by Kimberly Allen, RN
Though it is one of the most commonly diagnosed diseases causing knee pain in teens Osgood-Schlatter disease is not actually a disease. It’s actually a type of overuse injury. In Osgood-Schlatter disease or OSD adolescents, especially those that are active in sports, near the beginning of their growth spurts. This is about a 2 year period where teens grow the fastest. The growth spurts usually occur between 8 and 13 years of age for girls and 10 to 15 years of age for boys. until recent years OSD was much more common in boys than girls, however, with more and more girls participating in sports the gap has narrowed significantly. Experts believe 1 in 5 teen athletes are affected with OSD. And the type of sports activities available is wide ranging from the traditional football and basketball to the elegance of figure skating and gymnastics all of which can lead to the development of OSD.
In OSD the area just below the knee cap where the patellar tendon attaches to the tibia is affected. Your teen has growth plates at the end of the long bones in their arms and legs. This growth plate is made of cartilage which isn’t as strong as bone. Therefore, stress on his/her growth plate can lead to it becoming swollen and painful. Certain activities like running, jumping and bending, which are a part of almost every sport I can think of, causes your teens quadriceps, which are the thigh muscles, to pull on the patellar tendon which connects his/her knee cap to the shinbone. When these activities are repetitive there is a significant amount of stress that eventually causes the tendon to pull away from the bone. Sometimes your teens body may create new bone growth to close the gap, usually leaving a bony bump. The reason teens are so vulnerable to OSD is because everything is growing so fast, especially the bones, muscles and tendons, that they aren’t always growing at the same time. This leads to differences in size and strength between the different muscle groups which then puts an unusual amount of stress on the growth plate at the top of his/her growth plate on top of their tibia.
OSD usually develops slowly over time. The first symptom your teen will usually complain of is pain just below their knee which is most noticeable after repetitive activities. However, if there is a sudden development of pain without any preceding symptoms it could be a more serious condition called a tubercle avulsion. In OSD your teen will usually complain of pain that gets worse with activity and lessens with rest. He/she may also have some swelling and/or tenderness just below their knee as well as some tightness in the muscles around their knee. However, if your teen is experiencing thigh pain or pain when resting or if he/she wakes up in the night from severe pain these are not typical of OSD and you should contact your doctor.
Fortunately OSD usually resolves on it’s own by the time your teen is 18 years of age. Until then treatment is centered on symptom relief. Unfortunately the most important component in treating OSD is rest and the teens that typically develop OSD are unlikely to rest. The use of NSAID’s like ibuprofen and naproxyn can help with the pain and swelling. The use of shock absorbent insoles can help reduce the stress on your teens knee’s when they are active. Also have your teen apply moist to the knee for 15 minutes before the game and then ice for 20 minutes after the game can reduce the pin and swelling. There are also exercises that your teen can learn to help stretch his/her hamstrings and quadriceps. These can help to reduce the amount of tension that is put on the area where the patellar tendon attaches to the bone. There are also strengthening exercises that can stabilize their knee.
Along with the benefits of sports and exercise comes the risk of injury and though OSD can’t be prevented the impact it has on your teen can be minimized by following sports safety guidelines. First, teach young athletes the importance of protecting their bodies. They should always stretch and warm up for at least 15 to 30 minutes before and after activities. All sports programs should be supervised by trained coaches and no child at any age should be encouraged to “play through the pain” when injured.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at email@example.com.