Osgood-schlatter syndrome is the technical term to define knee pain in adolescences that is associated with growth spurts. It is in fact the most common cause of knee pain in adolesecents, being more common in the athletic population. Osgood-schlatter is inflammation of the boney point where the patella tendon inserts onto the top frontal point of the tibia from repetitive strain from the quadriceps.
The reasoning a to why children are susceptible to this is due to nature of the growth of the bone. At a young age a child’s bone is going through stages of growth, and during the start of the growth spurt their bones start to make a move towards their final stage before they fuse, but in this window some new boney protrusions develop. This new bone protrusion on the top of the tibia often seen around 11-15 for boys and 8-13 girls, isn’t fully fused with the rest of the bone, there it does not tolerate tensile forces well, so during repetitive strain put on this area from the quadriceps inflammation and irritation occurs.
There also cases where there is an imbalance of the growth/length of the bone and muscle, which causes the increase in, tensile forces on the knee.
Treatment – The vast majority of children with Osgood-schlatter syndrome are effectively rehabilitated with conservative treatment of icing, changing activities from high impact (running, jumping) towards low impact activities like swimming and cycling. There is also evidence towards a low impact pain free stretching regime
Strengthening the lower limb, especially the quadriceps, is normally only recommended if the child has below norms in muscular strength or muscle atrophy. Quad muscle weakness changes the way forces go through the knee, loading the knee pain itself, it can also influence how other muscles around the knee work, potentially leading to other issues.
With correct management and education for the child, Osgood-schlatter syndrome is normally effectively rehabilitation and once the growth plates fuse, there should be no issue with returning to previous exercise with adequate progression.
