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 patella (knee cap) which in-turn attaches to
patellar tendon. This patellar tendon 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.
This
swelling and irritation of the growth plate at the top of the shinbone is called
as Osgood-Schlatter disease (OSD).
OSD
goes away when a child stops growing and usually doesn't cause lasting problems.
What
Are the Signs & Symptoms of Osgood-Schlatter Disease?
OSD
typically causes pain and swelling below the kneecap. The pain usually gets
worse with running, jumping, going up stairs, and walking up hills. Severe pain
may lead to limping. OSD can happen in one or both knees.
Who
Gets Osgood-Schlatter Disease?
OSD usually happens in kids that are in their growth spurt (usually around 9–14 years old) and is active in sports or activities that involve a lot of running or jumping
OSD
is an overuse injury. This means it happens when a child does the same
movements over and over again.
How
Is Osgood-Schlatter Disease Diagnosed?
To diagnose Osgood-Schlatter disease, your doctor will ask about physical activities and do an examination.
Usually,
no testing is needed. Sometimes the doctor orders an X-ray to check for other
knee problems.
How
is Osgood-Schlatter disease treated?
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.
Medicines, 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.
Is
surgery ever needed for Osgood-Schlatter disease?
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 stop 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.
If
pain and swelling persist despite treatment, the athlete should be re-examined
by a doctor regularly. If the swelling continues to increase, the patient
should be re-evaluated.
How
Long Does Osgood-Schlatter Disease Last?
Osgood-Schlatter
disease usually goes away when the bones stop growing. Typically, this is when
a teen is between 14 and 18 years old.
Can
Kids With Osgood-Schlatter Disease Still Do Sports?
Yes, kids with OSD can usually do their normal activities, including sports, as long as:
The
pain is not bad enough to interfere with the activity.
The
pain gets better within 1 day with rest.
What are the consiquences in later in the adult life, if one had this diseade in childhood?
Most
symptoms will completely disappear when a child completes the adolescent growth
spurt, around age 14 for girls and age 16 for boys. For this reason, surgery is
rarely recommended. However, the prominence of the tubercle will persist.