Do you have pain and swelling right below your knee joint?
Yes. It could be Osgood-Schlatter disease, a condition that occurs around the knees due to overuse.
It is most likely to develop when the bones in and around the knee joint are going through a period of rapid growth and are subject to excessive stress (from sports and generally high activity levels), like during puberty and the teenage years.
One of the tell-tale signs of Osgood Schlatter's disease is a “boney” lump or swelling that develops around the knee joint just below the patella (kneecap).
If you believe that you or one of your children may have this condition, we recommend contacting us for an evaluation. Our movement experts can help reduce the pain, improve strength, and restore normal mobility and function in the knee(s), so you (or your child) can get back to playing sports and participating in other healthy activities without pain or discomfort.
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What is Osgood-Schlatter Disease?
It might sound like an exotic disease, but Osgood-Schlatter disease refers to irritation, pain, and swelling at the top of the tibia where the patellar tendon attaches your patella (kneecap) to your shin bone (tibia).
The condition most often develops when the bones in the knee and shin are under increased stress. For example, we often see this condition in young athletes and amateur sports players.
But why does it happen?
The bones, ligaments, tendons, and connective tissue that makes up our musculoskeletal system are the things that help us move around: run, jump, stretch, and pivot.
The ligaments connect our bones; the tendons link our muscles to the bones; and the connective tissue or fascia encases and protects the entire system and works as a shock absorber to cushion our landings (or falls).
Most of the time, everything is perfectly balanced and works together like a well-oiled machine.
However, during certain times of our lives, like the teenage years, our bones grow much faster, which can upset the apple cart.
During this time, which is usually between 13 and 14 for boys and 11 and 12 for girls (but it can be any time between 9 and 14), we get taller, and our bones grow longer.
In Osgood-Schlatter disease, it's the area at the end of the bones where the body makes new bone where the injury occurs, and the disease develops.
What Causes Osgood-Schlatter Disease?
Regardless of age, we can suffer injuries whenever we try to push our bodies past what they're capable of or prepared for.
These usually occur as a single incident that results in pain and swelling and forces us to rest until it heals – either on its own (not recommended) or with the help of physical therapy.
However, Osgood-Schlatter disease doesn't happen because of an isolated injury. It occurs because of repeated stress on growing bones and surrounding tissue from running, jumping, twisting, pivoting, and actively changing direction.
When the bones and other structures endure too much stress, in combination with rapid growth, and Osgood-Schlatter disease develops, you (or your child) will start to feel pain and see swelling underneath the kneecap at the top of the shin bone.
The swelling you see is a paradoxical increase in bone growth in response to stress.
That's why the lump below the kneecap is likely to feel “boney” and hard rather than soft and pliable.
But ideally, you should seek help from a physical therapist at first sight of soreness or swelling in this area before the boney growth develops and/or mobility and sporting performance are negatively affected.
What Are The Symptoms Of Osgood-Schlatter Disease?
There can be many different symptoms. But the most common symptoms of Osgood-Schlatter disease are:
Is It Osgood-Schlatter?
The symptoms of Osgood-Schlatter can mimic many other musculoskeletal conditions, so it's essential to get a professional evaluation and diagnosis from a Physical Therapist if you suspect that you or your child may have the condition.
We diagnose Osgood-Schlatter by asking questions about your activity levels (how often you play sports, etc.) and any relevant medical history, such as previous injuries or underlying medical conditions, and examining your knees and lower legs, getting you to perform specific movements.
It helps if you can tell us what does and does not exacerbate your symptoms.
We also check for swelling, inflammation, and/or “boney” growths and evaluate your muscle strength, flexibility, mobility, and range of motion.
Only then can we determine and confidently diagnose whether your symptoms relate to Osgood-Schlatter or something else.
In some cases, knee pain can relate to or be exacerbated by issues with your feet and ankles, core and lower back, or hips, so we examine the whole body before diagnosing Osgood-Schlatter.
How We Treat Osgood-Schlatter Disease
Once we’re confident that your symptoms (or your child's) are caused by Osgood-Schlatter disease and not another condition, we get to work on fixing the issue and restoring normal function in the knee with an individualized treatment plan that is specific to your symptoms and personal goals.
For example, you may have a game or a track and field competition that you want to take part in without worrying about pain.
We don't know until we examine you and talk to you about your goals what your specific treatment plan will be, but it may include the following:
Before we can work on rehabilitation, you may need rest to allow the acute symptoms and inflammation to subside.
The timing of rest and whether it is prescribed in your case is based on your initial evaluation and presenting symptoms.
We guide our patients through a set of therapeutic exercises that help improve the range of motion in the knee and strengthen the surrounding muscles.
There are exercises that you do with supervision from one of our physical therapists, along with exercises to do at home in between sessions.
All these exercises work to reduce the stress on the knee bones and the shin, which is the cause of Osgood-Schlatter.
Hands-on Physical Therapy
Another important aspect of physical therapy for Osgood-Schlatter is manual physical therapy, where we gently manipulate your joints, ligaments, tendons, and surrounding tissues with our hands.
These movements help to increase blood flow and oxygen to the area and improve your range of motion and mobility.
Education And Prevention
We would only be doing our job properly if we also advised our patients to prevent problems from reoccurring after we've fixed them.
With Osgood-Schlatter, there are several steps you can take to prevent the symptoms from reappearing, such as avoiding “using it when your body is tired or you feel pain in any of your joints or muscles.
You also need to ensure that you get enough rest and recovery time between games and/or training sessions.
We also give you a mobility and stretching routine to practice daily (or at least before and after sports).
One of the best ways to prevent Osgood-Schlatter is to track your weight and height over time. If you think you (or your child) might be going through a growth spurt, take extra care not to put too much stress on the knees.
We Can Help
At Cardin & Miller, we offer a full range of physical therapy services to help you move, feel, and ultimately live better.
But physical therapy isn’t just for athletes, beginner or advanced
Exclusively, we also offer a specialized service for children and teens, including a Developmental Pediatric Physical Therapy service for children and young adults with Gross Motor Delay, an abnormal walking pattern, Torticollis, or impaired function relating to congenital or genetic disability.
Even if your child or teen does not have any of these issues but is displaying symptoms of Osgood-Schlatter, we can help.
We help you find the answers to what is happening with your child, develop a plan to address their specific physical needs, and help to get your child back on the field running and to playing with their friends and OUT of the doctor’s office.
You can apply for a One-on-One Screen first, too, to find out what is going on with your child quickly and decide whether physical therapy is right for them.