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Knee Pain in Athletic Teens Can be Caused by Osgood-Schlatter Disease

By Kathy Hubbard
“When I was 12 or 13 I first noticed that I couldn’t kneel down directly on my knees. The pain was unbearable. It was constant,” wrote a 38-year old woman on Medicinenet.com’s website. “I was often crying with the pain and unable to sleep at night. Just below my knees I had these unsightly boney lumps, and still do.
“I was referred to a specialist and was put in a plaster cast for six weeks. I was not able to do any physical education lessons at all. I went to physiotherapy twice a week. None of that helped. The pain eventually stopped when I was around 19.”
This woman suffered from Osgood-Schlatter disease. Really more a syndrome than a disease, it was named in 1903 for Robert Osgood a US orthopedic surgeon and Carl Schlatter, a Swiss surgeon who concurrently described this condition.
OSD is a common cause of knee pain that strikes active adolescents around the beginning of their growth spurts, the approximately two year period during which they grow most rapidly. That occurs between the ages of 8 and 13 for girls and 10 to 15 for boys. OSD historically has affected more boys than girls, but that could be changing with girls participating in more strenuous athletic activities.
Kidshealth.org says, “Teens increase their risk for OSD if they play sports involving running, twisting, and jumping, such as basketball, football, volleyball, soccer, tennis, figure skating, and gymnastics. Doctors disagree about the mechanics that cause the injury but agree that overuse and physical stress are involved.”
The American Academy of Orthopaedic Surgeons explains, “The bones of children and adolescents possess a special area where the bone is growing called the growth plate. Growth plates are areas of cartilage located near the ends of bones. When a child is fully grown, the growth plates harden into solid bone.
“Some growth plates serve as attachment sites for tendons, the strong tissues that connect muscles to bones. A bony bump called the tibial tubercle covers the growth plate at the end of the tibia. The group of muscles in the front of the thigh (called the quadriceps) attaches to the tibial tubercle.
“When a child is active, the quadriceps muscles pull on the patellar tendon which in turn, pulls on the tibial tubercle. In some children, this repetitive traction on the tubercle leads to inflammation of the growth plate. The prominence, or bump, of the tibial tubercle may become very pronounced.”
And, those knobby knees hurt. They hurt to touch them right under the knee cap plus there can be swelling right there as well and the child may suffer from tight muscles in the front or back of the thigh.
“Treatment for Osgood-Schlatter disease focuses on reducing pain and swelling. This typically requires limiting exercise activity until your child can enjoy activity without discomfort or significant pain afterwards. In some cases, rest from activity is required for several months, followed by a strength conditioning program. However, if your child does not have a large amount of pain or a limp, participation in sports may be safe to continue,” the AAOS says.
They also say that stretching exercises may help with the pain and prevent it from reoccurring. And, they recommend over-the-counter anti-inflammatory meds such as ibuprofen and naproxen to reduce pain and swelling.
There’s an interesting YouTube video of self-proclaimed world-famous physical therapists Bob Schrupp and Brad Heineck titled “Top 3 Treatments for Osgood Schlatter Disease” that shows how a child can use massage, stretching and ice to relieve symptoms.
AAOS says that although most symptoms will completely disappear when a child completes the adolescent growth spurt, sometime around the age of 14 for girls and 16 for boys, the prominent tubercle will persist.
The forum I found had several participants that said they continue to suffer from OSD as adults, although other sites said that was unusual. Medicinenet.com says “If a bone fragment in this area continues to cause pain in adulthood, it may require surgery to remove.” Our 38-year old patient said she just wears clothes to cover up her protruding knee knobs.
Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 264-4029 or kathyleehubbard@yahoo.com.

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