellar tendon strap: a strap that is placed above the lower part of the knee, on the middle part of the patellar tendon, that is, exactly between the bottom of the patella and the tibial tubercle. ### Result Most symptoms disappear completely when the child completes the growth spurt — around age 14 for girls and 16 for boys. For this reason, surgery is rarely recommended. However, the prominence of the tibial tubercle may remain (i.e. still be seen or felt) and may increase in size until the child has finished growing. Why should you see an orthopedic specialist? If you or your child has symptoms of Osgood-Schlatter's disease, visiting Dr. Kokbi — **the best orthopedic surgeon and specialist in Tehran** — can help to: - Accurate diagnosis, because many knee pains are similar. - An appropriate treatment plan should be designed, including stretching, strengthening, modifying activities and home care. - Minimize your concern about the effect this disease may have on sports activities or daily life. - Prevent possible complications, such as chronic pain, impaired activity, or excessive enlargement of the tubercle. ### Final tips for parents and teens - Strenuous activities (such as running, jumping a lot, climbing stairs) during the treatment period should be done with caution or temporarily reduced. - Take stretching and strengthening exercises seriously — these will help improve posture. - Teach your child that if he sees pain or swelling in the area below the knee, to see an orthopedic specialist immediately. - Know that this condition usually does not cause permanent damage — with proper treatment, you can return to sports activities and daily life. - Surgery is considered only in very rare cases and after the end of growth. ### Frequently asked questions about Osgood-Schlatter disease **1. At what age does Osgood-Schlatter disease occur?** This disease is mostly seen during the rapid growth of bones; Usually in girls between 10 and 14 years and in boys between 12 and 16 years. **2. Is this disease dangerous?** No, in most cases it is temporary and harmless and will resolve on its own after the bones stop growing. But if treatment is neglected and high-pressure activities are continued, chronic pain may remain. **3. Does exercise make Osgood-Schlatter disease worse?** No, if exercise is performed with controlled intensity and under the supervision of an orthopedic specialist (like Dr. Cookby), it will not damage the knee. You should only have enough rest during severe pain. **4. How can the pain caused by this disease be reduced?** Use of ice, rest, non-steroidal anti-inflammatory drugs (such as ibuprofen), thigh and back stretching exercises, and in some cases tying a special band below the knee. **5. Is it necessary to perform surgery?** In most cases, surgery is not required. Only in rare cases where pain persists after the growth has stopped, an orthopedic surgeon may consider surgical intervention. **6. Does the bump under the knee disappear after the treatment?** In some people, the bump remains, but it is usually painless and does not affect the function of the knee. **7. When should you see an orthopedic specialist?** If the pain causes lameness, limited movement, or persistent swelling, you should definitely see an orthopedic surgeon (like Dr. Cookby) to rule out possible complications.