Osgood-Schlatter disease (also called tibial tubercle apophyseal traction injury) is a common condition affecting girls around 10-12 years old and boys around 13-15 years old (but these ages vary). It is one of the most common causes of knee pain in adolescents. Osgood-Schlatter results from excessive traction, or pulling, on the soft growth plate at the front of the shin bone below the knee cap. This is the area where the large tendon connects the knee cap and thigh muscle to the shin bone.

Despite its name, Osgood Schlatter is not really a disease, it is an injury to the knee caused by overuse. Luckily, Osgood Schlatter syndrome typically goes away over time, once normal bone growth stops.

WHAT CAUSES IT?

Osgood Schlatter's is typically a result of physical activity during a period of rapid growth (growth spurt). This condition occurs more frequently with boys, though that could be attributed to the amount and intensity of physical activity for that age group. Activities that involve a great deal of running, jumping, starting and stopping usually aggravate the condition.

WHAT ARE THE SYMPTOMS?

Symptoms range from aching and soreness, to swelling, limping and giving way. Physical examination usually finds tenderness directly over the area of inflammation. X-rays are usually normal or may show some widening of the growth center at the front of the shin bone.

WHAT IS THE TREATMENT?

Treatment is focused on decreasing soreness as the condition is usually self-limiting (once the growth plate closes the symptoms will go away). However in some individuals, the symptoms may come and go throughout their growing years. Children with mild symptoms may wish to continue with some or all of their activities, while others may need to decrease activity levels for a short period of time. If a child prefers to cease activity because of pain, that decision should be supported by the parents.

Treatment includes rest, icing the affected area, and stretching the muscles on the front and back of the leg. Occasionally physical therapy may be suggested to help the child get started with the appropriate stretches and exercises.

In general, activities that cause pain should be avoided or decreased. "Active" rest is a term used to describe continued activity on a limited basis. If a child is comfortable remaining active, or has soreness after activity that goes away with stretching and icing (or overnight) ­ it is usually OK to continue with that amount of activity. However, if a child has increasing pain; pain that begins to affect play or activities; or other unusual symptoms (i.e. limping, swelling, inability to run or jump normally) ­ then cutting back on the activity level is important.

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