RICE & MICE: Osgood-Schlatter Disease

Osgood-Schlatter disease (OSD) is one of the common causes of knee pain in children and adolescents. Calling it a disease definitely makes it sound much more serious and dangerous than it is. Disease is actually a misnomer, because it’s an overuse injury that causes painful lumps on the front of the knee at the top of the tibia, the bigger bone in the lower leg. The patellar tendon attaches to the tibia at the tibial tubercle OSD occurs when there is too much traction stress on the attachment of the patellar tendon during a growth spurt in young boys and girls.

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When we are young and still growing, the ends of our long bones (the bones of the arms and legs) have growth plates composed of cartilage. Stress on the growth plate may cause it to become swollen and painful and since the job of the growth plate is to produce bone tissue, the stress on the growth plate often results in a permanent bump deformity at the top of the shinbone.
OSD is common in sports and activities that involve running, jumping and quick changes of direction such as soccer, basketball, hockey, figure skating and ballet. Boys suffer from OSD more than girls, however since more girls are participating in sports, they are increasingly affected. The age range that each sex may experience OSD differs because girls typically go through growth spurts and puberty earlier than boys.

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OSD causes pain and swelling of the upper shinbone as well as tenderness of the bump at the top of the shin. Pain usually worsens with activity. Pain level can range from minor discomfort when jumping or with sudden change of direction to severe and constant pain that interferes with daily activities. OSD can affect one or both knees and may last from weeks to months and then may also recur until the child is finished growing.
The good news is that OSD is self limiting and resolves when growing stops. The bump deformity is not harmful usually causes no long-term difficulties or disabilities. Treatment of OSD is to rest and refrain from the activities that cause pain. Ironically, the most active kids are the ones that usually suffer from OSD and usually the ones that are least likely to rest. Rest, ice, and sometimes compression are mainstays of treatment, as well as a good stretching program, since tight hamstrings and quadriceps, the muscles of the thigh, often contribute to the development of OSD.  Knee straps or patellar tendon straps may help take tension off of the tibial tubercle.