when does osgood schlatter start?
Osgood-Schlatter disease is an overuse condition. It’s when the tendon at the front of a knee becomes injured and inflamed. This tendon connects the thigh muscles to the knee and shin bone. It's also known as the patellar tendon.
Osgood-Schlatter disease is caused by the constant pulling of the tendon in the knee. It's seen in growing children and teens. This is an age where the bones are typically growing faster than the muscles and tendons. As a result, the muscles and tendons tend to become tight.
Osgood-Schlatter disease is common in young athletes who play games or sports that involve running, jumping, or going up and down stairs. These include football, soccer, basketball, gymnastics, or ballet. It most often affects preteen and teenage boys ages 10 to 15.
The following are the most common symptoms of Osgood-Schlatter disease. Symptoms can occur a bit differently in each child. Symptoms may include:
These symptoms may seem like other health problems of the knee. See your child’s healthcare provider for a diagnosis.
Your child’s healthcare provider can diagnose Osgood-Schlatter disease with a complete health history and physical exam of your child’s knee. Your child may also need to have an X-ray of the affected knee.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
The goal of treatment is to control your child’s knee pain and prevent the condition from worsening. Treatment may include:
Osgood-Schlatter disease often goes away over time. In rare cases, your child may need surgery.
Your child can develop Osgood-Schlatter disease again. To prevent that from happening, have your child:
- Age: female 8-12 years & male between 12-15 years.
- Male sex (3:1)
- Rapid skeletal growth.
- Repetitive sprinting and jumping sports.
Osgood-Schlatter disease typically affects kids during their preadolescent growth spurt: in the tweens (10 to 13) for girls and the early teens (12 to 14) for boys. At this stage, a child's bones are typically growing faster than the muscles and tendons.
Osgood-Schlatter disease is a condition that causes pain and swelling below the knee joint, where the patellar tendon attaches to the top of the shinbone (tibia), a spot called the tibial tuberosity. There may also be inflammation of the patellar tendon, which stretches over the kneecap.
Osgood-Schlatter disease is most commonly found in young athletes who play sports that require a lot of jumping and/or running.
Osgood-Schlatter disease is caused by irritation of the bone growth plate. Bones do not grow in the middle, but at the ends near the joint, in an area called the growth plate. While a child is still growing, these areas of growth are made of cartilage instead of bone. The cartilage is never as strong as the bone, so high levels of stress can cause the growth plate to begin to hurt and swell.
The tendon from the kneecap (patella) attaches down to the growth plate in the front of the leg bone (tibia). The thigh muscles (quadriceps) attach to the patella, and when they pull on the patella, this puts tension on the patellar tendon. The patellar tendon then pulls on the tibia, in the area of the growth plate. Any movements that cause repeated extension of the leg can lead to tenderness at the point where the patellar tendon attaches to the top of the tibia. Activities that put stress on the knee—especially squatting, bending or running uphill (or stadium steps)—cause the tissue around the growth plate to hurt and swell. It also hurts to hit or bump the tender area. Kneeling can be very painful.
Osgood-Schlatter disease usually goes away with time and rest. Sports activities that require running, jumping or other deep knee-bending should be limited until the tenderness and swelling subside. Kneepads can be used by athletes who participate in sports where the knee might make contact with the playing surface or other players. Some athletes find wearing a patellar tendon strap below the kneecap can help decrease the pull on the tibial tubercle. Ice packs after activity are helpful, and ice can be applied two to three times a day, 20 to 30 minutes at a time, if necessary. The appropriate time to return to sports will be based on the athlete’s pain tolerance. An athlete will not be “damaging” his or her knee by playing with some pain.
Your doctor may also recommend stretching exercises to increase flexibility in the front and back of the thigh (quadriceps and hamstring muscles). This can be achieved either through home exercises or formal physical therapy.
Medicine, such as acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs)—like ibuprofen (Aleve and Advil)—can be used to help control pain. If your child needs multiple doses of medication daily and the pain affects their daily activities, there should be a discussion on resting from the sport.
In almost every case, surgery is not needed. This is because the cartilage growth plate eventually stops its growth and fills in with bone when the child stops growing. The bone is stronger than cartilage and less prone to irritation. The pain and swelling go away because there is no new growth plate to be injured. Pain linked to Osgood-Schlatter disease almost always ends when an adolescent stops growing.
In rare cases, the pain persists after the bones have stopped growing. Surgery is recommended only if there are bone fragments that did not heal. Surgery is never done on a growing athlete, since the growth plate can be damaged.
Knee pain is a common complaint among growing young athletes.
Doctors define Osgood-Schlatter as an inflammatory disease of the growth plate at the top of the shin. This growth plate is a soft tissue called cartilage.
It gets inflamed by repeated motion as the knee's main tendon pulls on the shin.
When a child finishes growing, their cartilage hardens into bone. Until then, these parts of the body can become inflamed when overused.
Active children are more at risk of overuse injuries in their joints, like the knee. Osgood-Schlatter affects about 10% of adolescents.
Tendons attach muscles to bones. These fibrous bands help our joints move.
The patellar tendon is a tendon in your knee that holds your kneecap in place.
It starts at the thigh muscle and attaches to the front of the shinbone, right below the knee. When overused, it can cause Osgood-Schlatter disease.
The constant pulling of that knee's tendon on the shin's growth plate causes pain and swelling.
It happens with young people because their bones and muscles don't all grow at the same rate. Their growth plates are also cartilage that hasn't hardened into bone yet. That means the plates are more at risk for injury.
Osgood-Schlatter usually goes away once a child stops growing. Their bones, muscles, and tendons become more "in balance," and the growth plates have sealed into bone.
Young athletes are most at risk for Osgood-Schlatter disease. It's most common in those who play sports that involve jumping, running, and landing.
Sports that seem to have the highest rate of this knee condition include:
Children who aren't athletes can also get Osgood-Schlatter.
Doctors diagnose Osgood-Schlatter most often in girls between 8 and 12 and boys between 12 and 15.
It lasts between 12 to 24 months and resolves on its own 90% of the time.
What is Osgood-Schlatter’s Disease?
Osgood-Schlatter's Disease is an inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia).
Who is at risk?
Occurs in skeletally immature patients between the ages of 12 and 18.
How do we treat the painful knee with Osgood-Schlatter’s?
The key treatment is RELATIVE REST. This does not mean elimination of athletic activities, rather it means alteration and modification of each individual's activities, this means possibly curtailing all activities up to 6 weeks, with subsequent gradual increase in activities. Other treatments include:
Polar therapy (heat and cold):
Once knee pain disappears can it reoccur?
Yes, Osgood-Schlatter’s is frequently a cyclical problem corresponding to the individuals activity level. Typically 12-24 months is required for resolution of symptoms (the approach of skeletal maturity).
Is there anything that can be done to prevent the recurrence of knee pain?
Can a strengthening program help?
For some individuals, an organized strengthening regimen can help. Exercises such as leg curls, straight leg raises, sit-ups, and wall sits can sometimes minimize symptoms. One should stay away from deep knee bends, squats with weights and exercises involving sudden jerking of the knee. Exercises such as cycling or swimming are excellent activities to maintain overall aerobic condition.
Will the bump on the front of the knee go away?
This bump will improve slightly as the inflammation and irritation resolves. However, the knee or knees will always looks “knobby” and one may have a difficulty kneeling on the bump in the future.
What is the long-term prognosis?