STADS Physiotherapy
Osgood-Schlatter disease
Keep playing sport with a knee that is still growing fast.
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Your child has pain just below the knee, especially when jumping, running, climbing stairs or kneeling. Perhaps you also see a painful bump there. In sporty, growing children, this is often Osgood-Schlatter disease. On this page you’ll read what it is, how long it lasts and how your child can keep moving without the pain taking over.
What is Osgood-Schlatter disease?
Osgood-Schlatter is a growth-related knee condition. It’s called a disease, but it is actually an overload of a growth plate. Below the kneecap runs the patellar tendon, which is attached to a bump at the front of the shinbone. In growing children, there is still a growth plate of soft, vulnerable bone at that spot.
The large thigh muscle at the front of the upper leg pulls on that spot via the kneecap and the patellar tendon. With a lot of running and jumping, that pulling force is large. For a while, the growth plate can’t cope with it well and becomes irritated. This causes pain, sometimes swelling, and often a bump you can feel and see.
Osgood-Schlatter is common in sporty children aged roughly 10 to 15, around the growth spurt. In girls it often starts a little earlier than in boys, because their growth spurt starts earlier. It can affect one or both knees. It’s annoying, but not dangerous, and it goes away by itself once growth has finished.
What symptoms can your child have?
- Pain at the front of the knee, just below the kneecap
- A painful, sometimes swollen bump on the shinbone below the knee
- More pain when jumping, sprinting, climbing stairs or squatting
- Pain when kneeling or when the bump gets knocked
- Pain during or after sport that eases again at rest
- Tight or short thigh muscles
What causes Osgood-Schlatter disease?
Osgood-Schlatter develops from an imbalance between load and load capacity. The load is everything the knee has to do in a day: sport, PE lessons, playing outside, cycling to school. The load capacity is how much the growth plate below the knee can handle at that moment.
During a growth spurt, that load capacity is temporarily lower. The bone grows quickly, the muscles and tendons still have to adapt and the growth plate is relatively vulnerable. If your child runs and jumps a lot during that period, the limit is quickly exceeded. That’s why sports such as football, basketball, volleyball, gymnastics, dance and athletics cause symptoms more often.
Other factors play a part too. A sudden increase in training, several sports at once, tournaments or a new season can trigger symptoms. Little recovery between training sessions and a lot of playing on hard surfaces also contribute. Tight thigh muscles or less strength in the hip and leg muscles can increase the load on the knee.
It’s important to know that the pain is a signal that the load is too great for now, not that something is being permanently damaged. That’s why treatment isn’t about complete rest, but about smart pacing.
How long does it last?
Osgood-Schlatter goes away by itself, at the latest when growth has finished and the growth plate has closed. How long that takes differs per child. In some children the symptoms are gone after a few months; in others they come back in waves and last one to two years or longer.
With good pacing of sport and targeted exercises, most children can simply keep playing sport, if necessary in an adapted form. The bump below the knee sometimes stays visible, even long after the pain has gone. Usually that bump causes few problems later on, although kneeling can sometimes stay tender.
When should you see a paediatric physiotherapist?
- The pain is holding your child back in sport or play
- Your child has had pain for weeks, even after taking it easier for a few days
- You don’t know how much sport your child can keep doing without it getting worse
- The symptoms keep coming back, for example with every new season
- Your child limps or walks differently because of the pain
- Your child wants to take part fully again and know how to do that safely
Can’t work it out on your own?
Our physiotherapists and occupational therapists are happy to help. In most cases you can come without a referral, in Eindhoven or Tilburg.
When should you see your GP?
See your GP if your child:
- Suddenly has severe pain after a fall, jump or blow and can no longer straighten the leg or put weight on it
- Has a swollen, warm knee, or has a fever and feels ill
- Wakes up at night from the pain, or is still in a lot of pain at rest
- Has pain in the hip, groin or thigh, or limps for no clear reason
Knee or thigh pain in children can sometimes come from the hip. That’s why it’s important that the hip is also examined if there is any doubt.
How STADS helps with Osgood-Schlatter disease
At STADS, we start by listening, to you and certainly also to your child. Which sports do they play, how often do they train and when is the pain there? Then we examine the knee, the hip and the leg muscles, and look at movements such as squatting, jumping and landing. That way we can assess things properly and rule out other causes as far as possible.
We explain what is happening in the knee and why pain with this condition is not a sign of damage. That gives peace of mind and helps you deal with it sensibly. Together with your child, we agree how much pain is acceptable during sport. A rule of thumb is that mild pain during sport is fine, as long as it’s gone again the next day.
Then we get to work on pacing the load. Sometimes that means temporarily fewer jumps or sprints, or one training session fewer per week, instead of stopping altogether. With exercises, we work on the strength of the thigh, hip and calf muscles, the flexibility of the leg muscles and a good landing technique. We gradually build the load back up towards full sport.
Our paediatric physiotherapists work with coaches and parents so your child can keep taking part as much as possible. For older athletes, sports physiotherapy can help with the final step back to competition level.
What can you do yourself?
- Let your child keep moving, but adjust sport and play to the pain
- Treat mild pain during sport as acceptable, as long as it’s gone again the next day
- Temporarily reduce the number of jumps and sprints, or drop one training session a week
- Cool the knee after sport with a cold pack wrapped in a cloth, if that feels good
- Use a knee pad or soft cushion when kneeling
- Discuss the symptoms with the coach so the load can be adjusted
Read also
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Good to know
Frequently asked questions
Do I need a referral?
In most cases, no. You can come to our paediatric physiotherapists with your child without a referral. We start with a short screening to check whether paediatric physiotherapy suits the complaints. Sometimes we ask for information from the GP, youth health doctor (jeugdarts) or specialist, so that we work well together.
Is it covered by my insurance?
For children under 18, paediatric physiotherapy is often (partly) covered by the basic insurance. Exactly how many treatments are covered depends on the complaint, your health insurance and sometimes your supplementary package. For some chronic conditions, a different arrangement applies under the basic insurance. For more information, see our page on reimbursements and rates or check your policy.
Does my child have to stop playing sport?
Usually not. Stopping completely is rarely necessary and can make it harder to build up again later. It’s about smart pacing. Mild pain during sport is fine, as long as it’s gone again the next day. If the pain is more severe or persists, we temporarily adjust the amount or type of sport.
Will the bump below the knee go away?
Not always. The pain disappears once growth has finished, but the bump can remain. That’s usually not a problem and rarely causes symptoms later on. For some people, kneeling stays a little tender. That’s annoying, but not a sign that anything is wrong with the knee.
Does a brace or strap help?
Some children find a strap below the knee comfortable during sport. It can play a supporting role, but it doesn’t solve the cause. The most important things remain pacing the load and exercises to make the leg muscles stronger and more flexible.
Our locations
Two practices, one team
In Eindhoven and Tilburg, physiotherapists and occupational therapists work together under one roof. Choose the practice that’s easiest for you.
Eindhoven
Centrally located on Geldropseweg, with spacious treatment rooms and a large exercise room. Easy to reach by bike, public transport and car.
Address
Geldropseweg 28
5611 SJ Eindhoven
Free parking behind the building
Tilburg
Right in the heart of the Reeshof, close to the A58 exit. Also easy to reach from the surrounding villages.
Address
Reeshofweg 40
5036 BK Tilburg
Mon to Fri, 08.00–18.00
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