Osgood-Schlatter Disease (Knee Pain in Growing Children)

Overview

Osgood-Schlatter disease is a common cause of knee pain in active children and teenagers. Despite the name, it is not a disease in the usual sense. The patellar tendon, which runs from the kneecap down to the top of the shin, attaches to a bony point called the tibial tuberosity. In growing children this point is still partly made of soft growth cartilage. Repeated pulling from the thigh muscles during running, jumping and kicking irritates it, causing pain and, often, a tender bump just below the kneecap.

It usually affects children aged around 10 to 15, often during or just after a growth spurt, and is more common in those who play football, basketball, gymnastics, dance or other sports with lots of running and jumping. One or both knees may be affected. Symptoms tend to come and go with activity levels.

For most young people, symptoms ease as growth slows and the growth plate matures, although this can take months and outcomes vary. The bump below the knee may remain into adulthood but is usually painless. The aim of treatment is to keep your child active and enjoying sport while managing the load on the knee.

Causes and risk factors

• Growth spurts, when bones lengthen faster than muscles and tendons adapt
• Sports with lots of running, jumping, kicking or kneeling
• A sudden increase in training, matches or squad sessions
• Tight quadriceps (front-of-thigh) muscles pulling on the tendon attachment
• Playing for several teams or sports at once with little rest
• Foot posture such as flat feet, which may change how load passes through the knee
• Age around 10–15, often slightly earlier in girls than boys

How we may be able to help

Our physiotherapists start by listening to your child and you, and examining the knee, hip and foot to confirm the diagnosis and rule out other causes of knee pain in growing children. Hip problems can sometimes cause pain felt in the knee, so we always check the hip as well.

Treatment focuses on load management rather than complete rest: working out how much sport your child can do comfortably, and adjusting training, jumping volume and kneeling for a while. A tailored programme of gentle quadriceps, hamstring and hip strengthening, along with flexibility work for tight thigh muscles, aims to make the knee more tolerant of sport. We explain the condition clearly so that your child, you and their coach know what to expect.

Kinesiology taping or a strap below the kneecap may help some children feel more comfortable during sport. Where foot posture, such as flat feet, appears to be contributing, a 3D foot scan and custom orthotics may be considered. If anything in the assessment suggests a different cause, we will advise on further medical review.

What you can do at home

• Reduce, rather than stop, sport — keep pain during and after activity mild and settling by the next day
• Use a wrapped ice pack on the bump for 10–15 minutes after sport
• Use a cushion or kneepad when kneeling, or avoid kneeling for now
• Do gentle quadriceps and hamstring stretches daily as shown by your physiotherapist
• Spread training through the week and allow rest days between hard sessions
• Let coaches know, so jumping and sprinting volume can be adjusted for a while