Osgood-Schlatter Disease

Providing taxi rides to and from practice for every sport offered to an adolescent, eating endless dinners in the car on the way to the practice field or a game, rearranging meetings at work to make sure I could make my taxi pick up at 4:00 pm and wiping the tears from my children after they lost a “game of a lifetime” were nothing compared to the day I had to explain Osgood-Schlatter Disease to my oldest son.

This young man didn’t know the definition of moderation.  Everything he did was higher, faster, longer, or it wasn’t worth doing.  He excelled in athletics from a very young age and loved every minute of practice, but competition was his real “high”.  This child took many hits and falls, but never acknowledged pain.  At age twelve he began to complain that his knees ached and that he was having difficulty sleeping because of the pain.  Having a nurse as a mother is not always the best thing for a boy.  I assumed he had just overdone it and encouraged him to take a hot bath and go to sleep. 

His complaints continued day after day.  He denied having had any high impact injury or having twisted his knees.  I have to admit that I was concerned when the achy feeling in one knee soon became an achy feeling in both knees.  I scheduled an appointment with his pediatrician just to make sure that everything was ok and that he just needed to rest.

X-rays of both knees were taken.  Blood tests were completed and Dr. Brown asked us to return to her office for a follow up visit.    Dr. Brown showed us the x-ray and told my son that he had Osgood-Schlatter Disease.

Osgood-Schlatter Disease is a condition causing pain and swelling at the tibial tuberosity.  The tibia is the large of the two lower leg bones.  The tibial tuberosity is the bump on the front of the tibia, just below the kneecap (patella).   The patellar tendon attaches the quadriceps to this bump or tuberosity.  In the adolescent the tuberosity does not yet have bony attachment to the rest of the tibia.  The mechanical attachment of the patellar tendon to the tuberosity is weak and occasionally causes separation of fragments of bone.  This separation causes pain and swelling in the teenager’s knee or knees.  Usually, this occurs in one knee, but research reveals that 25 % of the time both knee are affected.

My son’s daily athletic endeavors were just too much for his maturing knees.  Activities such as climbing stairs, running and deep knee bends increased his pain. 

The goal of treatment is to decrease the stress and inflammation at the tubercles.  My son was instructed to sit out of practice and games for the next two weeks.  He was given an anti-inflammatory medication to take three times a day and we were then to return to the doctor’s office for a recheck. 

All the way home, my son tried to convince me that the pain wasn’t that bad.  I listened and tried to calm his anger about being taken out of his beloved athletics.  Somehow my family made it through the next two weeks and we return for the follow up visit.  My son told the doctor that the pain was much better in both knees and pleaded to be able to return to his normal activity.  Dr. Brown recommended the anti-inflammatory medication be continued.  He was given permission to return to his regular activities, but was to take it easy for a while and not push his body “to its limits”.  Following any athletic work out he was to immediately ice both knees for twenty minutes.  He anxiously agreed to the treatment plan—anything to get back out on the field! 

My son’s pain slowly dissipated over a period of about three months.  He remained active and was able to do what he loved most-PLAY!  To this day I count my blessings.  Keeping this boy down was almost impossible and miserable for everyone in his life!  Osgood-Schlatter Disease may last over a period of months or years.  It may reoccur intermittently up until about age eighteen at which time the tuberosity fuses to the tibia.

If conservative treatment does not end the pain and swelling, it may be necessary to completely rest the knee or knees with a knee immobilizer or cast.  Luckily, this type treatment is rarely necessary.  The very best news is that Osgood-Schlatter Disease rarely causes any permanent injury except for an enlarged tuberosity (a larger protrusion on the lower portion of the knee).