ConditionChildren's health
Osgood-Schlatter Disease
Osgood-Schlatter disease is a common overuse condition in growing children and teens that causes pain and a tender bump just below the kneecap. Repeated pulling by the patellar tendon irritates the growth plate where it attaches to the shinbone (the tibial tubercle). It typically affects active children aged 10 to 15 during a growth spurt, especially in running and jumping sports. It is harmless in the long run: pain settles with activity changes, ice and stretching and usually stops once growth finishes, though the bump may stay.
Also called: Osgood-Schlatter syndrome, tibial tubercle apophysitis, Osgood's disease, growing knee pain below the kneecap
At a glance
- What it is
- Irritation of the growth plate at the top of the shinbone where the kneecap tendon attaches.
- Who gets it
- Active children aged about 10 to 15, slightly younger in girls, often in a growth spurt.
- Main signs
- Pain and a tender, bony bump below the kneecap, worse with running, jumping, kneeling and stairs.
- Diagnosis
- Usually by examination alone. X-ray if symptoms are unusual.
- Treatment
- Activity modification, ice, stretching, strengthening, a patellar strap, pain relief.
- Duration
- Flare-ups over months to about 2 years. Resolves when bones stop growing.
When to get help
See a doctor within a day or two
- Sudden severe pain and inability to straighten the knee or walk after a jump or sprint, which can be a tibial tubercle fracture
- A hot, red, swollen knee or shin with fever
- Knee pain that wakes your child at night, comes with weight loss, or is present at rest
Book a routine appointment
- Pain below the kneecap that limits sport or daily activities for more than 2 to 3 weeks
- Pain in only one knee that does not fit the typical pattern, or pain in the hip or thigh, which can come from the hip
- A bump that keeps hurting into adulthood
Usually safe to manage at home
- A tender bump below the kneecap after sport in an active preteen or teen who can walk normally, managed with ice, stretching and reduced jumping
What causes Osgood-Schlatter disease
The thigh muscle (quadriceps) straightens the knee by pulling on the kneecap, which pulls on the patellar tendon, which attaches to the tibial tubercle: a bony bump at the top of the shinbone. In children, the tubercle is a growth area (an apophysis) made partly of softer cartilage.
During a growth spurt, the bones lengthen faster than muscles and tendons stretch, so the quadriceps become tight. Repeated running, jumping and kicking make the tight tendon tug on the growth area thousands of times. This causes small areas of inflammation and tiny avulsions, and the body responds by laying down extra bone, which creates the bump.
Risk factors
- Age 10 to 15 (girls about 8 to 13, boys about 12 to 15), during growth spurts
- Sports with running, jumping and quick direction changes: soccer, basketball, volleyball, gymnastics, figure skating, ballet, track
- Tight quadriceps and hamstrings
- Rapid increases in training load
- Boys are affected more often, though the gap has narrowed as more girls play sport
It affects both knees in about 20% to 30% of children.
Symptoms
- Knee pain just below the kneecap, at the top of the shinbone
- A tender, firm bump that may grow larger over months
- Pain that worsens with running, jumping, squatting, kneeling and climbing stairs
- Pain that eases with rest
- Mild swelling over the bump
- Tightness in the thigh muscles
The knee joint itself is not swollen and moves normally. Symptoms often flare during sports seasons or growth spurts and settle in between.
Similar conditions
| Condition | Where the pain is | Typical age |
|---|---|---|
| Osgood-Schlatter disease | Bump below the kneecap on the shinbone | 10 to 15 |
| Sinding-Larsen-Johansson syndrome | Bottom tip of the kneecap | 10 to 13 |
| Patellar tendinitis (jumper's knee) | Tendon between kneecap and shin | Teens and adults |
| Patellofemoral pain syndrome | Around or behind the kneecap | Teens and adults |
Hip problems, such as a slipped capital femoral epiphysis, can cause knee pain in this age group too. A limp or pain with hip movement needs prompt assessment.
Diagnosis
A doctor diagnoses Osgood-Schlatter disease by examining the knee: tenderness and a bump over the tibial tubercle, with pain on straightening the knee against resistance. X-rays are not always needed but may be done to rule out a fracture, tumor or infection, especially if only one knee hurts or there is night pain. They may show a fragmented or prominent tubercle.
Treatment
Treatment aims to control pain while keeping your child as active as possible.
Activity modification
- Children can usually keep playing if pain is mild and does not cause limping.
- Reduce the amount of jumping, sprinting and kneeling when pain flares, and swap in lower-impact activity such as swimming or cycling.
- A short break of 2 to 6 weeks from the aggravating sport may be needed for severe flare-ups.
- Complete immobilization is rarely necessary.
Relief measures
- Ice for 15 to 20 minutes after activity, wrapped in a cloth.
- Pain relievers such as ibuprofen or acetaminophen (paracetamol), following the label dose. No aspirin for children or teenagers.
- Patellar tendon strap worn just below the kneecap during sport to spread the pull.
- Knee pads to protect the bump during kneeling sports.
Exercises
A physical therapist can guide a program. Common exercises:
- Quadriceps stretch: standing, hold one ankle behind you and gently pull the heel toward the buttock for 30 seconds. Repeat 3 times each side.
- Hamstring stretch: sitting with one leg straight, lean forward from the hips for 30 seconds.
- Straight leg raises and isometric quadriceps contractions to strengthen without loading the tubercle.
- Hip and core strengthening, such as side-lying leg lifts and bridges.
Surgery
Surgery is rarely needed. It is reserved for adults with persistent pain from loose bone fragments in the tendon after growth has finished.
Outlook
Osgood-Schlatter disease is self-limiting. Symptoms usually last 12 to 24 months on and off and disappear once the growth plate closes, around age 14 in girls and 16 in boys. A painless bump below the knee often remains for life. A small number of adults have discomfort when kneeling. Serious complications, such as a fracture through the tubercle, are rare.
Prevention
- Warm up and stretch the thigh muscles before and after sport.
- Increase training gradually and avoid year-round single-sport specialization.
- Build in rest days, especially during growth spurts.
Frequently asked questions
How long does Osgood-Schlatter disease last?
Symptoms usually come and go for 12 to 24 months and settle completely when the bones stop growing, typically around 14 in girls and 16 in boys. The bony bump below the knee may stay permanently, but it is usually painless.
Can my child keep playing sports with Osgood-Schlatter?
Usually yes, as long as pain is mild and your child is not limping. Cutting back on jumping and sprinting during flare-ups, icing after activity, stretching and wearing a patellar strap help. Severe pain may need a few weeks off the aggravating sport.
What exercises help Osgood-Schlatter disease?
Stretching the quadriceps and hamstrings is the most important, along with gentle strengthening of the quadriceps, hips and core. Avoid deep squats and repeated jumping when sore. A physical therapist can tailor a program.
Can adults have Osgood-Schlatter disease?
The condition starts in childhood, but some adults continue to have pain at the bump, especially when kneeling. This is usually caused by a small loose bone fragment within the tendon. If it persists, surgery to remove the fragment may help.
Is Osgood-Schlatter disease serious?
No. It is a common, temporary condition of growing children and does not damage the knee joint. It can be painful and frustrating for active kids, but it resolves with growth. Sudden severe pain or inability to walk should be checked for a fracture.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Orthopaedic Surgeons (OrthoInfo): Osgood-Schlatter Disease
- American Academy of Pediatrics (HealthyChildren.org): Osgood-Schlatter disease
- NHS: Osgood-Schlatter disease
- Mayo Clinic: Osgood-Schlatter disease
- Boston Children's Hospital: Osgood-Schlatter disease