Osgood-Schlatter disease
Osgood-Schlatter disease is a common cause of knee pain in active children and teenagers, producing a tender lump just below the kneecap where the patellar ligament attaches to the shin bone. Rest, activity changes, footwear advice, stretching programs, and orthotics can all help. Fiona assesses it in an initial consultation from $100.
What Osgood-Schlatter disease is
Osgood-Schlatter disease is a growth-related condition that causes pain and a tender lump just below the knee. The lump sits at the tibial tuberosity, the bony bump at the top of the shin where the patellar ligament attaches. It commonly affects young people between the ages of 9 and 16, particularly around the time of rapid growth. The condition is more common in children who play a lot of sport, and boys are affected more often than girls.
Symptoms
Symptoms usually come on during physical activity.
- A painful lump below the kneecap
- Pain during running, jumping, squatting, and going up and down stairs
- Tenderness over the lump when it is pressed
- Pain in one knee or in both knees
Causes and risk factors
Causes and risk factors for Osgood-Schlatter disease relate to growth, activity, and leg alignment. The condition develops when repeated pulling from the thigh muscles irritates the growth plate at the tibial tuberosity. A pronated foot (overpronation) can increase the quadriceps angle in a similar way to a knock-kneed position, and this angled pull can leave the tibial tuberosity more vulnerable to damage.
Risk factors that may contribute include a sudden increase in training or sporting activity, inappropriate training, recent growth spurts, and inappropriate footwear. Muscle tightness or weakness, particularly in the quadriceps, joint stiffness, poor lower limb biomechanics, and poor foot posture can play a part.
Treatment at the clinic
Treatment at the clinic starts with a biomechanical assessment. She can refer for X-ray, ultrasound or MRI when needed, and refer back to your GP when required. The assessment may lead to footwear advice, strapping and taping, and a stretching and strengthening program for the quadriceps and hamstrings. She may recommend custom or semi-custom orthotics when foot posture or lower limb biomechanics contribute to the pain.
An initial consultation costs from $100, and a standard consultation costs from $90. Custom orthotics, scanned with a 3D foot scanner, cost from $650, including the biomechanical assessment, fitting, and a review appointment. Semi-custom orthotics cost from $450, including the biomechanical assessment and fitting. Fiona provides podiatry for children from 4 years old at Narre Warren and at Cranbourne North inside Stirling Medical Centre.
Looking after it at home
Looking after it at home means easing the load through the knee. Rest the knee from sport and activities that bring the pain on. Ice, compression, and elevation can help when the lump is sore. Avoid a 'no pain, no gain' approach, because pushing through pain can make it worse.
When to see a podiatrist
When to see a podiatrist depends on the pattern of the pain. See a podiatrist when your child has pain below the knee that keeps returning with sport, when a tender lump appears, or when discomfort starts to limit activity. See a GP instead when the pain is severe or present at rest, when the knee is hot or very swollen, or when your child cannot bear weight on the leg. A GP manages pain medicines for children.
Questions
How long does Osgood-Schlatter disease last?
Osgood-Schlatter disease can continue while the growth plate at the top of the shin stays open. That growth plate is usually present up to about 16 years of age.
Can my child keep playing sport with Osgood-Schlatter disease?
Your child can often keep playing sport with the right training changes. Fiona can advise on modifying training while the knee is painful. A qualified person, such as a podiatrist or an experienced adolescent coach, should supervise the return to full activity.
Can a podiatrist help with knee pain in children?
Podiatrists assess and treat knee pain in children, including Osgood-Schlatter disease and patellofemoral pain syndrome. Foot posture, hip and knee positioning influence the way your child walks and how the knees move. Fiona determines the cause and nature of the knee pain before planning treatment.