Understand
What is Osgood-Schlatter disease?
Osgood-Schlatter disease, often described as a growth-related condition, is pain in the bony bump just below the kneecap (the tibial tuberosity), where the patellar tendon attaches. It affects sporty children and teenagers, usually between 10 and 15 years old, a little earlier in girls. During growth spurts this area is still partly made of cartilage: pulled by the tendon with every jump, sprint or kick, it ends up irritated (traction apophysitis).
It is not a serious disease and it does not damage the knee: it heals on its own, usually at the end of growth when this area fuses, even if the bump may remain. Stopping all sport is rarely useful: with the help of your parents and your coach, the aim is to find the right training dose and strengthen the thighs and hips, so you can keep playing with the pain under control.
See a doctor promptly if…
- The pain wakes you at night or stays strong at rest
- Fever, or a hot, red and very swollen knee
- Sudden pain below the knee after a jump, and you cannot straighten your leg or put weight on your foot (the bone may have pulled away)
- You are limping, or your hip or groin hurts too: in teenagers, a hip problem can be felt in the knee
Common causes
- Growth spurt: the area where the patellar tendon attaches to the shin bone is still partly made of cartilage, which is more fragile
- Repeated jumps, sprints, kicks and changes of direction (football, basketball, volleyball, gymnastics…)
- A rapid increase in training: start of the season, camps, several teams at once
- Tight front-thigh muscles (quadriceps), which sometimes lag behind the growth of the bones
Symptoms
- Pain on the bump below the kneecap, during and after sport
- A more prominent bump, sometimes swollen and tender to the touch
- Pain when jumping, sprinting, on stairs or kneeling
- Pain that eases at rest and returns with effort, often in flare-ups
Timeline
How long does Osgood-Schlatter disease last?
These are guidelines: the condition follows growth, not the calendar, and usually settles for good when the growth area fuses at the end of puberty. Until then, the aim is to keep you active with the pain under control.
- Back to full training, with a well-dosed load
- A few weeks to 3 months
- Pain completely gone
- Several months, sometimes 1 to 2 years
- Possible painful flare-ups
- Until the end of growth
- The bump below the knee
- May stay for life, harmless
Diagnosis
Our approach
The first step is always a medical consultation. Complementing this: clinical assessment by the physiotherapist (tenderness on the bump, flexibility and strength of the thighs and hips, jumping and landing) and a review of your training load (club, school, camps) with you and your parents. Imaging (X-ray or ultrasound) with Dr Massimo Donalisio only if the picture is unusual: pain on one side that wakes you at night, fever, major swelling, a fall or a blow to the knee.
Care at Off-Field
- Physiotherapy (explanations for you and your parents, pain management, thigh and hip flexibility)
- Physical preparation (progressive strengthening of the thighs, hips and calves, dosing of jumps and sprints, training adapted to growth)
- No injections, PRP or shockwave therapy: in a growing child, these interventions are not part of the care for this condition
Rehab
Physio treatment, step by step
- 01
Understand and dose
Understand what is happening, with your parents: the knee is not damaged. Then reduce what hurts most (sprints, jumps, kicks, kneeling) and keep what is tolerated, with mild pain at most that is back to normal by the next morning.
- 02
Strengthen without irritating
Static thigh contractions (isometrics), well tolerated even when the knee is sensitive, hip and calf strengthening and gentle thigh flexibility, several times a week.
- 03
Load progressively
Increasingly demanding squats, lunges and step-ups, then a gradual return of jumps and sprints once strength work is well tolerated.
- 04
Back to full play
Return to full training and matches in stages, monitoring next-day pain. Then 1 to 2 short strength sessions a week, to keep up while you are growing.
Exercises
Exercises for Osgood-Schlatter disease
Wall sit
Back against a wall, slide down to an angle where the pain stays mild and hold for 30 to 45 seconds. 4 to 5 repetitions, 1 minute's rest in between.
Glute bridge
On your back with knees bent, lift your hips and hold for 3 seconds at the top. 3 sets of 12.
Step-up
Step onto a stair or bench by pushing through the top leg, knee in line with your foot, then step down slowly. 3 sets of 8 to 10 per leg.
Quadriceps stretch
Lying on your front or standing, gently bring your heel towards your buttock, knees side by side. Hold for 30 seconds, 3 times per leg, without going into pain below the knee.
Examples to adapt with your physio after the assessment: pain during exercise should stay moderate and settle within 24 hours.
Return to sport
Back to full training: when and how?
- Mild pain at most (3 out of 10) during training, back to normal by the next morning
- Walking, stairs and running without a limp
- Sufficient thigh and hip strength, checked with strength and jump tests
- Training volume and playing time rebuilt in stages, taking camps and tournaments into account
Questions
Frequently asked questions about Osgood-Schlatter disease
Another question? We reply quickly on WhatsApp.
Message us on WhatsAppDo you have to stop football with Osgood-Schlatter?
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Is strength training risky at this age?
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