If you are the parent of a teenager who is just hitting a growth spurt and complains of knee pain, you may have heard of Osgood-Schlatter Disease. Named for the two physicians who first described it, in 1903, it sounds much worse than it actually is!
Symptoms of Osgood-Schlatter Disease include pain immediately below the knee cap during certain activities and a painful boney bump right below the knee.
It really shouldn’t be called a disease at all, since it isn’t progressive and is usually caused by the quadriceps (front thigh muscle) failing to keep pace with the quickly lengthening thigh bone (femur) in a growth spurt.
The boney bump felt right below the knee, called the tibial tuberosity, is the attachment point of the quadriceps muscle. During rapid growth, as in the teen years, the strong quadriceps may not be adequately stretched—especially if the youngster is involved in sports and has strengthened this muscle. The strengthened muscle then pulls on its attachment, causing the covering of the bone (periosteum) to rise up. Resulting are both inflammation and a bump on the bone that is painful to kneel on.
Your family physician, noting the symptoms and the presence of the bump, typically makes a diagnosis of Osgood-Schlatter’s, as it is usually termed.
It is fairly widespread. Thirteen percent of the teenagers in a recent Finnish study had symptoms of Osgood-Schlatter’s. Previously affecting mostly males, it now is seen nearly as often in females. Currently, more than 25 million children in the U.S. are in the susceptible age group. That means there is the possibility of 3.25 million American teens dealing with this problem yearly.
To decrease susceptibility to Osgood-Schlatter’s, remain aware of whether the hip flexors and quadriceps have become tight, and stretch and massage the long leg muscles, especially the quadriceps, frequently.
With a doctor’s okay to stretch, ask the teen to use two particular positions to gently stretch both parts of the muscle.
You can test for quadriceps tightness. Have your teen lie on the floor and pull one knee up toward the chest as far as is comfortable. Now check to see whether the leg on the floor is completely flat or lifted, especially at the knee. If it is lifted even a little, the hip flexors (part of the upper quadriceps) are tight.
In the first test, simply use the leg muscles to strengthen the leg that lies flat on the floor and try to have it as straight as possible while the teen pulls the opposite leg up to the chest. Hold for 10 seconds and repeat 10 times.
Next, to check the lower part of the quadriceps, see whether the youngster can bring the heel to buttock while lying face down. If not, the lower part of the quadriceps is tight.
Neither test should cause any pain, just a little stretch in the front thigh muscle. The tests should be done in a slow, easy, relaxed fashion.
To stretch the lower quadriceps, the youngster should gently pull the heel toward the buttock with a hand or a belt, while lying on the stomach. Never pull too hard because this will actually tighten the muscle. Hold the stretch for 20 seconds and repeat 5 times on each leg.
If Osgood-Schlatter’s develops in just on one knee, there is probably an imbalance in the pelvis that creates an imbalance in the tension of the quadriceps. Having the alignment of legs and pelvis evaluated by a physical therapist experienced in manual therapy and in the correction of pelvic obliquely (malalignment) can help correct the problem.
When the enthusiasm and energy of youth meets Osgood-Schlatter’s, the result can prove worrisome to parents and teens alike. The condition can be awkward and painful. But treatment is generally easy to accomplish, with typically good results.