Several times a month, we get a call from an anxious parent. They’ve just been told their child has something called Osgood-Schlatter Disease, a sinister-sounding condition related to the knees. The diagnosis may have come from a GP, or perhaps from a physio or sports coach. And now they’re worried. What is this thing? Is it serious? How serious? What should they do about it?
Our short answer to these questions is: don’t panic.
The slightly longer answer is: Osgood-Schlatter is a common condition that affects quite a lot of young people, and once you know a bit more about it you should hopefully begin to feel more reassured. So let’s take a closer look at what’s happening here.
How does it start?
Osgood-Schlatter usually starts with a young, active person noticing a pain or lump in their knee. By young we mean around puberty, so roughly eight to 13 for girls or 10 to 14 for boys. The pain or swelling typically gets worse during activities like running, jumping and walking up stairs – and worse still during high-impact sports like football. It can occur in one or both knees and it often runs in families.
What’s actually going on?
As you might have guessed, the condition usually sets in during the growth spurt. As a child grows, their bones and tissues develop at different rates. In Osgood-Schlatter, the thigh muscles start to pull on the tendon connecting the kneecap and shinbone. This puts stress on the growth plate at the top of their shinbone, resulting in pain and swelling. There may also be a bony lump, which can be painful to kneel on.
Is it dangerous?
No. We usually order an MRI scan to check we’re not missing anything – say, a meniscal tear or a cartilage lesion. But if Osgood-Schlatter is the correct diagnosis, we would expect it to pass as the growth plates close. This usually happens in the mid to late teens. Some patients hear scare stories – that they should steer completely clear of exercise, or that they’ll be stuck with the disease for life. The truth is that the condition should simply burn itself out.
How should I manage it?
It’s natural to want to wrap your child in cotton wool and stop sport altogether. But this is likely to be counterproductive. The main thing is to let your child keep doing whatever they’re comfortably able to do. If pain occurs during activity and it’s manageable, your child could use simple painkillers and the standard PRICE therapy (protection, rest, ice, compression, elevation) to ease swelling and discomfort. You may also want to consider some activity modification and even some physio. But avoiding exercise completely isn’t a great outcome, not least because your child needs to keep their knee joints mobile. Even if the exercise is painful, it’s unlikely to be doing permanent damage.
Is surgery ever necessary?
Surgery is very unlikely. There is one exception: sometimes we see patients in their twenties with lumps on the knees. Typically, they’ll have developed Osgood-Schlatter as an adolescent. They got through it. It burned out. But they were left with a bony protrusion at the top of their shinbone (an ossicle). This may just be aesthetically unpleasant. It could also be painful to kneel on. In these cases, we can remove the lump with a simple surgical procedure. But it must be said that this outcome is pretty uncommon. For the most part, Osgood-Schlatter is a short-lived issue that passes off with adolescence. So while it may be unpleasant, the outlook is very reassuring.
In most cases, time and patience are the best remedies for Osgood-Schlatter. But it’s important to get a proper diagnosis. If you think your child may have OSD, we can take a thorough look and help you decide on the best management plan. Just call the team on 01962 826107 or click onto the website. We’ll be happy to help put your mind at rest.