Osgood Schlatters: Managing Youth Patella Pain

Painful Osgood Schlatters Disease

He has this huge bump below his knee, his doctor says he’ll grow out of it but it hurts him all the time.  What should we do?’ his mother said, frustratingly seeking an answer.

Following a fund raising golf tournament recently a good friend of mine came to me looking for a clear answer for a strange injury with a bizarre name.  Her athletic teenager had an overly large bony lump just below his right knee.  He was 16 years old, still growing and she was understandingly concerned about her son’s knee.

Osgood Schlatters Disease is an orthopedic disorder that results in an enlarged tibial tuberosity just below the front of the knee.  The tibial tuberosity is the lower attachment of the patella tendon.  Because of the excessive forces generated by the quadriceps (muscles located in the front of the thigh) muscles, the load is transferred to the patella (kneecap) and directly to the tibial tubercle on the tibia (shin bone).

Patella injuries are usually a mechanical injury.  In a simplistic manner, when these muscles are contracted, the forces are applied to the tibial tuberosity and the knee is extended.  That’s the easy part.

A growth plate is typically a location at the end of most long bones.   At a growth plate, a cartilaginous ring allows for the growth of the bone.

Chondromalacia is commonly associated with many types of patella injuries.

Here comes the interesting part…..a growth plate is located at the tibial tuberosity.  Therefore, when an active teenager creates excessive forces at the knee with activities such as jumping, squatting, running, trauma,…etc., the rate and the direction of the growth at that tibial growth plate can easily be altered.  Hence, the bump gets larger and more painful.

Patella injuries are successful resolved when addressed promptly. With an early onset of Osgood Schlatters, if the young athlete rests the area for 2-4 weeks and avoids the specific sports activities that worsen his pain, his symptoms will resolve themselves.

Osgood Schlatters and chondromalacia are similar in the fact that when these conditions occur, the athlete is typically predisposed to having symptoms in the future.  With Osgood Schlatters, when the athlete stops growing and his growth plates mature or “close”, the athlete has much less problems with the injury other than the cosmetic appearance and mechanical issues of an enlarged tibial tubercle.

Suggestions to Alleviate Osgood Schlatters Pain

  1. See his doctor to clearly diagnose this problem and to “rule out the bad stuff.”
  2. Ice his knee after every workout and competition.
  3. Become a flexibility machine.  My advice on flexibility: start young and stick to it.
  4. Avoid aggressive leg strengthening exercises and agility work whenever possible.
  5. Rest the knees.  A little rest now will help him avoid missing large chunks of time later.

I think this young man will do well if he follows this advice.  The Osgood Schlatters will quiet down in time.  Meanwhile, the enlarged tibial tubercle will probably not return to its normal size.

As with most sports injuries, the earlier you address the problem the quicker they quiet down.  Being smart now will ensure that you will be active and healthy later!

Author: Mike Ryan

After 26 seasons as a full-time certified athletic trainer and registered physical therapist in the National Football League, Mike Ryan has outstanding first-hand experience. His unique professional and athletic background has sharpened his skills in the arts of sports injury management, elite rehabilitation, performance enhancement and injury prevention. Mike is now taking his experience to mainstream America. His mission is simple: Sports Medicine advice that is easy to use and brings fast results. Learn more about Mike Ryan

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