© 2015 Roy Benaroch, MD
Betty asked, “My husband has this lump under his knee—he says it hurts when he kneels on it. And now, my 11 year old son is getting one of these too! I think it’s Osgood-Schlatter syndrome. What can I do about it?”
Osgood-Schlatter syndrome (or, sometimes, disease—I’ve seen it both ways) is a very characteristic knee problem that occurs in some growing children. Boys get it around 12-13 years, girls more like 10-12. Technically, the definition looks like this:
Osgood Schlatter syndrome (O-S) is a traction apophysitis of the tibial tubercle due to repetitive strain on the secondary ossification center of the tibial tuberosity.
(You may guess from that definition that neither Drs. Osgood nor Schlatter went out on a lot of dates.)
“Traction apophysitis” is pulling on a growth plate—and since only growing kids have these, pain from Osgood-Schlatter is only seen in children. After the growth plates fuse, the discomfort of O-S fades away. Sometimes, a bump stays under the knee in adults, and that can hurt with kneeling.
Why does it happen? Probably because there’s already some swelling at the growth plate, and the quadriceps tendon rubs right across there at the top of the lower leg.
The pain of O-S is typically not severe. It’s more of an achy sort of pain, mostly after exercise, especially after jumping or running. The area under the knee can also be tender, so if it’s banged up from falling or from being hit, that will hurt, too.
I don’t think there’s any great way to prevent O-S. Once it starts, ice or ibuprofen can help with the discomfort, and often that’s all that’s necessary. Continuing to play on it will not cause arthritis or knee damage—as long as the pain isn’t too bad, it’s reasonable to ice the area and keep playing. However, if it’s getting worse and worse a period of relative rest is a good idea, Maybe consider changing sports for a season.
You can also buy a little band like this one that goes right under the knee. It will provide a little padding to protect the tender area. Some people claim that these bands change the biomechanics of the tendon so it won’t rub—that’s not actually true, but hey, if it helps a kiddo feel better, wear it.
Another strategy is physical therapy, to strengthen and stabilize the quads and knee. It will also give Junior something active to do while sitting out of sports.
In time, after a year or so, O-S pain improves. Betty should take her son to his doctor to confirm the diagnosis and learn more about it. Usually, the history and physical exam are so characteristic that x-rays aren’t needed. Most kids can live with this until it gets better on its own.