Osgood-Schlatter disease can cause a painful lump below the kneecap in children and adolescents experiencing growth spurts during puberty.

Osgood-Schlatter disease occurs most often in children who participate in sports that involve running, jumping and swift changes of direction — such as soccer, basketball, figure skating and ballet.

While Osgood-Schlatter disease is more common in boys, the gender gap is narrowing as more girls become involved with sports.

Age ranges differ by sex because girls experience puberty earlier than do boys. Osgood-Schlatter disease typically occurs in boys ages 13 to 14 and girls ages 11 to 12. The condition usually resolves on its own, once the child's bones stop growing.

The pain associated with Osgood-Schlatter disease varies from person to person. Some have only mild pain while performing certain activities, especially running and jumping. For others, the pain is nearly constant and debilitating.

Osgood-Schlatter disease usually occurs in just one knee, but sometimes it develops in both knees. The discomfort can last from weeks to months and may recur until your child has stopped growing.

When to see a doctor

Call your child's doctor if knee pain interferes with your child's ability to perform routine daily activities. Seek medical attention if the knee is also swollen and red, or if the knee pain is associated with fever, locking or instability of the knee joint.

During activities that involve a lot of running, jumping and bending — such as soccer, basketball, volleyball and ballet — your child's thigh muscles (quadriceps) pull on the tendon that connects the kneecap to the shinbone.

This repeated stress can cause the tendon to pull away from the shinbone a bit, resulting in the pain and swelling associated with Osgood-Schlatter disease. In some cases, your child's body may try to close that gap with new bone growth, which can result in a bony lump at that spot.

The main risk factors for Osgood-Schlatter disease are:

  • Age. Osgood-Schlatter disease occurs during puberty's growth spurts. Age ranges differ by sex because girls experience puberty earlier than do boys. Osgood-Schlatter disease typically occurs in boys ages 13 to 14 and girls ages 11 to 12.
  • Sex. Osgood-Schlatter disease is more common in boys, but the gender gap is narrowing as more girls become involved with sports.
  • Sports. The condition happens most often with sports that involve a lot of running, jumping and swift changes in direction.

Complications of Osgood-Schlatter disease are uncommon. They may include chronic pain or localized swelling. Even after symptoms have resolved, a bony lump may remain on the shinbone in the area of the swelling. This lump may persist to some degree throughout your child's life, but it doesn't usually interfere with knee function.

You'll likely first bring this problem to the attention of your family doctor or your child's pediatrician. He or she might refer you to a doctor who specializes in knee injuries or sports medicine.

What you can do

Bring to the appointment a written list that includes:

  • Detailed descriptions of your child's symptoms
  • Information about medical problems your child has had in the past
  • Information about medical problems common in your family
  • All the medications and dietary supplements your child takes
  • Questions you want to ask

Below are some basic questions to ask a doctor who is examining your child for possible Osgood-Schlatter disease. If any additional questions occur to you during your visit, don't hesitate to ask.

  • Do you expect my child will be able to continue in his or her current sport?
  • Does my child need to make any changes to his or her activities, such as playing a different position or training with different exercises? If so, for how long?
  • What signs or symptoms would signal a need for my child to take a complete break from athletics?
  • What other self-care measures would help my child?

What to expect from your doctor

Your child's doctor is likely to ask a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask your child:

  • How severe is your pain?
  • Does your pain occur before, during or after your workouts — or is it constant?
  • Have you noticed any swelling near your kneecap?
  • Have you experienced any problems with mobility or stability?
  • What is your regular exercise or sports-training routine?
  • Have you recently made any changes to your training routine, such as training harder or longer or using new techniques?
  • Are you able to tolerate the pain you experience while playing your sport at your usual intensity?
  • Are your symptoms affecting your ability to complete normal, daily tasks, such as walking up stairs?
  • Have you tried any at-home treatments so far? If so, has anything helped?
  • Have you recently had any injuries that may have caused knee damage?

During the physical exam, your doctor will check your child's knee for tenderness, swelling, pain and redness. X-rays may be taken to look at the bones of the knee and leg and to more closely examine the area where the kneecap tendon attaches to the shinbone.

Osgood-Schlatter disease usually gets better without formal treatment. Symptoms typically disappear after your child's bones stop growing. Until that happens, your doctor may recommend mild pain relievers and physical therapy.

Medications

Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve) may be helpful.

Therapy

A physical therapist can teach your child exercises to stretch the thigh's quadriceps and hamstring muscles, which may help reduce the tension on the spot where the kneecap's tendon attaches to the shinbone. Strengthening exercises for the quadriceps can help stabilize the knee joint.

It may help your child to follow these tips:

  • Rest the joint. Limit the time spent doing activities that aggravate the condition, such as kneeling, jumping and running.
  • Ice the affected area. This can help with pain and swelling.
  • Stretch leg muscles. Stretching the quadriceps, the muscles on the front of the thigh, is especially important.
  • Protect the knee. When your child is participating in sports, have him or her wear a pad over the affected knee at the point where the knee may become irritated.
  • Try a strap. A patellar tendon strap fits around the leg just below the kneecap. It can help to "tack down" the kneecap's tendon during activities and distribute some of the force away from the shinbone.
  • Cross-train. Suggest that your child switch to activities that don't involve jumping or running, such as cycling or swimming, until symptoms subside.
Feb. 28, 2014